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Sample records for psychiatric services dental

  1. Psychiatric services in Algeria.

    Science.gov (United States)

    Benmebarek, Zoubir

    2017-02-01

    The paper describes the current provision of psychiatric services in Algeria - in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.

  2. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service......, and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics...

  3. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    , and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics......A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...

  4. Family dental health care service

    OpenAIRE

    Riana Wardani

    2008-01-01

    The Family Dental Health Care Service is a new approach that includes efforts to serve oral and dental patients that focuses on maintenance, improvement and protection. This oral and dental health approach uses basic dentistry science and technology. The vision of the Family Dental Health Care Service is the family independences in the effort of dental health maintenance and to achieve the highest oral and dental health degree as possible through family dentist care that is efficient, effecti...

  5. [Social psychiatric service as a cornerstone of psychiatric community care].

    Science.gov (United States)

    Hoffmann, P; Tiggemann, H G

    1991-12-01

    Psychiatric care has gradually been shifting in Germany from its original inpatient basis to outpatient and complementary treatment. This shift of emphasis resulted in a transfer of psychiatry-political responsibility to communal bodies and hence also to communal public health services. Sociopsychiatric service ranks high in communal psychiatric care setups, since it promotes cooperation and helps to coordinate efforts in individual cases in respect of focal points on which such care is centered. For the future, an expert commission has suggested that the various institutions actively engaged in community psychiatric care should team up in each region. This applies in particular to mobile services visiting the patients in their homes, and to the offices providing contracts to sociopsychiatric services of public health offices. Despite positive outlooks there are also quite a few negative aspects of present-day practice. One of them is poor definition of tasks and functions of communal sociopsychiatric services, whereas another one are the unsatisfactory quantitative and qualitative means at their disposal. It is also too often overlooked that psychiatric patients and disabled persons are entitled to compensation insurance payments to promote their rehabilitation, as provided for by individual legislation in the various German laender. To tap these sources sufficiently well, sociopsychiatric services must be better equipped in every respect. The professional competence of social workers and physicians, as well as of the relevant staff, must be safeguarded by continuing education and specialist training measures.

  6. Establishment of a local psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1981-01-01

    of senile psychoses. The total increase amounts to 2.4 times the admission rates of psychiatric cases to the General Hospital and 4.4 times the admission rates to the Psychiatric Hospital in Nykøbing in the last years prior to the start of the local service. The outpatient department has grown steadily...

  7. 42 CFR 415.184 - Psychiatric services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Psychiatric services. 415.184 Section 415.184 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.184...

  8. Service Dogs, Psychiatric Hospitalization, and the ADA

    National Research Council Canada - National Science Library

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    A service dog is defined as “any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability...

  9. Service dogs, psychiatric hospitalization, and the ADA.

    Science.gov (United States)

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    2015-01-01

    A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.

  10. Family dental health care service

    Directory of Open Access Journals (Sweden)

    Riana Wardani

    2008-07-01

    Full Text Available The Family Dental Health Care Service is a new approach that includes efforts to serve oral and dental patients that focuses on maintenance, improvement and protection. This oral and dental health approach uses basic dentistry science and technology. The vision of the Family Dental Health Care Service is the family independences in the effort of dental health maintenance and to achieve the highest oral and dental health degree as possible through family dentist care that is efficient, effective, fair, evenly distributed, safe and has a good quality. To support this effort, the Ministry of Health has issued Health Care Policy and Implementation Guideline as well as the licensing standard for family dentist practice.

  11. Dental Services Among Medicare Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Current Beneficiary Survey (MCBS) has a data highlight based on the 2012 Cost and Use Research Files. This work highlights dental information collected...

  12. Factors affecting dental service quality.

    Science.gov (United States)

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia

    2015-01-01

    Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.

  13. Stigmatization of psychiatric symptoms and psychiatric service use: a vignette-based representative population survey.

    Science.gov (United States)

    Sowislo, Julia F; Lange, Claudia; Euler, Sebastian; Hachtel, Henning; Walter, Marc; Borgwardt, Stefan; Lang, Undine E; Huber, Christian G

    2017-06-01

    Background There is evidence for two different types and/or sources of mental illness stigma, namely the display of psychiatric symptoms and the use of psychiatric service institutions. However, no current study has compared the two. Furthermore, gaps exist in our knowledge of both types of stigma. Little is known about the perceived stigma of specific psychiatric service treatment environments, for instance forensic settings. In addition, systematic research on stigma attached to symptoms of personality disorders in the general population is scarce, and for borderline personality disorder, nonexistent. Methods We conducted a representative survey of the general population (N = 2207) in the canton of Basel-Stadt, Switzerland. Participants were asked to read a vignette depicting either the psychiatric symptoms of a fictitious character or a psychiatric service institution to which the character had been admitted, and indicate desired social distance (an indicator for stigma). Type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied between vignettes. Findings Desired social distance was significantly lower in relation to psychiatric service use than to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and the fictitious character's being male tend to increase stigmatization. Interestingly, the character's being hospitalized in a psychiatric unit at a general hospital and also respondent familiarity with psychiatric services tend to decrease stigmatization. Interpretation Familiarity of the general population with psychiatric patients should be increased. Furthermore, treatment in psychiatric units located within general hospitals should be promoted, as such treatment is associated with decreased stigma.

  14. Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities.

    Science.gov (United States)

    Takenoshita, Miho; Sato, Tomoko; Kato, Yuichi; Katagiri, Ayano; Yoshikawa, Tatsuya; Sato, Yusuke; Matsushima, Eisuke; Sasaki, Yoshiyuki; Toyofuku, Akira

    2010-10-13

    Burning mouth syndrome (BMS) and atypical odontalgia (AO) are two conditions involving chronic oral pain in the absence of any organic cause. Psychiatrically they can both be considered as "somatoform disorder". From the dental point of view, however, the two disorders are quite distinct. BMS is a burning or stinging sensation in the mouth in association with a normal mucosa whereas AO is most frequently associated with a continuous pain in the teeth or in a tooth socket after extraction in the absence of any identifiable cause. Because of the absence of organic causes, BMS and AO are often regarded as psychogenic conditions, although the relationship between oral pain and psychologic factors is still unclear. Some studies have analyzed the psychiatric diagnoses of patients with chronic oral pain who have been referred from dental facilities to psychiatric facilities. No study to date has investigated patients referred from psychiatric facilities to dental facilities. To analyze the psychiatric diagnoses of chronic oral pain patients, diagnosed with BMS and AO, and referred from psychiatric facilities to dental facilities. Psychiatric diagnoses and disease conditions of BMS or AO were investigated in 162 patients by reviewing patients' medical records and referral forms. Psychiatric diagnoses were categorized according to the International Statistical Classification of Disease and Related Health Problems, Tenth Revision. The proportion of F4 classification (neurotic, stress-related, and somatoform disorders) in AO patients was significantly higher than in BMS patients. BMS patients were more frequently given a F3 classification (mood/affective disorders). However, 50.8% of BMS patients and 33.3% of AO patients had no specific psychiatric diagnoses. Although BMS and AO are both chronic pain disorders occurring in the absence of any organic cause, the psychiatric diagnoses of patients with BMS and AO differ substantially.

  15. Psychiatric Service Use and Psychiatric Disorders in Adults with Intellectual Disability

    Science.gov (United States)

    Bhaumik, S.; Tyrer, F. C.; McGrother, C.; Ganghadaran, S. K.

    2008-01-01

    Background: UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric…

  16. Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities

    Directory of Open Access Journals (Sweden)

    Miho Takenoshita

    2010-10-01

    Full Text Available Miho Takenoshita1, Tomoko Sato1, Yuichi Kato1, Ayano Katagiri1, Tatsuya Yoshikawa1, Yusuke Sato2, Eisuke Matsushima3, Yoshiyuki Sasaki4, Akira Toyofuku11Psychosomatic Dentistry, 2Complete Denture Prosthodontics, 3Liaison Psychiatry and Palliative Medicine, 4Center for Education and Research in Oral Health Care, Faculty of Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, JapanBackground: Burning mouth syndrome (BMS and atypical odontalgia (AO are two conditions involving chronic oral pain in the absence of any organic cause. Psychiatrically they can both be considered as “somatoform disorder”. From the dental point of view, however, the two disorders are quite distinct. BMS is a burning or stinging sensation in the mouth in association with a normal mucosa whereas AO is most frequently associated with a continuous pain in the teeth or in a tooth socket after extraction in the absence of any identifiable cause. Because of the absence of organic causes, BMS and AO are often regarded as psychogenic conditions, although the relationship between oral pain and psychologic factors is still unclear. Some studies have analyzed the psychiatric diagnoses of patients with chronic oral pain who have been referred from dental facilities to psychiatric facilities. No study to date has investigated patients referred from psychiatric facilities to dental facilities.Objective: To analyze the psychiatric diagnoses of chronic oral pain patients, diagnosed with BMS and AO, and referred from psychiatric facilities to dental facilities.Study design: Psychiatric diagnoses and disease conditions of BMS or AO were investigated in 162 patients by reviewing patients’ medical records and referral forms. Psychiatric diagnoses were categorized according to the International Statistical Classification of Disease and Related Health Problems, Tenth Revision.Results: The proportion of F4 classification (neurotic, stress

  17. Conceptions of mobile emergency service health professionals concerning psychiatric emergency

    Directory of Open Access Journals (Sweden)

    Diego Bonfada

    2012-06-01

    Full Text Available Under the Brazilian Psychiatric Reformation, assistance to psychological seizures represents a challenge for the emergency services. Therefore, the objective of this paper is the analysis of the conceptions of health professionals who work at the Mobile Emergency Service in Natal on psychiatric emergency care. This paper is, then, a qualitative study that used interviews as tools for collecting information. By using thematic analysis, the speeches were grouped into three categories: the stigma on patients and the professionals' fear of services interventions in psychiatric emergencies; having psychiatric emergencies regarded as harmful to patients and others' security; psychiatric emergencies being taken as patients' aggressiveness or severe depression. The data collected indicate that the interviewed professionals' ideas are supported by elements associated with the ideology that insanity implies social segregation and dangerousness. Thus, the survey prompted reflection on relevant issues to the process of psychiatric reformation implementation.

  18. Dental responsibility loadings and the relative value of dental services.

    Science.gov (United States)

    Teusner, D N; Ju, X; Brennan, D S

    2017-09-01

    To estimate responsibility loadings for a comprehensive list of dental services, providing a standardized unit of clinical work effort. Dentists (n = 2500) randomly sampled from the Australian Dental Association membership (2011) were randomly assigned to one of 25 panels. Panels were surveyed by questionnaires eliciting responsibility loadings for eight common dental services (core items) and approximately 12 other items unique to that questionnaire. In total, loadings were elicited for 299 items listed in the Australian Dental Schedule 9th Edition. Data were weighted to reflect the age and sex distribution of the workforce. To assess reliability, regression models assessed differences in core item loadings by panel assignment. Estimated loadings were described by reporting the median and mean. Response rate was 37%. Panel composition did not vary by practitioner characteristics. Core item loadings did not vary by panel assignment. Oral surgery and endodontic service areas had the highest proportion (91%) of services with median loadings ≥1.5, followed by prosthodontics (78%), periodontics (76%), orthodontics (63%), restorative (62%) and diagnostic services (31%). Preventive services had median loadings ≤1.25. Dental responsibility loadings estimated by this study can be applied in the development of relative value scales. © 2017 Australian Dental Association.

  19. Impact of social-psychiatric services and psychiatric clinics on involuntary admissions.

    Science.gov (United States)

    Emons, Barbara; Haussleiter, Ida Sybille; Kalthoff, Jörg; Schramm, Anja; Hoffmann, Knut; Jendreyschak, Jasmin; Schaub, Markus; Armgart, Carina; Juckel, Georg; Illes, Franciska

    2014-11-01

    Germany provides a wide range of highly developed mental health care to its citizens. The aim of this study was to identify factors influencing the voluntariness of admissions to psychiatric hospitals. Especially the impact of demographic factors of the region, characteristics of the psychiatric hospitals and characteristics of the psychosocial services was analyzed. A retrospective analysis of hospital admission registers from 13 German adult psychiatric hospitals in 2009 was conducted. Public data on the regional psychiatric accommodation and demographic situation were added. Hospitals were dichotomously divided according to their index of involuntary admissions. Group comparisons were performed between the clinics with low and high involuntary admission indices. Analysis was conducted with clinical, psychiatric provision and demographic data related to inpatients in the Landschaftsverbands Westfalen-Lippe (LWL)-PsychiatryNetwork. Especially the range of services provided by the social-psychiatric services in the region such as number of supervised patients and home visits had an influence on the proportion of involuntary admissions to a psychiatric hospital. Some demographic characteristics of the region such as discretionary income showed further influence. Contrary to our expectations, the characteristics of the individual hospital seem to have no influence on the admission rate. Social-psychiatric services show a preventive impact on involuntary acute psychiatry interventions. Sociodemographic factors and patient variables play a role with regard to the number of involuntary hospitalizations, whereas characteristics of hospitals seemed to play no role. © The Author(s) 2013.

  20. Psychiatric services: a platform for MTM.

    Science.gov (United States)

    Lynum, Karimah S Bell; Hill, Angela M

    2015-02-01

    Deinstitutionalization in the 1960s shifted the care of the mentally ill from state-funded institutions to community settings. Unfortunately, funding to support the treatment needs of this population has continued to be minimized, and countless individuals have not received much needed care. This has resulted in a large increase in mentally ill patients surfacing in jails, homeless shelters, and emergency departments. Subsequently, the federal government has begun to prioritize funding to address the mental health needs of our communities. Pharmacists are in a unique position to influence treatment outcomes for patients with mental illnesses, and the current state of health reform provides avenues for the pharmacist to become an essential part of the health care delivery team in numerous ambulatory care clinical settings. The challenges with adherence, medical and psychiatric comorbidities, polypharmacy with psychotropics, potential for life-threatening adverse effects, and the ever-present need for patient education are but a few reasons why pharmacists can be utilized to provide Medication Therapy Management services for these patients. © The Author(s) 2015.

  1. Dental fear and satisfaction with dental services in Switzerland.

    Science.gov (United States)

    Armfield, Jason M; Enkling, Norbert; Wolf, Christian A; Ramseier, Christoph A

    2014-01-01

    Dental satisfaction is associated with continuity of dental care, compliance with dentist advice, and positive health outcomes. It is expected that people with higher dental fear might have less dental satisfaction because of more negative dental experiences. The objective of this study was to examine satisfaction and reasons for satisfaction with dental practitioners in Switzerland and variations by dental fear. A national sample of 1,129 Swiss residents aged 15-74 (mean = 43.2 years) completed a personal interview at their home with questions assessing dental fear, dental service use, general satisfaction with their dentist, and reasons for satisfaction or dissatisfaction. Overall, 47.9 percent of participants responded that they were satisfied with their dentist and 47.6 percent that they were very satisfied. Satisfaction differed significantly by gender, language spoken, region of residence, and educational attainment. Greater dental fear was significantly associated with greater dissatisfaction with the dentist. The percentage of people who were very satisfied with the dentist ranged from 56.0 percent among people with no fear to 30.5 percent for participants with "quite a lot" of fear but was higher (44.4 percent) for people who stated that they were "very much" afraid of the dentist. The most common reasons attributed for satisfaction with dentists were interpersonal characteristics of the dentist and staff. People with "quite a lot" of fear were found to endorse these sentiments least. Although higher dental fear was associated with more dissatisfaction with the dentist, the level of satisfaction among fearful individuals in Switzerland is still high. © 2012 American Association of Public Health Dentistry.

  2. Dental health status of recipients of community dental health services.

    OpenAIRE

    Gelbier, S; Packham, J; Simmons, S; Hopes, I

    1983-01-01

    A new information system was used routinely to monitor clinical dental services. Data on 20,729 courses of treatment support the validity and usefulness of continuously collected information about dental health status. Patients who had not attended a community clinic within the year before examination did not need courses of treatment that differed appreciably from those for patients who had attended within the previous year. Patients who attended without scheduled appointments had a lower pr...

  3. The supply and utilization of dental services

    NARCIS (Netherlands)

    Groenewegen, P.P.; Postma, J.H.M.

    1984-01-01

    In this article the question is addressed whether regional differences in the supply of dental manpower influences the utilization of dental services. The percentage of the population that visits the dentist, is indeed higher in regions with a higher density of dentists. The number of people that

  4. The supply and utilization of dental services.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Postma, J.H.M.

    1984-01-01

    In this article the question is addressed whether regional differences in the supply of dental manpower influences the utilization of dental services. The percentage of the population that visits the dentist, is indeed higher in regions with a higher density of dentists. The number of people that

  5. Refugee children have fewer contacts to psychiatric healthcare services

    DEFF Research Database (Denmark)

    Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith

    2016-01-01

    Purpose: Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country. Methods: This study compared 24,427 refugee children from...... and psychiatrists in private practice. Results: Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40–0.45) among refugee boys...... and 0.35 (95 % CI 0.33–0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. Conclusions: Refugee children used fewer psychiatric healthcare services than Danish...

  6. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

    Science.gov (United States)

    Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

    2016-03-02

    In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

  7. Psychiatric emergency services in Copenhagen 2012

    DEFF Research Database (Denmark)

    Moltke, Katinka; Høegh, Erica B; Sæbye, Ditte

    2015-01-01

    BACKGROUND: Since the first publication of the psychiatric emergency units (PEUs) in Copenhagen 1985, outpatient facilities have undergone considerable changes. Our aim is to examine how these changes have influenced the activities in the PEUs in the same catchment area. METHODS: We conducted...... reduced the number of visits in the PEUs considerably. The results have shown a change of diagnostic distribution and more severe conditions requiring acute admissions for emergency treatment. Close collaboration with the patients' families, GPs, social authorities and specialized psychiatric outpatient...

  8. Alcohol Use and Abuse in a University Psychiatric Health Service: Prevalence and Patterns of Comorbidity with Other Psychiatric Problems.

    Science.gov (United States)

    Ross, Helen E.; Tisdall, Gordon W.

    1994-01-01

    Examined use and abuse of alcohol and other drugs in university psychiatric health service and patterns of comorbidity with other psychiatric problems. Psychiatric service students (n=110) tended to drink less than did undergraduate comparison group and to report similar frequencies of adverse consequences. Alcohol disorders were significantly…

  9. Use of dental services among Danish youths

    DEFF Research Database (Denmark)

    Lissau, I; Holst, D; Friis-Hasché, E

    1989-01-01

    and perceived economic barriers. Secondly, the variables concerning the individual resources were set into a multiple dummy regression model as independent variables. The results showed that the following variables had a significant effect: sex, social conditions, pain tolerance, dental anxiety, and perceived...... main groups all together were inserted as independent dummy variables into a regression model. The results showed that sex, social conditions, pain tolerance, dental anxiety, perceived economic barriers of the youth themselves, general assessment of Child Dental Care compared to Youth Dental Care were......The purpose of the present study was to analyze the separate effect and the total effect of the social environment, the individual and the delivery system on frequency of use of dental services among youths. The variables of use were divided into the three main groups according to Coleman (12...

  10. Triage in psychiatric emergency services in Copenhagen

    DEFF Research Database (Denmark)

    Sæbye, Ditte; Høegh, Erica Bernt; Knop, Joachim

    2017-01-01

    Inspired by the Australasian triage system, a regional psychiatric triage system was introduced in the psychiatric emergency units (PEUs) in Copenhagen in 2011. Our aim of the study is to determine the characteristics of the patient according to the defined triage criteria and check...... if this is in accordance with recommendations. A random 10% data sample was obtained throughout 2012 in three PEUs of Copenhagen. Triage category, demographic, social and clinically relevant variables were collected. A total of 929 contacts were registered. We found significant associations between triage category...... and several clinical parameters. Time of visit was correlated to diagnoses. The results indicate that use of the new triage system in emergency psychiatry has facilitated urgency categorization, reduced waiting time, and optimized clinical decisions. These goals are important clinical implications...

  11. Psychiatric Services in Dubai (A Short Descriptive Report)

    Science.gov (United States)

    Al Mualla, Saoud

    2011-01-01

    The paper gives an account of psychiatric services in Dubai (U.A.E). It describes the unique demographic constitution of Dubai and its complex health system. It also discusses the reasons behind the primitiveness of psychiatry in comparison to other medical specialties and services, especially considering the wealth of Dubai. The paper then goes…

  12. Shared Decision Making for Psychiatric Rehabilitation Services Before Discharge from Psychiatric Hospitals.

    Science.gov (United States)

    Zisman-Ilani, Yaara; Roe, David; Elwyn, Glyn; Kupermintz, Haggai; Patya, Noa; Peleg, Ido; Karnieli-Miller, Orit

    2018-02-02

    Shared decision making (SDM) is an effective health communication model designed to facilitate patient engagement in treatment decision making. In mental health, SDM has been applied and evaluated for medications decision making but less for its contribution to personal recovery and rehabilitation in psychiatric settings. The purpose of this pilot study was to assess the effect of SDM in choosing community psychiatric rehabilitation services before discharge from psychiatric hospitalization. A pre-post non-randomized design with two consecutive inpatient cohorts, SDM intervention (N = 51) and standard care (N = 50), was applied in two psychiatric hospitals in Israel. Participants in the intervention cohort reported greater engagement and knowledge after choosing rehabilitation services and greater services use at 6-to-12-month follow-up than those receiving standard care. No difference was found for rehospitalization rate. Two significant interaction effects indicated greater improvement in personal recovery over time for the SDM cohort. SDM can be applied to psychiatric rehabilitation decision making and can help promote personal recovery as part of the discharge process.

  13. Dental service in 2008 Summer Olympic Games.

    Science.gov (United States)

    Yang, Xiao-Jiang; Schamach, Patrick; Dai, Jian-Ping; Zhen, Xiao-Zhen; Yi, Biao; Liu, Hongchen; Hu, Min; Clough, Tony; Li, Yuan; Ma, Chun-mei

    2011-04-01

    How to organise an appropriate team to provide quality dental care during the Olympic Games has become an important consideration for each successive host country. The aims of this study were to document dental services provided at the Olympic Games and to provide data for planning future events. SET-UP OF THE DENTAL CARE DEPARTMENT: There were six dental chairs in six independent treatment rooms, one technical laboratory, a sterilising room and an x-ray room equipped with one digital panoramic screening machine and one intraoral x-ray machine in the polyclinic in the Olympic Village in Beijing. Shifts comprised 80 dentists and 28 nurses who were organised into three shifts working from 08:00 until 23:00. In the 2008 Olympic Games, there were 1607 cases involving 1126 patients requiring dental care: 795 cases from 516 athletes; 483 cases from 370 coaches and other staff; and 99 cases from volunteers. Endodontic treatments, permanent fillings, oral hygiene, mouthguards and treatment of pericoronitis were the most frequent procedures in dental care. The Mouthguard Service was extremely popular and well utilised. 122 athletes received new custom-made mouthguards in Beijing. As the utilisation of the dental service grows, and the burden of providing care for such a large cohort increases, a well-organised dental team becomes increasingly important. More general-practice dentists were needed in the team. Different kinds of specialist were suggested for working in the team-for example, oral and maxillofacial surgeons, sport dentists for mouthguards and endodontists.

  14. Price elasticity of demand for psychiatric consultation in a Nigerian psychiatric service.

    Science.gov (United States)

    Esan, Oluyomi

    2016-12-01

    This paper addresses price elasticity of demand (PED) in a region where most patients make payments for consultations out of pocket. PED is a measure of the responsiveness of the quantity demanded of goods or services to changes in price. The study was done in the context of an outpatient psychiatric clinic in a sub -Saharan African country. The study was performed at the University College Hospital (UCH), Ibadan, Nigeria. Aggregate data were collected on weekly clinic attendance over a 24-month period October 2008 - September 2010 representing 12 months before, to 12months after a 67% increase in price of outpatient psychiatric consultation. The average weekly clinic attendance prior to the increase was compared to the average clinic attendance after the price increase. Arc-PED for consultation was also estimated. Clinic attendance dropped immediately and significantly in the weeks following the price increase. There was a 34.4% reduction in average weekly clinic attendance. Arc-PED for psychiatric consultation was -0.85. In comparison to reported PED on health care goods and services, this study finds a relatively high PED in psychiatric consultation following an increase in price of user fees of psychiatric consultation.

  15. Motivating your patients: marketing dental services.

    Science.gov (United States)

    Grönroos, C; Masalin, K

    1990-02-01

    In most industrialized countries the issues of unemployment or under-employment are becoming more critical for the members of the dental associations. In some countries this is creating greater competition between the private practitioners and public health dentists as well as between private dental practitioners themselves. Modern marketing, especially service marketing theory and models, can provide dentists and dental associations with tools to improve their position in relation to patients, political decision makers and other public agencies. However, marketing has to be understood correctly as a philosophy providing a means of approaching the establishing, maintaining and enhancing patient or customer relationships and not as a narrowly defined set of tools. As long as marketing is considered to be external campaigns, such as advertising and not much else, it is bound to fail. Other dimensions of marketing, such as interactive marketing and internal marketing, are of much greater importance to dental practitioners.

  16. dental services and attitudes towards its regular utilization among

    African Journals Online (AJOL)

    standardized, pretested and self-administered questionnaire was utilized to elicit responses on dental services ... attitude towards regular dental service utilization and this improved with ... Culture, National Directorate of Employment,. National ...

  17. Patient satisfaction towards dental services among secondary ...

    African Journals Online (AJOL)

    Aim: To assess patient satisfaction on dental services among secondary school students. Design: Cross-sectional study. Study participants: 200 Secondary school students in Makambako township randomly selected from school class registers. Methods: Self-administered structured questionnaire in a class room. Reliability ...

  18. Dental workforce availability and dental services utilization in Appalachia: a geospatial analysis.

    Science.gov (United States)

    Feng, Xue; Sambamoorthi, Usha; Wiener, R Constance

    2017-04-01

    There is considerable variation in dental services utilization across Appalachian counties, and a plausible explanation is that individuals in some geographical areas do not utilize dental care due to dental workforce shortage. We conducted an ecological study on dental workforce availability and dental services utilization in Appalachia. We derived county-level (n = 364) data on demographic and socioeconomic characteristics and dental services utilization in Appalachia from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) using person-level data. We obtained county-level dental workforce availability and physician-to-population ratio estimates from Area Health Resources File and linked them to the county-level BRFSS data. The dependent variable was the proportion using dental services within the last year in each county (ranging from 16.6% to 91.0%). We described the association between dental workforce availability and dental services utilization using ordinary least squares regression and spatial regression techniques. Spatial analyses consisted of bivariate local indicators of spatial association (LISA) and geographically weighted regression (GWR). Bivariate LISA showed that counties in the central and southern Appalachian regions had significant (P dental workforce availability, low percent dental services utilization). GWR revealed considerable local variations in the association between dental utilization and dental workforce availability. In the multivariate GWR models, 8.5% (t-statistics > 1.96) and 13.45% (t-statistics > 1.96) of counties showed positive and statistically significant relationships between the dental services utilization and workforce availability of dentists and dental hygienists, respectively. Dental workforce availability was associated with dental services utilization in the Appalachian region; however, this association was not statistically significant in all counties. The findings suggest that program and policy efforts to

  19. Psychiatric service users' experiences of emergency departments

    DEFF Research Database (Denmark)

    Carstensen, Kathrine; Lou, Stina; Jensen, Lotte Groth

    2017-01-01

    regarding service users’ experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. Methods: A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries. Screening by title...

  20. Usage of psychiatric emergency services by asylum seekers

    DEFF Research Database (Denmark)

    Reko, Amra; Bech, Per; Wohlert, Cathrine

    2015-01-01

    predominantly male and married. The group consisted primarily (61%) of failed asylum seekers. Most patients (81%) presented with relevant mental health problems. The main reasons for presenting to the acute psychiatric emergency service were suicidal ideation and/or behaviour (60%). The most frequent diagnosis...... by asylum seekers in Denmark shows some of the acute mental health needs asylum seekers present with. The findings of high levels of suicidal ideation and possible diagnostic difficulties are discussed, as well as possible improvements of the referral and psychiatric evaluation processes....

  1. Perceived Dangerousness as Related to Psychiatric Symptoms and Psychiatric Service Use – a Vignette Based Representative Population Survey

    Science.gov (United States)

    Sowislo, Julia F.; Gonet-Wirz, Franca; Borgwardt, Stefan; Lang, Undine E.; Huber, Christian G.

    2017-01-01

    Perceptions of dangerousness are an influential component of mental health stigma and can be driven by the display of psychiatric symptoms and the use of psychiatric service institutions. Yet, no previous study compared symptoms and service use associated perceptions of dangerousness. Therefore, we conducted a representative survey (N = 2,207) in the canton of Basel-Stadt, Switzerland. Participants were asked to answer the perceived dangerousness scale with respect to a vignette that either depicted psychiatric symptoms of a fictitious character or a psychiatric service institution the fictitious character had been admitted to. Between the vignettes, type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied. Perceived dangerousness was significantly lower as related to psychiatric service use than related to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and male gender of the fictitious character tend to increase perceived dangerousness. Furthermore, being hospitalized in a psychiatric unit at a general hospital or the rater being familiar with psychiatric services tends to decrease perceived dangerousness. Effective anti-stigma initiatives should integrate education about dangerousness as well as methods to increase familiarity with psychiatry. Additionally, an integration of modern psychiatry in somato-medical care institutions might decrease stigmatization. PMID:28367993

  2. Perceived Dangerousness as Related to Psychiatric Symptoms and Psychiatric Service Use - a Vignette Based Representative Population Survey.

    Science.gov (United States)

    Sowislo, Julia F; Gonet-Wirz, Franca; Borgwardt, Stefan; Lang, Undine E; Huber, Christian G

    2017-04-03

    Perceptions of dangerousness are an influential component of mental health stigma and can be driven by the display of psychiatric symptoms and the use of psychiatric service institutions. Yet, no previous study compared symptoms and service use associated perceptions of dangerousness. Therefore, we conducted a representative survey (N = 2,207) in the canton of Basel-Stadt, Switzerland. Participants were asked to answer the perceived dangerousness scale with respect to a vignette that either depicted psychiatric symptoms of a fictitious character or a psychiatric service institution the fictitious character had been admitted to. Between the vignettes, type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied. Perceived dangerousness was significantly lower as related to psychiatric service use than related to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and male gender of the fictitious character tend to increase perceived dangerousness. Furthermore, being hospitalized in a psychiatric unit at a general hospital or the rater being familiar with psychiatric services tends to decrease perceived dangerousness. Effective anti-stigma initiatives should integrate education about dangerousness as well as methods to increase familiarity with psychiatry. Additionally, an integration of modern psychiatry in somato-medical care institutions might decrease stigmatization.

  3. Strategies for service-learning assessment in dental hygiene education.

    Science.gov (United States)

    Burch, Sharlee

    2013-10-01

    A large body of literature exists on the instructional pedagogy known as service-learning. Service-learning is a teaching and learning approach characterized by the dental hygiene student's practical application of academic studies and occurs within a community setting, to the benefit of both the student and community. Dental hygiene educators use service-learning to enhance student knowledge and application of oral health curriculum. This manuscript reports on the importance of service-learning assessment to the National Dental Hygiene Research Agenda as well as the future of the profession of dental hygiene and the successful strategies in service-learning evaluation available for utilization by dental hygiene educators.

  4. Who’s Boarding in the Psychiatric Emergency Service?

    Directory of Open Access Journals (Sweden)

    Scott A. Simpson

    2014-09-01

    Full Text Available Introduction: When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods: We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results: 521 of 5363 patient encounters (9.7% resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/ seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion: Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. [West J Emerg Med. 2014;15(6:669-674

  5. Nurses of the psychiatric service as the specific occupational group

    Directory of Open Access Journals (Sweden)

    Klimentova I.V.

    2016-06-01

    Full Text Available The demand for psychiatric services in modern health care system will increase due to the growth in number of mental diseases. The role of nurses in prevention, treatment and rehabilitation of mental illness has a number of features. These features are related to care of patients with high level of aggressiveness, behavioral deviations, and problems in self-service. Differences in procedure practice and communicative space specialize and make narrower the nurses' professional practice in psychiatry and determine appearance of specific mechanisms and norms bound up with the necessity of supervision of patients while respecting their rights. Personnel's oversight functions, deviant behavior of patients, high degree of closure of psychiatric medical institutions — are the reasons for specialization of nurses' professional group in psychiatry, forming special mechanisms of maintaining tolerance to patients in professional sphere of this community.

  6. The exploration of in-service training needs of psychiatric nurses

    African Journals Online (AJOL)

    2014-10-10

    Oct 10, 2014 ... to psychiatric nursing. This study aimed to increase the awareness of the needs and benefits of in-service training of psychiatric nurses and to formulate recommendations for in- service training for psychiatric nursing. Research method and design. Design. A qualitative research design with explorative, ...

  7. Utilization of dental services in a population of Nigerian University ...

    African Journals Online (AJOL)

    Conclusion: This study revealed low utilisation of dental services among this sample of Nigerian university students with a gender difference in utilisation. The majority of the subjects seek dental care for symptomatic reasons. The implementation of oral health education programme to improve dental awareness among the ...

  8. Determinants of Dental-Services Utilization in a University Population.

    Science.gov (United States)

    Snyder, Thomas L.; And Others

    1982-01-01

    A study explored attitudes and perceptions that may influence how University of Maryland students utilize dental services. Significant variables included: (1) students' attitudes toward dentists; (2) mother's visits to dentists; (3) dental problems experienced the previous year; (4) dental anxiety; (5) sex; and (6) perceptions of the number and…

  9. Perceived Dangerousness as Related to Psychiatric Symptoms and Psychiatric Service Use ? a Vignette Based Representative Population Survey

    OpenAIRE

    Julia F. Sowislo; Franca Gonet-Wirz; Stefan Borgwardt; Lang, Undine E.; Christian G. Huber

    2017-01-01

    Perceptions of dangerousness are an influential component of mental health stigma and can be driven by the display of psychiatric symptoms and the use of psychiatric service institutions. Yet, no previous study compared symptoms and service use associated perceptions of dangerousness. Therefore, we conducted a representative survey (N?=?2,207) in the canton of Basel-Stadt, Switzerland. Participants were asked to answer the perceived dangerousness scale with respect to a vignette that either d...

  10. The demand for preventive and restorative dental services.

    Science.gov (United States)

    Meyerhoefer, Chad D; Zuvekas, Samuel H; Manski, Richard

    2014-01-01

    Chronic tooth decay is the most common chronic condition in the United States among children ages 5-17 and also affects a large percentage of adults. Oral health conditions are preventable, but less than half of the US population uses dental services annually. We seek to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. Using data from the 2001-2006 Medical Expenditure Panel Survey and an American Dental Association survey of dental procedure prices, we jointly estimate the probability of using preventive and both basic and major restorative services through a correlated random effects specification that controls for endogeneity. We found that dental coverage increased the probability of preventive care use by 19% and the use of restorative services 11% to 16%. Both conditional and unconditional on dental coverage, the use of dental services was not sensitive to out-of-pocket costs. We conclude that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants. Copyright © 2013 John Wiley & Sons, Ltd.

  11. The Ukrainian Dental Market: Characteristics of Demand for Services in the Segment of Dental Implantation

    Directory of Open Access Journals (Sweden)

    Slipchenko Tetiana O.

    2017-05-01

    Full Text Available The article is aimed at analyzing the market for dental services in Ukraine in the implantology segment, studying the demand factors for these services and developing a system of measures to manage the demand for dental implantation services. It has been proven that the market for dental services according to a complex of its attributes is more in line with the type of market of monopolistic competition. One of the promising ways of developing the dental market is to transform producers of dental services into the vertically integrated holdings. As one of the specific features of the dental services market is allocated the asymmetry of information, which leads to a conflict between the medical and economic interests of dentists. The price and non-price factors of demand for dental implantation services were determined, the prime cost structure of a dental service was analyzed. The characteristic attributes of a medical service have been defined as consistently defined actions or a complex of actions by medical personnel aimed at prevention, diagnosis, treatment, and rehabilitation, which have a self-contained complete meaning and a certain price.

  12. Patterns of dental services and factors that influence dental services among 64-65 year-old regular users of dental care in Denmark

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Rosing, Kasper; Lempert, Susanne Merethe

    2016-01-01

    to dental status and caries experience. Finally, to discuss the future planning of dental services aimed at the increasing population of elderly citizens. [Correction made on 21 March 2014, after first online publication: The sentence ‘Data on elderly's dental service are scarce, although increased use...... status and DMFT. Geographical, socio-demographic and socioeconomic data derived from public registers. Results Almost all received restorations, while periodontal treatment was received by services was dominated by periodontal services. Periodontal services were......Objectives To describe the pattern of dental services provided to 64–65-year-old Danes who are regular users of dental care over a 5-year period, to analyse whether this pattern is associated with socio-demographic and/or socioeconomic factors, and if different uses of dental services are related...

  13. Dental Services and Attitudes towards its regular Utilization among ...

    African Journals Online (AJOL)

    Background: Regular utilization of dental services is key to the attainment of optimal oral health state, an integral component of general health and well being needed for effective productivity by working personnel. Objective: This study assessed the rate and pattern of dental service utilization among civil servants and their ...

  14. Increased Use of Dental Services by Children in Medicaid

    Data.gov (United States)

    U.S. Department of Health & Human Services — This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children...

  15. Identifying barriers to receiving preventive dental services: expanding access to preventive dental hygiene services through affiliated practice.

    Science.gov (United States)

    Gross-Panico, Michelle L; Freeman, Wilbur K

    2012-01-01

    Minority children and children from lower income families are more likely to experience the burden of oral disease. Since oral disease reduces quality of life, it is a priority to utilize preventive dental services. The research questions ask if affiliated practice increases utilization of preventive dental services by underserved children from birth to 18 years of age, and what the barriers to receiving preventive dental services are and their level of importance. A survey was administered to parents/guardians of patients from birth to 18 years of age who received preventive dental services from Catholic Healthcare West East Valley Children's Dental Clinic, an affiliated practice dental clinic in Chandler, Arizona. Thirty-four surveys were completed: 21 completed in English and 13 completed in Spanish. The data was analyzed to provide descriptive statistics and non-parametrically analyzed using the Friedman's, Kendall's W and Wilcoxon Signed Ranks Tests. The cost of preventive dental services is more important to this population than both convenience of appointment time and distance traveled. As the cost increases for preventive dental services, this population will utilize preventive dental services less frequently. The study indicated that the increase of self-reported utilization of preventive dental services by underserved children, ranging in age from birth to 18 years old, in Arizona affiliated practice dental clinics, was primarily impacted by perceived reduced costs of receiving care. Funding efforts, reimbursement mechanisms and legislative policies should support this dental care delivery model to provide care to underserved children, adults and seniors throughout the U.S.

  16. Predicting Incarceration of Clients of a Psychiatric Probation and Parole Service

    National Research Council Canada - National Science Library

    Solomon, Phyllis; Draine, Jeffrey; Marcus, Steven C

    2002-01-01

    OBJECTIVE: This study assessed the extent to which clinical characteristics, psychiatric status, and use of mental health services explain incarceration for technical violations of probation or parole rather...

  17. Dental caries experience and use of dental services among Brazilian prisoners.

    Science.gov (United States)

    Cavalcanti, Alessandro Leite; Rodrigues, Iris Sant Anna Araujo; de Melo Silveira, Ingrid Thays; de Oliveira, Thaliny Batista Sarmento; de Almeida Pinto, Magaly Suenya; Xavier, Alidianne Fabia Cabral; de Castro, Ricardo Dias; Padilha, Wilton Wilney Nascimento

    2014-11-25

    This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, and oral health impacts were investigated. The mean DMFT index value was 19.72. Of the components, the decayed component showed the highest mean value (11.06 ± 5.37). Statistically significant association was found between DMFTs with values from 22 to 32 and oral health satisfaction (p = 0.002), difficulty speaking (p = 0.024), shame of talking (p = 0.004) and smiling (p dental services, 80% had their last dental appointment less than one year ago, with most visits occurring in prison (80%), with restorative treatment (32%), followed by dental pain (26.4%), being the main reasons for such appointments. Most prisoners used dental services provided by the prison. Although restorative treatment has been the main reason for the use of dental services, "decayed" and "missing" components contributed to the high mean DMFT index.

  18. Leadership crisis in psychiatric services: a change theory perspective.

    Science.gov (United States)

    Skelton-Green, J

    1997-01-01

    In 1990, after twenty years of service, the psychiatrist who had been Director of Psychiatric Services at Alpha Hospital decided to take an early retirement. What followed was a dramatic leadership struggle, which peaked with the resignation (in the summer of 1992) of most of the hospital's psychiatrists. In the years since, there has been a great deal of healing. The psychiatrists are all back at work. Joint leadership of the services is established under the direction of a (psychiatrist) Clinical Director and a (non-psychiatrist) Administrative Director. Management of the programs and services has been reorganized to a much more efficient and effective system. And feelings among the key players are more trusting and collaborative. This paper will explore how this crisis may be understood in terms of change theory. It will also outline the process utilized to resolve the crisis, and will draw implications for other mental health administrators who, in these times of rapid and dramatic change, will undoubtedly confront similar challenges.

  19. Income Inequality and Use of Dental Services in 66 Countries.

    Science.gov (United States)

    Bhandari, B; Newton, J T; Bernabé, E

    2015-08-01

    This study explored the association between income inequality and use of dental services and the role that investment in health care plays in explaining that association. We pooled individual-level data from 223,299 adults, 18 years or older, in 66 countries, who participated in the World Health Organization (WHO) World Health Surveys with country-level data from different international sources. Income inequality was measured at the national level using the Gini coefficient, and use of dental services was defined as having received treatment to address problems with mouth and/or teeth in the past year. The association between the Gini coefficient and use of dental services was examined in multilevel models controlling for a standard set of individual- and country-level confounders. The individual and joint contributions of 4 indicators of investment in health care were evaluated in sequential modeling. The Gini coefficient and use of dental services were inversely associated after adjustment for confounders. Every 10% increase in the Gini coefficient corresponded with a 15% lower odds of using dental services (odds ratio: 0.85; 95% confidence interval: 0.70-0.99). The association between the Gini coefficient and use of dental services was attenuated and became nonsignificant after individual adjustment for total health expenditure, public expenditure on health, health system responsiveness, or type of dental health system. The 4 indicators together explained 80% of the association between the Gini coefficient and use of dental services. This study suggests that more equal countries have greater use of dental services. It also supports the mediating role of investment in health care in explaining that association. © International & American Associations for Dental Research 2015.

  20. Service-learning in dental education: meeting needs and challenges.

    Science.gov (United States)

    Hood, Janet Grobe

    2009-04-01

    Community-based service-learning is increasingly common in dental education. By definition, service-learning combines educational goals with service to the community, and the community and school are equal partners. The three main goals of service-learning are improving learning, promoting civic engagement, and strengthening communities. There have been calls from many groups to reform dental education to better serve the public, and service-learning is one of the most often recommended methods to help meet this goal. One of the key attributes of service-learning is its potential to promote civic engagement and social responsibility during the student's education. The social responsibility of dentists and aspects of professionalism can be learned by students through participation in well-structured service-learning programs. Community-based service-learning programs can also address societal needs by improving the public's access to oral health care through partnerships among dental schools, oral health providers, and communities. This article describes service-learning programs at several dental schools to illustrate application of this educational strategy in predoctoral dental education. This article also describes challenges that confront schools desiring to implement and sustain service-learning programs, including academic quality, faculty development and training, interprofessionalism, making time in the curriculum, budget, faculty shortages and time, student credit, quality control, and remote sites away from the dental school.

  1. Dental service utilization by Europeans aged 50 plus.

    Science.gov (United States)

    Listl, Stefan; Moran, Valerie; Maurer, Jürgen; Faggion, Clovis M

    2012-04-01

    To describe variations in the utilization of dental services by persons aged 50+ from 14 European countries and to identify the extent to which such variations are attributable to differences in oral health need and in accessibility of dental care. We use data from the Survey of Health, Ageing, and Retirement in Europe (SHARE Waves 2 and 3) and estimate a series of multivariate logistic regression models to analyze variations in dental service utilization (overall dental attendance, preventive treatment and/or operative treatment, dental attendance in early life years) Overall dental attendance and incidence of solely preventive treatment are comparatively high in the Netherlands, Sweden, Denmark, Germany, and Switzerland. In contrast, overall dental attendance is relatively low in Spain, Italy, France, Greece, Poland, and Ireland. Moreover, a high incidence of solely operative treatment is observed in Austria, Italy, and France, whereas in the Netherlands, Sweden, Denmark, Switzerland, and Ireland, the incidence of solely operative treatment is comparably low. By and large, these variations persist even when controlling for cross-country differences in oral health need and in accessibility of dental care. In comparison with other European regions, there is a tendency toward more frequent and preventive dental treatment of the elderly populations residing in Scandinavia and Western Europe. Such utilization patterns appear only partially attributable to differences in need for and accessibility of dental care. © 2011 John Wiley & Sons A/S.

  2. Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.

    Science.gov (United States)

    Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra

    2015-10-01

    In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value dental services, thereby increasing the oral health status of the population.

  3. Ethnic Disparities in School-Based Behavioral Health Service Use for Children with Psychiatric Disorders

    Science.gov (United States)

    Locke, Jill; Kang-Yi, Christina D.; Pellecchia, Melanie; Marcus, Steven; Hadley, Trevor; Mandell, David S.

    2017-01-01

    Background: We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders. Methods: Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD],…

  4. Utilization of psychiatric emergency services by homeless persons in Spain.

    Science.gov (United States)

    Pascual, Juan Carlos; Malagón, Angeles; Arcega, Jose M; Gines, Jose M; Navinés, Ricard; Gurrea, Alfredo; Garcia-Ribera, Carlos; Bulbena, Antoni

    2008-01-01

    Studies examining the relationship between homeless persons and the use of psychiatric emergency services (PES) in a country with universal access to health care are lacking. This study aimed to determine the prevalence of homelessness in adults visiting a PES in Spain, identify the differences between homeless and non-homeless patients in the use of PES and analyze the factors associated with homelessness and the decision to hospitalize. The study included a total of 11 578 consecutive admissions to a PES in a tertiary hospital in Barcelona, Spain, over a 4-year period. Data collected included socio-demographic and clinical information, and score on the Severity of Psychiatric Illness (SPI) scale. Multivariate logistic regression analyses were used to calculate odds ratios for the factors associated with homelessness and the decision to hospitalize. Five hundred sixty (4.8%) admissions were considered homeless. Homeless patients had more psychotic and drug abuse disorders, greater severity of symptoms, more risk of being a danger to others and more frequent hospitalization needs than non-homeless patients. Factors related to homelessness were male gender, substance abuse and immigrant status from North Africa, Sub-Sahara Africa and Western countries. The decision to hospitalize homeless patients was associated with psychosis diagnosis, suicide risk, danger to others, symptom severity, medical problems and noncompliance with treatment. In an attempt to decrease the use of emergency resources and prevent the risk of homelessness, mental health planners in a universal healthcare system should improve outpatient access for populations with risk factors such as substance abuse and immigration.

  5. Utilization of dental health services by Danish adolescents attending private or public dental health care systems.

    Science.gov (United States)

    Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise; Lone, Laurberg

    2002-03-01

    The objectives of the study were: 1) to describe the choice of dental care system among 16-year-olds, 2) to describe the utilization of dental services among 16-17-year-olds enrolled in either public or private dental care systems, and to compare the dental services provided by the alternative systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (Pdental services were provided more frequently by the public than the private system (P< 0.001). Despite the fact that the economic barrier was eliminated a lower attendance rate was observed for patients transferred to the private practice system.

  6. Effects of occupational regulations on the cost of dental services: evidence from dental insurance claims.

    Science.gov (United States)

    Wing, Coady; Marier, Allison

    2014-03-01

    In the United States, occupational regulations influence the work tasks that may legally be performed by dentists and dental hygienists. Only a dentist may legally perform most dental procedures; however, a smaller list of basic procedures may be provided by either a dentist or a dental hygienist. Since dentists and hygienists possess different levels of training and skill and receive very different wages, it is plausible that these regulations could distort the optimal allocation of skills to work tasks. We present simple theoretical framework that shows different ways that such regulations might affect the way that dentists and dental hygienists are used in the production of dental services. We then use a large database of dental insurance claims to study the effects of the regulations on the prevailing prices of a set of basic dental services. Our empirical analysis exploits variation across states and over time in the list of services that may be provided by either type of worker. Our main results suggest that the task-specific occupational regulations increase prices by about 12%. We also examine the effects of related occupational regulations on the utilization of basic dental services. We find that allowing insurers to directly reimburse hygienists for their work increases one year utilization rates by 3-4 percentage points. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Service evaluation of a nurse-led dental anxiety management service for adult patients

    OpenAIRE

    Porritt, Jenny; Jones, K; Marshman, Z

    2016-01-01

    Objective Evaluate patients' and professionals' experiences of a nurse-led dental anxiety management service (NDAMS).\\ud \\ud Design Service evaluation.\\ud \\ud Setting The NDAMS operates as part of the Sheffield Salaried Primary Dental Care Service.\\ud \\ud Subjects and methods Questionnaire survey of anxious patients and qualitative interviews with patients and professionals.\\ud \\ud Interventions Dental nurses delivered low-level psychological interventions as part of an integrated care pathwa...

  8. Utilization of dental health services by Danish adolescents attending private or public dental health care systems

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise

    2002-01-01

    systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88......% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (P... that the economic barrier was eliminated a lower attendance rate was observed for patients transferred to the private practice system....

  9. 42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.

    Science.gov (United States)

    2010-10-01

    ... surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... medicine. Medicare Part B pays for services furnished by a doctor of dental surgery or dental medicine... performed by a doctor of medicine or osteopathy. 1 1 For services furnished before July 1, 1981, Medicare...

  10. Community dental service--four years on.

    Science.gov (United States)

    Naidoo, S

    2007-07-01

    In July 2000, the first group of graduates entered compulsory community dental service. The aim of this study was to document the experiences of the community dentists four years on. A cross-sectional, descriptive study was carried out among 232 community dentists. A structured questionnaire divided into nine sections: demography, the allocation process, accommodation & living conditions, dental clinic facilities - equipment and materials, work environment, income, sense of achievement, intellectual fulfillment. Forty five per cent of the sample (n = 105) responded, 51% were male and the mean age of the sample was 24.8 years. Of the responadents 47% could speak the local language; nearly a quarter (24%) felt that the allocation process was not handled efficiently and 30% said that they needed more information about their placement posting. Sixty per cent were placed within 20km of the nearest town; 11% did not have access to telephone or fax and 47% were provided with accommodation. Thirty five per cent described the condition of the clinics operating as poor. A fifth of the respondents (21%) indicated that they did not have full sets of instruments. Eight per cent did not have an autoclave and 7% a high-speed hand piece. Fifty one per cent did not have oxygen and nearly two thirds (58%) of the clinics did not have any emergency equipment. Seventy one per cent reported that the equipment broke down often and 65% that it was not fixed promptly. Nearly all (90%) indicated that they would welcome a short course that might assist them to repair broken down equipment. Eighty five per cent reported that they enjoyed their work environment. Seventy per cent had no supervision, but more than a third felt confident enough to work without it. Although 80% felt that their professional competence had improved, an equal number indicated that they have lost some of their clinical competence in one or other area. Despite the fact that 65% reported that there were many

  11. Postsecondary Students With Psychiatric Disabilities Identify Core Services and Key Ingredients to Supporting Education Goals.

    Science.gov (United States)

    Biebel, Kathleen; Mizrahi, Raphael; Ringeisen, Heather

    2017-10-26

    Accessing and successfully completing postsecondary educational opportunities may be challenging for those living with psychiatric disabilities. This exploratory study highlights the experiences of individuals with psychiatric disabilities participating in postsecondary educational support initiatives. Investigators conducted case studies with 3 education support initiatives across the United States. Focus groups revealed what concrete supported education services were helpful and key ingredients in delivering education supports. Access to specialists, mindfulness techniques, help with time management and procrastination, and facilitating classroom accommodations were identified as critical. Developing authentic relationships with supported education staff, flexibility in service delivery and access to student peers living with psychiatric disabilities were noted as key ingredients in service delivery. Incorporating the voice of students with psychiatric disabilities into supported education services can increase access, involvement, and retention, therein providing more supports to students with psychiatric disabilities achieving their postsecondary education goals. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Child use of dental services and receipt of dental care in New Zealand.

    Science.gov (United States)

    Jamieson, Lisa M; Koopu, Pauline I

    2007-11-01

    To examine dental service use and dental care receipt by a range of factors among Maori, Pacific and New Zealand European or Other children in New Zealand. Data were from the 2002 National Children's Nutrition Survey. Bivariate associations were calculated between three dental service use and dental care receipt measures, and 48 personal characteristics in five domains. Analyses took into account the complex sampling design. Some 3275 children participated; 37.4% Maori, 32.3% Pacific and 30.3% New Zealand European or Other. Irregular dental attendance was associated with children who were 11-14 years, Pacific, had not always lived in New Zealand, lived in rented accommodation, frequently watched television, consumed breakfast on the way to school, purchased lunch, consumed sugar-containing products or had food security issues. A higher proportion of children who were aged 11-14 years, Maori, had low household income, lived with 4+ children, regularly watched television, consumed breakfast on the way to school, frequently consumed high-sugar foods, had food security issues, experienced dental pain at night or had received dental care under a general anaesthetic had received a restoration. Extraction receipt was associated with children who were Pacific, had low household income, had a disability, purchased their lunch, regularly consumed high-sugar-containing products, had food security issues, had experienced dental pain at night or received dental care under a general anaesthetic. Material and behavioural factors all play a role in New Zealand child use of dental services and receipt of dental care.

  13. The new asylums in the community: severely ill psychiatric patients living in psychiatric supported housing facilities. A Danish register-based study of prognostic factors, use of psychiatric services, and mortality

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Pedersen, Marianne G; Pedersen, Carsten B

    2012-01-01

    INTRODUCTION: Reorganization of psychiatric treatment in Denmark involved a declining number of psychiatric long-stay beds and an increasing number of psychiatric supported housing facilities in the community. Very few studies have focused on the population in such facilities. METHODS: Information...... was generated combining addresses of supported psychiatric housing facilities with information from the Danish Civil Registration System to create a case register of persons living in supported psychiatric housing facilities. Through linkage with the Danish Psychiatric Central Register, we examined predictors...... of becoming a resident in a psychiatric housing facility, use of psychiatric services around the time of entrance to a supported psychiatric housing facility, and mortality rates for residents in a psychiatric housing facility compared to non-residents and to persons in the general population who never...

  14. Utilization of emergency services for non-traumatic dental disease.

    Science.gov (United States)

    Da Silva, Keith; Kunzel, Carol; Yoon, Richard K

    2013-01-01

    To identify and characterize children who utilize emergency dental services for non-traumatic dental disease. Caregivers of children under 12 years old who seek out emergency services for the treatment of non-traumatic dental disease will be surveyed regarding their child's current oral health status. Patient's clinical data will be obtained and they will be further followed for a period of 2 months to determine if they follow-up with recommendations for comprehensive dental care. One hundred and ninety-eight people participated in the study (97% response rate). Eighty-three percent of the children were diagnosed with dental caries. Seventy-four percent of patients of record presented with an emergency at least once before and 73% had a history of one or more broken appointments. Patients with a history of previous emergency visits (OR = 3.45, CI = 2.05, 5.81) or a history of missed appointments (OR = 2.21, CI = 1.42, 3.58) were significantly more likely to fail to return for comprehensive care (P dental services as their primary means for dental care.

  15. Emergency presentations to an inner-city psychiatric service for children and adolescents.

    NARCIS (Netherlands)

    Dil, L.M.; Vuijk, P.J.

    2012-01-01

    Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of

  16. Psychiatric treatment and research unit for adolescent intensive care: the first adolescent forensic psychiatric service in Finland.

    Science.gov (United States)

    Kahila, K; Kilkku, N; Kaltiala-Heino, R

    2004-04-01

    Finland does not have a history of providing forensic adolescent psychiatric units although the need for this kind of service has been established. According to legislation patients who are minors have to be treated separately from adults, however, this has not been possible in practice. Also, adolescent psychiatric wards have not always been able to admit the most severely ill patients, those with impulsive and aggressive behaviours, because of lack of staff resources, problems associated with protecting other vulnerable patients and a shortage of secure environments. A previous report demonstrated the significant increase in adolescent's involuntary treatment within adult psychiatric wards. Data from this report were acknowledged as an important starting point in the planning process for the psychiatric treatment and research unit for adolescent intensive care. This paper describes the background, development process, plan of action, tailor-made education programme and supporting evidence for the first Finnish adolescent forensic service opened in April 2003 in the Department of Psychiatry, Tampere University Hospital. The tool used for planning the unit's activities and staff education programme was the Balanced Score Card approach, the structure and development of which is also outlined within the paper.

  17. [Users satisfaction with dental care services provided at IMSS].

    Science.gov (United States)

    Landa-Mora, Flora Evelia; Francisco-Méndez, Gustavo; Muñoz-Rodríguez, Mario

    2007-01-01

    To determine users' satisfaction with dental care services provided at Instituto Mexicano del Seguro Social in Veracruz. An epidemiological survey was conducted in 14 family medicine clinics located in the northern part of the state of Veracruz. The clinics were selected by stratified-random sampling. All users older than 20 years seeking medical or dental care services were interviewed; previously, their informed consent was obtained. We used the 6-items United Kingdom dental care satisfaction questionnaire (Spanish version) where question number four evaluates user satisfaction. From October to December 2005, 3601 users were interviewed. We excluded 279 questionnaires because the age of the interviewees was <20 years. The final analysis included 3322 interviews (92%); 73% were female with an average age of 45 +/- 16 years old. 82% were satisfied with dental care services and 91% never felt like making a complaint. Waiting time of less than 30 minutes and last visit to the dentist in the last year were the only variables related to satisfaction (p = 0.0001). There is a high level of satisfaction regarding dental care services among Mexican Institute of Social Security users. However, it would be possible to increase the level of satisfaction if the waiting time is reduced and the number of dental care users attending twice a year increases.

  18. A model to facilitate collaboration between institutions of higher education and psychiatric health care services to promote psychiatric clinical nursing education

    OpenAIRE

    2010-01-01

    D.Cur. The purpose of this research study was to describe a model to facilitate collaboration between the institutions of higher education and psychiatric health care services in order to promote psychiatric clinical nursing education, with guidelines to operationalise the model. In spite of the calls by statutory bodies and contemporary legislation for collaboration between institutions of higher education and psychiatric health care services, there are few instances where formalised coll...

  19. Bibliotherapy for mental health service users Part 2: a survey of psychiatric libraries in the UK.

    Science.gov (United States)

    Fanner, Deborah; Urqhuart, Christine

    2009-06-01

    UK health policy advocates a patient-centred approach to patient care. Library services could serve the rehabilitation needs of mental health service users through bibliotherapy (the use of written, audio or e-learning materials to provide therapeutic support). Part 2 of this two-part paper assesses the views of psychiatric libraries in the UK on providing access to service users and possible services provided. An e-mail questionnaire survey of psychiatric library members of the psychiatric lending co-operative scheme (n = 100) obtained a response rate of 55%, mostly from libraries based in hospitals. At present, libraries funded by the health service provide minimal facilities for service users. Librarians are uncertain about the benefits and practicalities of providing access to service users. In order to implement change, information providers across the National Health Service (NHS) will need to work collaboratively to overcome attitudinal and institutional barriers, including the key issue of funding.

  20. Substance Misuse in the Psychiatric Emergency Service; A Descriptive Study

    Directory of Open Access Journals (Sweden)

    Yves Chaput

    2014-01-01

    Full Text Available Substance misuse is frequently encountered in the psychiatric emergency service (PES and may take many forms, ranging from formal DSM-IV diagnoses to less obvious entities such as hazardous consumption. Detecting such patients using traditional screening instruments has proved problematic. We therefore undertook this study to more fully characterize substance misuse in the PES and to determine whether certain variables might help better screen these patients. We used a prospectively acquired database of over 18,000 visits made to four PESs during a 2-year period in the province of Quebec, Canada. One of the variables acquired was a subjective rating by the nursing staff as to whether substance misuse was a contributing factor to the visit (graded as direct, indirect, or not at all. Substance misuse accounted for 21% of all diagnoses and alcohol was the most frequent substance used. Patients were divided into those with primary (PSM, comorbid (CSM or no substance misuse (NSM. Depressive disorders were the most frequent primary diagnoses in CSM, whereas personality and substance misuse disorders were frequent secondary diagnoses in PSM. Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools. Those situations that did have sufficient details included those with a previous history of substance misuse, substance misuse within 48 hours of the visit, and visits graded by the nursing staff as being directly and/or indirectly related to substance misuse. Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM. The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.

  1. Race and psychiatric services in post-apartheid South Africa: a preliminary study of psychiatrists' perceptions.

    Science.gov (United States)

    Kohn, Robert; Szabo, Christopher P; Gordon, Alan; Allwood, Clifford W

    2004-03-01

    The primary objective of this study was to examine the perception of the quality of psychiatric services five years after apartheid, and specifically whether care for black patients had improved. A survey was distributed to South African psychiatrists during a national congress and by mail. The questionnaire focused on the quality of psychiatric care in general, for black and white patients, the racial composition of each respondent's psychiatric practice currently, and the racial composition of the psychiatric practice during apartheid. Psychiatric services in South Africa were viewed as deteriorating. The end of apartheid has done little to improve the quality of psychiatric care for both black and white patients. Although less pronounced, racial inequality in psychiatric care continues to exist. Psychiatric practices continue to be overrepresented with white patients. There remains a differential in quality of psychiatric care and further monitoring should continue. Continued efforts to improve racial equality and the need for greater awareness of cultural issues need to be addressed. Limitations of this study included possible social desirability bias, use of subjective rather than objective measures, and a survey that was limited in scope.

  2. Determinants of Demand in the Public Dental Emergency Service.

    Science.gov (United States)

    Matsumoto, Maria Sa; Gatti, Marcia An; de Conti, Marta Hs; de Ap Simeão, Sandra F; de Oliveira Braga Franzolin, Solange; Marta, Sara N

    2017-02-01

    Although dental emergencies are primarily aimed at pain relief, in practice, dental emergency services have been overwhelmed by the massive inflow of patients with less complex cases, which could be resolved at basic levels of health care. They frequently become the main gateway to the system. We investigated the determinant factors of demand at the Central Dental Emergency Unit in Bauru, São Paulo, Brazil. The questionnaire was applied to 521 users to evaluate sociodemographic profile; factors that led users to seek the service at the central dental emergency; perception of service offered. About 80.4% of users went directly to the central dental emergency, even before seeking basic health units. The reasons were difficulty to be attended (34.6%) and incompatible time (9.8%). To the perception of the necessity of the service, responses were problem as urgent (78.3%) and pain was the main complaint (69.1%). The profile we found was unmarried (41.5%), male (52.2%), white (62.8%), aged 30 to 59 (52.2%), incomplete basic education (41.6%), family income up to 2 minimum wages (47.4%), and no medical/dental plan (88.9%). It was concluded that the users of central dental emergency come from all sectors of the city, due to difficult access to basic health units; they consider their complaint urgent; and they are satisfied with the service offered. To meet the profile of the user urgency's service so that it is not overloaded with demand that can be fulfilled in basic health units.

  3. Utilization of Preventive Dental Services Before and After Health Insurance Covered Dental Scaling in Korea.

    Science.gov (United States)

    Jang, Young-Eun; Kim, Chun-Bae; Kim, Nam-Hee

    2017-01-01

    Health insurance reduces the economic burden of diseases and enhances access to medical services. This study compared, among social classes, the utilization of preventive dental service before and after health insurance covered dental scaling. We analyzed time-series secondary data for 3  175  584 participants from 253 survey areas nationwide in the Community Health Survey (2009-2014) in Korea. The weighted proportion of participants who underwent dental scaling was defined as the scaling rate. Data regarding demographic and socioeconomic characteristics were collected. Scaling rates continuously increased over the 6-year period, particularly in 2014. College graduates had significantly higher scaling rates. Monthly income and scaling rate were positively related. Differences by education decreased over time. Differences by income were particularly high between 2012 and 2014. For women, the temporal rate was 2 times higher for professionals than for the unemployed. Despite increased dental scaling rates since the health coverage change in 2013, socioeconomic differences persist.

  4. Dental service provision by oral health therapists, dental hygienists and dental therapists in Australia: implications for workforce modelling.

    Science.gov (United States)

    Teusner, D N; Amarasena, N; Satur, J; Chrisopoulos, S; Brennan, D S

    2016-03-01

    Dental service provision rates are necessary for workforce planning. This study estimates patient and service rates for oral health therapists (OHTs), dental hygienists (DHs) and dental therapists (DTs). To identify important variables for workforce modelling, variations in rates by practice characteristics were assessed. A cross-sectional self-complete mailed questionnaire collected demographic and employment characteristics, and clinical activity on a self-selected typical day of practice. Private and public dental practices in Australia. Members of the two professional associations representing DHs, DTs and OHTs. For each practitioner type, means and adjusted rate ratios of patients per hour, services per visit and preventive services per visit were estimated. Comparisons by practice characteristics were assessed by negative binomial regression models. Response rate was 60.6% (n = 1,083), 90.9% were employed of which 86.3% were working in clinical practice and completed the service log. Mean services per patient visit provided by OHTs, DHs and DTs were 3.7, 3.5 and 3.3 and mean preventive services per patient were 2.1, 2.1 and 1.8 respectively. For all three groups, adjusting for explanatory variables, the rate of preventive services per patient varied significantly by practice type (general or specialist) and by the proportion of child patients treated. Services rates varied by age distribution of patients and type of practice. If these factors were anticipated to vary over-time, then workforce planning models should consider accounting for the potential impact on capacity to supply services by these dental workforce groups.

  5. Are larger dental practices more efficient? An analysis of dental services production.

    Science.gov (United States)

    Lipscomb, J; Douglass, C W

    1986-01-01

    Whether cost-efficiency in dental services production increases with firm size is investigated through application of an activity analysis production function methodology to data from a national survey of dental practices. Under this approach, service delivery in a dental practice is modeled as a linear programming problem that acknowledges distinct input-output relationships for each service. These service-specific relationships are then combined to yield projections of overall dental practice productivity, subject to technical and organizational constraints. The activity analysis reported here represents arguably the most detailed evaluation yet of the relationship between dental practice size and cost-efficiency, controlling for such confounding factors as fee and service-mix differences across firms. We conclude that cost-efficiency does increase with practice size, over the range from solo to four-dentist practices. Largely because of data limitations, we were unable to test satisfactorily for scale economies in practices with five or more dentists. Within their limits, our findings are generally consistent with results from the neoclassical production function literature. From the standpoint of consumer welfare, the critical question raised (but not resolved) here is whether these apparent production efficiencies of group practice are ultimately translated by the market into lower fees, shorter queues, or other nonprice benefits. PMID:3102404

  6. Service-learning's impact on dental students' attitude towards community service.

    Science.gov (United States)

    Coe, J M; Best, A M; Warren, J J; McQuistan, M R; Kolker, J L; Isringhausen, K T

    2015-08-01

    This study evaluated service-learning programme's impact on senior dental students' attitude towards community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students' attitude towards community service that will eventually lead into providing care to the underserved. Two surveys (pre- and post-test) were administered to 105 senior dental students. For the first survey (post-test), seventy-six students of 105 responded and reported their attitude towards community service immediately after the service-learning programme completion. Three weeks later, 56 students of the 76 responded to the second survey (retrospective pre-test) and reported their recalled attitude prior to the programme retrospectively. A repeated-measure mixed-model analysis indicated that overall there was improvement between pre-test and post-test. Scales of connectedness, normative helping behaviour, benefits, career benefits and intention showed a significant pre-test and post-test difference. An association between attitude towards community service and student characteristics such as age, gender, ethnicity and volunteer activity was also examined. Only ethnicity showed an overall significant difference. White dental students appear to have a differing perception of the costs of community service. The service-learning programme at VCU School of Dentistry has positively impacted senior dental students' attitude towards community service. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Service-learning’s Impact on Dental Students’ Attitude toward Community Service

    Science.gov (United States)

    Coe, J. M.; Best, A. M.; Warren, J. J.; McQuistan, M. R.; Kolker, J. L.; Isringhausen, K. T.

    2014-01-01

    Introduction This study evaluated service-learning program’s impact on senior dental students’ attitude toward community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students’ attitude toward community service that will eventually lead into providing care to the underserved. Materials and methods Two surveys (pre and post-test) were administered to 105 senior dental students. For the first survey (post-test), seventy six students out of 105 responded and reported their attitude toward community service immediately after the service-learning program completion. Three weeks later, fifty six students out of the 76 responded to the second survey (retrospective pre-test) and reported their recalled attitude prior to the program retrospectively. Results A repeated-measure mixed-model analysis indicated that overall there was improvement between pre-test and post-test. Scales of connectedness, normative helping behavior, benefits1, career benefits, and intention showed a significant pre-test and post-test difference. An association between attitude toward community service and student characteristics such as age, gender, ethnicity, and volunteer activity was also examined. Only ethnicity showed an overall significant difference. White dental students appear to have a differing perception of the costs of community service. Conclusions The service-learning program at VCU School of Dentistry has positively impacted senior dental students’ attitude toward community service. PMID:25142286

  8. Psychiatric emergency services in Copenhagen 2012: A 27-year psychiatric and demographic follow-up study.

    Science.gov (United States)

    Moltke, Katinka; Høegh, Erica B; Sæbye, Ditte; Larsen, Peter Lindorff; Reff, Kasper Thybo; Knop, Joachim

    2015-08-01

    Since the first publication of the psychiatric emergency units (PEUs) in Copenhagen 1985, outpatient facilities have undergone considerable changes. Our aim is to examine how these changes have influenced the activities in the PEUs in the same catchment area. We conducted a follow-up study to describe this development in the past 27 years by comparing 1985 variables with same measures in 2012. A random sample of all visits every 10 days in 2012 to three PEUs in Copenhagen were registered and compared with data collected, using the same study design in 1985. The number of visits has decreased significantly from 367 visits/year/10,000 inhabitants in 1985 to 225 in 2012. Apart from a considerable number (15.6%) of visitors with non-Danish background, the demographic variables have not changed significantly since 1985. Compared with 1985, the diagnostic distribution among the 2012 visitors shows an increased frequency of affective disorders and neurotic and stress disorders, while schizophrenia spectrum and personality disorders show almost the same frequencies in 1985 and 2012. Rates of alcoholism and organic mental disorders show a minor reduction during the 27-year follow-up period. In 1985, 20.7% of the visits ended up without any referrals, compared with 4.8% in 2012. The rate of acute admissions into a psychiatric ward was 60.8% in 2012 compared with 35.65% in 1985. The extension of the psychiatric outpatients' facilities since 1985 has reduced the number of visits in the PEUs considerably. The results have shown a change of diagnostic distribution and more severe conditions requiring acute admissions for emergency treatment. Close collaboration with the patients' families, GPs, social authorities and specialized psychiatric outpatient clinics is emphasized.

  9. Higher education and psychiatric disabilities: national survey of campus disability services.

    Science.gov (United States)

    Collins, Mary Elizabeth; Mowbray, Carol T

    2005-04-01

    Students with psychiatric disabilities are an increasing presence on college and university campuses. However, there is little factual information about the services available to these students in campus disability services offices or the extent to which they use these services. This article reports the results of a survey of disability services offices at colleges and universities in 10 states. Data from 275 schools revealed the number of students with psychiatric disabilities seeking assistance from disability services offices, characteristics of these offices, and the types of services they provide. Survey data also identified barriers to full participation of these students in academic settings. Implications of the study are discussed to inform policy and postsecondary institutional practices with the goal of better serving psychiatrically disabled students to maximize their talents and potential. Copyright (c) 2005 APA, all rights reserved.

  10. Access to dental public services by disabled persons.

    Science.gov (United States)

    Leal Rocha, Lyana; Vieira de Lima Saintrain, Maria; Pimentel Gomes Fernandes Vieira-Meyer, Anya

    2015-03-13

    According to the World Health Organization, one in every 10 people has a disability, and more than two-thirds of them do not receive any type of oral dental care. The Brazilian Constitution of 1988 guarantees all civilians including disabled people the right to healthcare, shaping the guidelines of the Brazilian National Health Care System (Sistema Único de Saúde--SUS). However, there is limited information about the true accessibility of dental services. This study evaluated the accessibility of public dental services to persons with disabilities in Fortaleza, Ceará, which has the third highest disability rate in Brazil. A cross-sectional quantitative study using structured questionnaires was administered to dentists (n = 89) and people with disabilities (n = 204) to evaluate the geographical, architectural, and organizational accessibility of health facilities, the communication between professionals and patients with disabilities, the demand for dental services, and factors influencing the use of dental services by people with motor, visual, and hearing impairments. 43.1% of people with disabilities do not recognize their service as a priority of Basic Health Units (BHU), 52.5% do not usually seek dental care, and of those who do (n = 97), 76.3% find it difficult to receive care and 84.5% only seek care on an emergency basis. Forty-five percent are unaware of the services offered in the BHU. Of the dentists, 56.2% reported difficulty in communicating with deaf patients, and 97.8% desired interpreters stationed in the BHU. People with disabilities gave better accessibility ratings than dentists (p = 0.001). 37.3% of the patients and 43.8% of dentists reported inadequate physical access infrastructure (including doors, hallways, waiting rooms, and offices). Dentists (60%) reported unsafe environments and transportation difficulties as geographical barriers, while most people with disabilities did not report noticing these barriers. While access to dental

  11. Medical Services: Medical, Dental, and Veterinary Care

    Science.gov (United States)

    2002-01-28

    Temporomandibular disorder patients in maintenance therapy. c. Class 3. Patients who have oral conditions that if not treated are expected to result in dental...oral infections, or provide timely follow-up care (for example, drain or suture removal) until resolved. (8) Temporomandibular disorders requiring...Standards. Cervical cytological smear (Papanicolaou smear) screening results should be available to the patient within 14 days of specimen collection

  12. Patient aggression in psychiatric services: the experience of a ...

    African Journals Online (AJOL)

    Afr J Psychiatry 2011;14:130-133. African Journal of Psychiatry • May 2011. 130. Introduction. Aggression within in-patient psychiatric settings is well researched, and the attitude of health professionals towards aggression is often the focus of many research reports.1-4. Attitudes are defined as 'a predisposition toward any.

  13. Mood disorders in general hospital inpatients: one year data from a psychiatric consultation-liaison service.

    Science.gov (United States)

    Elisei, Sandro; Pauselli, Luca; Balducci, Pierfrancesco Maria; Moretti, Patrizia; Quartesan, Roberto

    2013-09-01

    Mood disorders (MD) show higher prevalence among psychiatric disorders. As a matter of fact 10% of inpatients in non psychiatric health care structures are affected by MD. A consultation-liaison service bridges the gap between psychiatric and other medical disciplines and increases the cooperation in the context of care, improving the diagnostic process for all inpatients in medical wards. Our sample is composed of 1702 patients assessed from 1 January 2012 to 31 December 2012 referred from the wards for psychiatric specialist evaluation in Santa Maria della Misericordia, Perugia, Italy. Each patient was assessed by a consultant psychiatrist performing a psychiatric interview leading to a diagnosis according to DSM-IV-TR criteria. Clinical and sociodemographic data were collected and registrered in the clinical records. SPSS software (ver. 18) was used for data analysis. Chi-square test and T-student tests were performed as appropriate. A p-valueconsultation referral urgent status we found that 84% of requests needed to be seen within 24 h, most of them come from Emergency room. Statistically significant correlations can be found between the source of referrals, the reasons for the referrals, psychiatric care prior to the evaluation and the psychiatric disorder which was diagnosed during the assessment. Consultation-liaison service for MD in an italian general hospital is generally based on emergency/urgency referrals from the Emergency room for patients already assessed to mental care facilities by private or national health service psychiatrists.

  14. Dental Service Utilization Among Children in the Child Welfare System.

    Science.gov (United States)

    Finlayson, Tracy L; Chuang, Emmeline; Baek, Jong-Deuk; Seidman, Robert

    2018-02-08

    To examine predisposing, enabling, and need-related factors associated with dental utilization by children involved with the child welfare system (CWS). Data were analyzed from the National Survey of Child and Adolescent Well-Being (NSCAW; Wave II), a national probability sample of children (2-17 years) following a welfare assessment during 2008-2009 (n = 2806). Caregiver-reported child receipt of dental services in the past year was the outcome in weighted logistic regression models. Two-thirds of children had a recent dental visit. Older children (OR 2.95, 95% CI 2.06,4.21 for ages 6-11; OR 2.47, CI 1.82, 3.37 for ages 12-17, compared to ages 2-5) were more likely to have visited the dentist, as were children of more educated caregivers (OR 1.68; CI 1.20, 2.36 for high school, OR 2.45; CI 1.71, 3.52 for more than high school). Children without a usual source of care (OR 0.50; CI 0.27, 0.94) and those living with non-biological parents had lower odds of a recent visit (OR 0.64; CI 0.43, 0.97). Children with dental problems were twice as likely to have a recent visit (OR 2.02; CI 1.21, 3.38), while children with unmet needs who could not afford care had lower odds of utilizing services (OR 0.28; CI 0.16, 0.46). Many children in the CWS, especially younger children (ages 2-5), did not have a reported dental visit in the past year. Cost was a barrier, and caregiver status was associated with the likelihood of obtaining dental care. Health and social service providers should refer these children for dental care.

  15. The Low Proportion and Associated Factors of Involuntary Admission in the Psychiatric Emergency Service in Taiwan

    Science.gov (United States)

    Wang, Jen-Pang; Chiu, Chih-Chiang; Yang, Tsu-Hui; Liu, Tzong-Hsien; Wu, Chia-Yi; Chou, Pesus

    2015-01-01

    Background The involuntary admission regulated under the Mental Health Act has become an increasingly important issue in the developed countries in recent years. Most studies about the distribution and associated factors of involuntary admission were carried out in the western countries; however, the results may vary in different areas with different legal and socio-cultural backgrounds. Aims The aim of this study was to investigate the proportion and associated factors of involuntary admission in a psychiatric emergency service in Taiwan. Methods The study cohort included patients admitted from a psychiatric emergency service over a two-year period. Demographic, psychiatric emergency service utilization, and clinical variables were compared between those who were voluntarily and involuntarily admitted to explore the associated factors of involuntary admission. Results Among 2,777 admitted patients, 110 (4.0%) were involuntarily admitted. Police referrals and presenting problems as violence assessed by psychiatric nurses were found to be associated with involuntary admission. These patients were more likely to be involuntarily admitted during the night shift and stayed longer in the psychiatric emergency service. Conclusions The proportion of involuntary admissions in Taiwan was in the lower range when compared to Western countries. Dangerous conditions evaluated by the psychiatric nurses and police rather than diagnosis made by the psychiatrists were related factors of involuntary admission. As it spent more time to admit involuntary patients, it was suggested that multidisciplinary professionals should be included in and educated for during the process of involuntary admission. PMID:26046529

  16. Which skills boost service provider confidence when managing people presenting with psychiatric emergencies?

    Science.gov (United States)

    Poremski, Daniel; Lim, Xin Ya; Kunjithapatham, Ganesh; Koh, Doris; Alexander, Mark; Cheng, Lee

    2016-12-01

    The way service seekers interact with the staff at emergency services has been shown to influence the standard of care, especially in the case of certain psychiatric manifestations. Staff reactions to psychiatric complaints have been linked to their comfort dealing with these types of service users as well as their competencies understanding the illness. It is therefore vital to understand which skills increase confidence in treating psychiatric emergencies. Twenty-six open-ended convergent interviews were conducted with staff working in a psychiatric emergency department. Thematic analysis was used to analyze the data. Participants reported several non-technical skills which developed from exclusively serving people with psychiatric emergencies: 1) Vigilance allowed staff to be sensitive to minor changes in behavior which precede psychiatric emergencies. 2) The ability to negotiate and find tangible solutions was particularly important when dealing with psychiatric complaints which may not have tangible resolutions. 3) The ability to appraise social support networks allowed staff to plan follow-up actions and ensure continuity of care when support was available. 4) The ability to self-reflect allowed participants to learn from their experience and avoid burnout, frustration, and fatigue. Participants also reported several other clinical skills which they gained during training, including teamwork, de-escalating techniques and risk assessment. Tentatively speaking, these skills improve staff's confidence when treating psychiatric emergencies. Certain skills may be generalized to staff working in medical emergency departments who frequently encounter psychiatric complaints. © 2016 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd on behalf of Australian College of Mental Health Nurses Inc.

  17. Utilization of dental services among Medicaid-enrolled children.

    Science.gov (United States)

    Bouchery, Ellen

    2013-01-01

    To assess what characteristics of children and their communities are associated with lower dental service use rates, to support development of strategies to target subgroups of children with lower utilization. The Medicaid Analytic Extract (MAX) 5-percent sample file, known as Mini- MAX 2008. Multivariate logistic regression was used to assess the association between enrollee and county characteristics and dental preventive and treatment service utilization. There is substantial variation in service use by age. Relative to a 9-year-old, a 2-year-old is 28 percentage points less likely, and a 15-year-old is 15 percentage points less likely, to receive a preventive dental service. Children enrolled in Medicaid for only part of the year were significantly less likely to receive a preventive or a treatment service relative to children covered by Medicaid for the full year. For preventive care, children enrolled for nine months were 15 percentage points less likely to have a service. Those enrolled for six months were 30 points less likely; those enrolled for three months were 41 points less likely. Children eligible for Medicaid based on disability were 9 and 6 percentage points less likely to receive a preventive or treatment service, respectively, than their counterparts who were eligible based on income alone. This study identifies some subgroups of children who are particularly underserved and for whom states may need to devote more attention.

  18. Awareness and utilization of dental services among secondary ...

    African Journals Online (AJOL)

    mwakagugu

    Abstract. Aim: To determine the awareness and utilization of dental services among secondary school students in Moshi. Municipality. Materials and Methodology: This cross sectional study among 200 secondary school students aged. 13-21 years old was done using a supervised Kiswahili self administered questionnaire.

  19. Mobile and Portable Dental Services Catering to the Basic Oral ...

    African Journals Online (AJOL)

    Ganavadiya R, Chandrashekar BR, Goel P, Hongal SG, Jain M. Department of ... on the various mobile dental service programs successfully implemented in some developed and .... one parenting variable discussed. ..... pieces, triple syringe and a light curing unit. ... that focused on human immunodeficiency virus positive.

  20. Al Ain Community Survey of Psychiatric Morbidity III. The natural history of psychopathology and the utilization rate of psychiatric services in Al Ain.

    Science.gov (United States)

    Daradkeh, T K; Ghubash, R; Abou-Saleh, M T

    2000-12-01

    We evaluated the natural history of psychopathology in a stratified sample (n = 245) comprising subjects with no DSM-III-R psychiatric disorder, subthreshold disorder and threshold (DSM-III-R) psychiatric disorder, respectively, over a 12-months period, using the Structured Clinical Interview for DSM-III-R mental disorders (SCID) as an assessment tool. A representative sample categorized 1 year earlier into DSM-III-R psychiatric disorder, subthreshold disorder and no DSM-III-R psychiatric disorder were reassessed with SCID 1 year on. The incidence, recovery rates and the percentage of subthreshold disorders which become DSM-III-R disorders were calculated. The utilization rate of psychiatric services was also assessed. The incidence rate of new cases was 10.4%. The recovery (remission) rate was 41.5%, and approximately 20% of subthreshold disorders became definitive disorders (DSM-III-R) after 1 year. Anxiety disorders tend to have a higher magnitude of temporal stability in comparison with depressive disorders. Male sex and contact with psychiatric services were found to affect the recovery rate. Approximately 13% of the sample had made contact with psychiatric services with no gender differences, but men were significantly more often hospitalized than women. Our findings indicate that mental disorders are relatively common. The high incidence rate found in this study is attributed in part to the high negative rate at baseline assessment. Approximately 60% of psychiatric disorders in the community are persistent, and patients with emotional disorder under-utilize existing services.

  1. Differences between Irish and Australian psychiatric nurses' family-focused practice in adult mental health services

    LENUS (Irish Health Repository)

    Grant, Anne

    2016-04-01

    Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

  2. Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia.

    Science.gov (United States)

    Kruger, Estie; Perera, Irosha; Tennant, Marc

    2010-01-01

    Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.

  3. Clinical and demographic profile of cancer patients in a consultation-liaison psychiatric service

    Directory of Open Access Journals (Sweden)

    Vanessa de Albuquerque Citero

    Full Text Available ABSTRACT CONTEXT: An almost 50% prevalence of psychiatric disorders among cancer patients has prompted a series of studies on consultation-liaison psychiatry. Nonetheless, there are few reports on the epidemiological factors involving comorbidity between cancer and psychiatric disorders. OBJECTIVE: To evaluate the epidemiological profile of cancer inpatients referred to the consultation-liaison psychiatric service in an oncology hospital during its first year of activity. TYPE OF STUDY: Descriptive study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: 319 patients referred 412 times to the consultation-liaison psychiatry service. PROCEDURES: From August 97 to July 98, an appraisal was made of data on all admissions registered at the Hospital do Câncer, and also all referrals registered at the consultation-liaison psychiatry service. MAIN MEASUREMENTS: The demographics and patients' clinical data, the type and flow of the request, and the evaluation conducted by the service were analyzed and comparisons with the hospital data were made. The distribution of the number of referrals was used to construct a profile of patients who had repeatedly used the service. RESULTS: Psychiatric diagnoses were found in 59% of the cases. Forty-three percent of these required medication, 18.3% needed psychotherapy, 22.1% family intervention and 20.5% guidance from the staff. Over 22.8% of the consultations were reevaluations, mainly involving younger male patients with worst prognoses. These patients required lengthier and more elaborate intervention, and had higher prevalence of depressive and behavioral disorders. CONCLUSION: A younger and mainly male population of non-surgical oncological cases was referred to the consultation-liaison psychiatric service during its first year of activity. The psychiatric disorder prevalence was higher than expected, and consisted predominantly of mood disorders. We detected a priority group, namely the reevaluated

  4. [Utilization of dental services among the elderly in Brazil].

    Science.gov (United States)

    Martins, Andréa Maria Eleutério de Barros Lima; Barreto, Sandhi Maria; Pordeus, Isabela Almeida

    2007-11-01

    To investigate the pattern of dental services use and its determinants among the elderly in Brazil. The study included the elderly participating in the Ministry of Health of Brazil's oral health survey carried out in 2002 and 2003 who had used dental services at least once in their lifetime. Dentulous and edentulous individuals were compared and analyzed separately using multiple logistic regression. Of 5,009 participants, 46.0% were dentulous and 54.0% edentulous. The prevalence of dental services use in the year right before the survey was 26.6% and 10.4%, respectively. Among dentulous participants, the utilization rate was higher in those with more years of schooling, those who perceived their chewing as poor/very poor, and those who reported feeling oral pain; and lower in those who did not have information on oral health, who perceived their oral health as poor/very poor, those with lower per capita income, those who required prostheses and used them, and who required prostheses and did not use them, those with periodontal problems, and with a higher number of extracted teeth. Among edentulous participants, the utilization rate was higher in those with more years of schooling and those reporting oral pain; and lower in non-whites and in those who did not have information on oral health. The oral health of the elderly in Brazil is deficient and the use of dental services was lower among those who needed them most. The factors associated with dental services utilization differ for dentulous and edentulous individuals. The only similarities are schooling, having information on oral health, and having experienced pain in the teeth and gums in the previous three months. Public investment in oral health is needed to turn around this scenario.

  5. The cost minimization analysis of an outreach dental service: a pilot ...

    African Journals Online (AJOL)

    Background: Access to dental services improves oral health and thereby, overall general health. For people with limited or no access to oral health care services, outreach dental services may be used to reduce oral health inequality. There is however paucity of information on the economic analysis of outreach dental ...

  6. Reconsidering Co-Morbid Traits in Explanatory Models of High Dental Anxiety Using a Comparison of Psychiatric and Normal Patient Samples

    DEFF Research Database (Denmark)

    Moore, Rod; Jensen, Christina Gundlev; Andersen, Line Bæk

    2016-01-01

    Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic...... (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears; 2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items.......) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.; 25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety...

  7. Factors affecting utilization of dental health services and satisfaction among adolescent females in Riyadh City

    Science.gov (United States)

    Al-Hussyeen, Al Johara A.

    2009-01-01

    Objectives This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit. Subjects and methods Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh. Results Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P dental care was the most encouraging factor (P pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P dental care as discouraging factor for using dental services (P dental care as encouraging for the use of dental clinics (P dental care was found to be significantly associated with high quality of dental care, convenient appointment, friendly staff, modern dental clinics and clinics recommended by friends. Conclusion Quality of dental care, reasonable fees for dental services and close location of dental clinics to students’ homes are encouraging factors for utilization of dental services. PMID:23960475

  8. Factors affecting utilization of dental health services and satisfaction among adolescent females in Riyadh City.

    Science.gov (United States)

    Al-Hussyeen, Al Johara A

    2010-01-01

    This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit. Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh. Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P dental care was the most encouraging factor (P pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P dental care as discouraging factor for using dental services (P dental care as encouraging for the use of dental clinics (P dental care was found to be significantly associated with high quality of dental care, convenient appointment, friendly staff, modern dental clinics and clinics recommended by friends. Quality of dental care, reasonable fees for dental services and close location of dental clinics to students' homes are encouraging factors for utilization of dental services.

  9. Responsibility loadings for dental services by general dentists

    Directory of Open Access Journals (Sweden)

    Spencer A John

    2010-06-01

    Full Text Available Abstract Background Responsibility loadings determine relative value units of dental services that translate services into a common scale of work effort. The aims of this paper were to elicit responsibility loadings for a subset of dental services and to relate responsibility loadings to ratings of importance of the components of responsibility. Methods Responsibility loadings and ratings of components of responsibility were collected using mailed questionnaires from a random sample of Australian private general practice dentists in 2007 (response rate = 77%. Results Median responsibility loadings were 1.25 for an initial oral examination and for a 3+-surface amalgam restoration, 1.50 for a simple extraction and for root canal obturation (single canal, and 1.75 for subgingival curettage (per quadrant. Across the five services coefficients from a multivariate logit model showed that ratings of importance of knowledge (0.34, dexterity (0.24, physical effort (0.28 and mental effort (0.48 were associated with responsibility loadings (P Conclusions The elicited median responsibility loadings showed agreement with previous estimates indicating convergent validity. Components of responsibility were associated with loadings indicating that components can explain and predict responsibility aspects of dental service provision.

  10. What do you think of us? Evaluating patient knowledge of and satisfaction with a psychiatric outpatient service.

    LENUS (Irish Health Repository)

    Jabbar, F

    2011-03-01

    This study aimed to measure patient satisfaction with the care they were receiving; examine patients\\' knowledge of the psychiatric services in general; and identify variables associated with satisfaction.

  11. Measuring quality of dental care: Caries prevention services for children.

    Science.gov (United States)

    Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

    2015-08-01

    The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention services. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  12. Perceptions of Private Dental Practitioners of Specialist Prosthodontic Dental Services in Gujarat: A Survey.

    Science.gov (United States)

    Shah, Rachana J; Shah, Sujal G; Vyas, Sneha; Patel, Ghanshyam C

    2014-12-01

    To identify the perceptions towards and utilization of specialist Prosthodontic services among Private Dental Practitioners (PDPs) of Gujarat state. To study the influence of presence or absence of a Prosthodontic post graduate course during the PDP's dental education and years of experience in practice on the decisions to treat Prosthodontic cases themselves or to utilise Prosthodontic speciality services. A postal questionnaire examined by a panel of Prosthodontists, piloted on 15 PDPs, was sent to 150 randomly selected private dental practitioners of Gujarat state. The collected data were subjected to descriptive and Chi-square statistical analysis. Though 78.64 % dentists considered the treatment provided by the Prosthodontist to be effective, only 34.95 % of them availed their services. 33 % PDPs without a Prosthodontic post graduate course in their institute were significantly more likely to refer patients to a Prosthodontist. Years of experience had no influence on utilization of Prosthodontic speciality service. 18.44 % PDPs had a Prosthodontic speciality clinic in their region, 65.04 % did not have, whereas 11.65 % were not aware of such clinic. PDPs have high regards for the Prosthodontic speciality but their reported demand was less as compared to other specialities indicating a need for the Prosthodonitst to put in efforts to make the PDPs aware of their services.

  13. Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?

    Directory of Open Access Journals (Sweden)

    Minna Sadeniemi

    2014-08-01

    Full Text Available Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration.

  14. The Dental Services Research Scholars Program.

    Science.gov (United States)

    Keenan, Terrance

    1983-01-01

    A foundation program to bring research on health services and policy issues into the domain of clinical scholarship is described. The principal approach is to train young clinicians for academic careers with major responsibilities in health studies at university health sciences centers. (MSE)

  15. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service

    Directory of Open Access Journals (Sweden)

    Savanheimo Nora

    2012-10-01

    Full Text Available Abstract Background Dental general anaesthesia (DGA is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients’ overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. Methods The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age ( Results The DGA patients (n=349 were aged 2.3 to 67.2 years. Immigrants predominated in the youngest age group (p Conclusions Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of comprehensive, conservative DGA in the Helsinki PDS. The reasons for the use of DGA and the treatments provided varied according to personal and medical background, and immigration status with no gender-differences. Preventive measures formed only a minor part of the dental care given under DGA.

  16. Explaining lifetime criminal arrests among clients of a psychiatric probation and parole service.

    Science.gov (United States)

    Solomon, P; Draine, J

    1999-01-01

    This study examines the extent to which sociodemographic characteristics, clinical characteristics, substance abuse problems, and the array of lifetime criminal behavior may explain lifetime arrests among offenders supervised by the psychiatric probation and parole service. Three hundred twenty-five clients with new cases at a psychiatric probation and parole service in a large urban center were screened for major psychiatric disorders. They were also interviewed for socio-demographic characteristics, mental health treatment history, criminal behavior, and arrest history. Hierarchical block multiple regression analysis tested a model explaining lifetime arrests. After controlling for age and other demographic variables, the number of lifetime psychiatric hospitalizations and lifetime occurrences of mania diagnosis significantly explained lifetime arrests. The total model explained about 10 percent of the variance in lifetime arrests after controlling for opportunity variables, which explained 45 percent. The explanatory power of lifetime hospitalizations and mania support the contention that symptoms, rather than diagnosis, may be the most important clinical factor in explaining criminal arrest among persons with mental illness. Implications for psychiatric services include the development of effective jail diversion programs.

  17. Children's use of dental services: influence of maternal dental anxiety, attendance pattern, and perception of children's quality of life.

    Science.gov (United States)

    Goettems, Marília L; Ardenghi, Thiago M; Demarco, Flávio F; Romano, Ana R; Torriani, Dione D

    2012-10-01

    The purpose of the study was to investigate the influence of a child's clinical condition; maternal characteristics such as dental anxiety and dental visit pattern; socioeconomic conditions; and maternal perception of the child's oral health-related quality of life (OHRQoL) on a child's use of dental care services. A cross-sectional study of 608 mother-child dyads was conducted during the Children's Immunization Campaign in Pelotas, Brazil. Mothers answered a questionnaire regarding their use of dental services, dental anxiety (Dental Anxiety Scale), socioeconomic status, and perception of their children's OHRQoL (the Early Childhood Oral Health Impact Scale). Clinical examination of the children was performed to assess dental caries (dmf-t). Associations between the above-mentioned factors and child use of dental services were assessed using Poisson regression models (prevalence ratio [PR]; 95% CI; P ≤ 0.05). The majority of children (79.3%) had never had a dental appointment and of the children who had visited a dentist, 55 (43.65%) presented with untreated dental caries at the time of examination. More than half the mothers (60.2%) did not visit a dentist regularly. In the final model, low schooling level of mothers (PR, 0.64) and irregular visits to a dentist by the mother (PR, 0.48) were factors because of which a child did not have a dental appointment. Children who had experienced pain (PR, 1.56), those who had poor OHRQoL (PR, 1.49), and older children (PR, 2.14) visited a dentist with higher frequency. Use of dental care services by preschool children was low, and treatment was neglected even among children who had visited a dentist. Children of mothers with low schooling level who do not visit a dentist regularly were at greater risk of not receiving dental care. Maternal perception of their child's oral health motivated visits to the dentist. © 2012 John Wiley & Sons A/S.

  18. Hard to reach communities or hard to access services? Migrant mothers' experiences of dental services.

    Science.gov (United States)

    Riggs, E; Gussy, M; Gibbs, L; van Gemert, C; Waters, E; Kilpatrick, N

    2014-06-01

    Good oral health is an important component of overall health which can help migrants settle in a new country. Infant oral health is intimately associated with maternal oral health knowledge and behaviours and therefore, encounters with dental services. This study aimed to explore the experiences of dental service use from the perspective of migrant mothers living in Melbourne, Australia. A participatory research approach utilizing qualitative methods was adopted. Women from Iraq, Lebanon and Pakistan participated. Semi-structured focus groups and interviews were conducted and thematic analysis of the data was completed. Focus groups (n = 11) and interviews (n = 7) were conducted with 115 women. Despite an understanding that visiting the dentist was important for promoting oral health, the first dental contact for both the women and their children was typically for emergency care. Accessibility, cost and waiting lists were identified as significant barriers to attendance. Problematic interpreter encounters often led to negative experiences which were compounded by a perception that public services provided poorer quality of care. Despite evidence of poorer oral health, migrant women face significant barriers in accessing mainstream dental services. Reorientation of such services, to address the accessibility and experience for migrant communities may help reduce oral health inequalities. © 2014 Australian Dental Association.

  19. Psychiatric services for preschoolers: an emerging need | Lumu ...

    African Journals Online (AJOL)

    52.8%; N = 70), and was not over-represented amongst boys. ... Vulnerability of this age group and limited sub-specialist resources emphasise the need for the development of community services leading to early recognition and intervention.

  20. [The transformation of the dental services market and the battle over a monopoly in 19th century dental practice].

    Science.gov (United States)

    Carvalho, Cristiana Leite

    2006-01-01

    The article analyzes the process by which dentistry acquired the status of a profession. The setting is the mid-nineteenth-century United States, where the West's first professional dental organizations were founded, and the focus is on some aspects of the development of a dental market and on the professional disputes among practitioners of the dental trade, who wanted a monopoly within this field of knowledge. Certain outside factors played a major role in the emergence of the profession, including changes in patterns of sugar consumption (which spread dental caries disease throughout society) as well as the expansion of the dental service market. The subsequent proliferation of distinct groups of dental practitioners--both qualified and unqualified to practice dentistry--and their competition for a place in the dental market reflect the battle waged to establish jurisdiction in this field and the emergence of dentistry as a 'modern profession'.

  1. New Research into General Psychiatric Services for Adults with Intellectual Disability and Mental Illness

    Science.gov (United States)

    Chaplin, R.

    2009-01-01

    Background: There are a variety of models for the mental health care of adults with comorbid intellectual disability (ID) and mental illness. There has been a long-running debate as to whether this should be provided by general psychiatric or specialised ID services. A previous review concluded that there was no clear evidence to support either…

  2. 75 FR 22140 - Office of Clinical and Preventive Services; Division of Oral Health; Dental Preventive and...

    Science.gov (United States)

    2010-04-27

    ... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services; Division of Oral Health; Dental Preventive and Clinical Support Centers Program Announcement Type: New and Continuing Competitive... Service (IHS) is accepting competitive applications for the Dental Preventive and Clinical Support Centers...

  3. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear

    OpenAIRE

    Spencer A John; Stewart Judy F; Armfield Jason M

    2007-01-01

    Abstract Background Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored. Methods The study used a telephone interview survey with interviews predominantly conducted in 2002. A random sample of 6,112 Australian residents aged 16 years and over was selected from 13 strata across all States and Territories....

  4. Psychiatric services in primary care settings: a survey of general practitioners in Thailand

    Directory of Open Access Journals (Sweden)

    Saipanish Ratana

    2006-07-01

    Full Text Available Abstract Background General Practitioners (GPs in Thailand play an important role in treating psychiatric disorders since there is a shortage of psychiatrists in the country. Our aim was to examine GP's perception of psychiatric problems, drug treatment and service problems encountered in primary care settings. Methods We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand. Results Four hundred and thirty-four questionnaires (36.4% were returned. Sixty-seven of the respondents (15.4% who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years. 65.6% (SD = 19.3 of the total patients examined had physical problems, 10.7% (SD = 7.9 had psychiatric problems and 23.9% (SD = 16.0 had both problems. The most common psychiatric diagnoses were anxiety disorders (37.5%, alcohol and drugs abuse (28.1%, and depressive disorders (29.2%. Commonly prescribed psychotropic drugs were anxiolytics and antidepressants. The psychotropic drugs most frequently prescribed were diazepam among anti-anxiety drugs, amitriptyline among antidepressant drugs, and haloperidol among antipsychotic drugs. Conclusion Most drugs available through primary care were the same as what existed 3 decades ago. There should be adequate supply of new and appropriate psychotropic drugs in primary care. Case-finding instruments for common mental disorders might be helpful for GPs whose quality of practice was limited by large numbers of patients. However, the service delivery system should be modified in order to maintain successful care for a large number of psychiatric patients.

  5. Community-oriented services in a psychiatric hospital. Effort to ...

    African Journals Online (AJOL)

    “Yaba apa osi” (Yaba to the left side). Consequently, in the year 2000 the hospital stepped up its efforts on destigmatization through public enlightenment programmes and provision of commercial /social as well as general health care services in the institution that would bring or attract the citizenry to its facilities. We carried ...

  6. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear.

    Science.gov (United States)

    Armfield, Jason M; Stewart, Judy F; Spencer, A John

    2007-01-14

    Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored. The study used a telephone interview survey with interviews predominantly conducted in 2002. A random sample of 6,112 Australian residents aged 16 years and over was selected from 13 strata across all States and Territories. Data were weighted across strata and by age and sex to obtain unbiased population estimates. People with higher dental fear visited the dentist less often and indicated a longer expected time before visiting a dentist in the future. Higher dental fear was associated with greater perceived need for dental treatment, increased social impact of oral ill-health and worse self-rated oral health. Visiting patterns associated with higher dental fear were more likely to be symptom driven with dental visits more likely to be for a problem or for the relief of pain. All the relationships assumed by a vicious cycle of dental fear were significant. In all, 29.2% of people who were very afraid of going to the dentist had delayed dental visiting, poor oral health and symptom-driven treatment seeking compared to 11.6% of people with no dental fear. Results are consistent with a hypothesised vicious cycle of dental fear whereby people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear.

  7. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear

    Directory of Open Access Journals (Sweden)

    Spencer A John

    2007-01-01

    Full Text Available Abstract Background Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored. Methods The study used a telephone interview survey with interviews predominantly conducted in 2002. A random sample of 6,112 Australian residents aged 16 years and over was selected from 13 strata across all States and Territories. Data were weighted across strata and by age and sex to obtain unbiased population estimates. Results People with higher dental fear visited the dentist less often and indicated a longer expected time before visiting a dentist in the future. Higher dental fear was associated with greater perceived need for dental treatment, increased social impact of oral ill-health and worse self-rated oral health. Visiting patterns associated with higher dental fear were more likely to be symptom driven with dental visits more likely to be for a problem or for the relief of pain. All the relationships assumed by a vicious cycle of dental fear were significant. In all, 29.2% of people who were very afraid of going to the dentist had delayed dental visiting, poor oral health and symptom-driven treatment seeking compared to 11.6% of people with no dental fear. Conclusion Results are consistent with a hypothesised vicious cycle of dental fear whereby people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear.

  8. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    LENUS (Irish Health Repository)

    Prabhu, Neeta T

    2010-03-01

    The goal of this study was to elicit the views of patients or parents\\/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients\\/parents\\/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent\\/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.

  9. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    Science.gov (United States)

    Prabhu, Neeta T; Nunn, June H; Evans, D J; Girdler, N M

    2010-01-01

    The goal of this study was to elicit the views of patients or parents/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients/parents/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.

  10. Child maltreatment - prevalence and characteristics of mandatory reports from dental professionals to the social services.

    Science.gov (United States)

    Kvist, Therese; Cocozza, Madeleine; Annerbäck, Eva-Maria; Dahllöf, Göran

    2017-01-01

    Dental professionals are required to report suspicions of child maltreatment to the social services. As yet, no studies assess the prevalence of these mandated reports from dental care services or their content. This study investigates the prevalence and characteristics of mandated reports from dental professionals to the social services. Furthermore, it analyses associations between dental professionals reporting suspicions of maltreatment with such reports from other sources. The study collected dental mandatory reports from within one municipality of Sweden during 2008-2014. The material consisted of a total of 147 reports by dental professionals regarding 111 children. The total prevalence of reports from dental care services to the social services was 1.5 per 1000 children with a significant increase between 2008 and 2011 (P social services. Reports to the social services from dental care services on suspicions of child maltreatment concern parental deficiencies (failure to attend appointments) and neglect (dental neglect). Mandated reports from dental care services often co-occur with other mandated reports. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Factors influencing the use of public dental services: An application of the Theory of Planned Behaviour

    Directory of Open Access Journals (Sweden)

    Spencer A John

    2008-04-01

    Full Text Available Abstract Background There is limited evidence of the influence of psychosocial factors and health beliefs on public dental patient's patterns of service use in Australia. The research aims were to examine associations between dental attitudes and beliefs of public dental service users and dental visiting intention and behaviour using the Theory of Planned Behaviour. Methods 517 randomly selected adult public dental patients completed a questionnaire assessing dental attitudes and beliefs which was matched with electronic records for past and future dental service use. A questionnaire measured intentions, attitudes, subjective norms and perceptions of behavioural control and self-efficacy in relation to visiting public dentists. A measure of dental attendance at public dental clinics was obtained retrospectively (over 3 1/2 years and prospectively (over a one year period following the return of the questionnaire by accessing electronic patient clinical records. Results Participants had positive attitudes, subjective norms and self-efficacy beliefs towards dental visiting but perceived a lack of control over visiting the dentist. Attitudes, subjective norms, self-efficacy and perceived control were significant predictors of intention (P Conclusion Public dental patients held favourable attitudes and beliefs but perceived a lack of control towards dental visiting. Reducing structural barriers may therefore improve access to public dental services.

  12. [Factors associated with satisfaction with dental services among the elderly].

    Science.gov (United States)

    Rodrigues, Carlos Alberto Quintão; Silva, Paula Luciana Veloso; Caldeira, Antônio Prates; Pordeus, Isabela Almeida; Ferreira, Raquel Conceição; Martins, Andréa Maria Eleutério de Barros Lima

    2012-12-01

    To analyze the prevalence of elderly users' satisfaction with dental care and associated factors. Cross-sectional study conducted with 495 elderly individuals aged 65-74 years, without cognitive impairment according to the Mini-Mental State Examination, who used dental services of the municipality of Montes Claros (Southeastern Brazil) from 2008 to 2009. A two-stage cluster, complex probability sample was used. Trained/ calibrated professionals and students conducted tests and household interviews using handheld computers with software developed for this purpose. In the statistical analysis, with correction by design effect, PASW® Statistics 18.0 was utilized. To identify associations between satisfaction and the factors of interest, Poisson regression was conducted, estimating the prevalence ratio and the 95% confidence interval (PR / 95%CI). Overall, 91.4% of the elderly were satisfied. Greater satisfaction was found among users of services of the Sistema Único de Saúde (SUS - Brazil's National Health Service) (PR = 1.07; 95%CI 1.01;1.12); those who had access to information on how to avoid oral problems (PR = 1.09; 95%CI 1.02;1.16); those who did not use medicines (PR = 1.05; 95%CI 1.00;1.10); and those who rated the appearance of their teeth and gums as excellent or good (PR = 1.13; 95%CI 1.00;1.28). The elderly who access the service offered by SUS have greater satisfaction with dental treatment, as well as those who do not use medicines, those with better self-perception of the aesthetics of teeth and gums and those who have more access to information about how to prevent oral problems. Therefore, health care policies in the SUS have been presenting positive results.

  13. "Meth Mouth": An Interdisciplinary Review of a Dental and Psychiatric Condition.

    Science.gov (United States)

    Stanciu, Cornel N; Glass, Magdalena; Muzyka, Brian C; Glass, Oliver M

    Chronic methamphetamine (MA) users experience many dental problems, a condition characterized as "meth mouth." These devastating effects on dentition is the main reason why many seek professional help. Here, we discuss the effects of MA on oral health and advocate for improved collaboration between dentists and mental health providers. We also introduce a dental evaluation tool with the goal of improving the quality of care for this often-marginalized patient population. A Medline literature search (1985-2016) was conducted with keywords "meth mouth," "methamphetamine AND oral health"; "methamphetamine AND dental"; "methamphetamine AND dentist." Results were supplemented by references gleaned from recent reviews, credible online sources, and citations of search returns. MA predisposes users to tooth decay. They are also more likely to have missing dentition with a linear relationship correlating the number of years of use. A constellation of dental symptoms resulting from chronic MA use has been described in literature: gingival inflammation, excessive tooth wear, decreased salivary output, and severe dental caries. With continued use, mucosal lesions may appear on the lips and the gingival tissue may recede. MA can trigger bruxism, resulting in severe wear patterns and even cracked teeth. Users of MA have many unmet medical and mental health needs. An interdisciplinary approach between dentists and mental health providers can improve outcomes. The dental evaluation tool described here can improve the bidirectional collaboration between mental health and dentistry. Dental professionals are in a unique position to identify users and can facilitate referral to substance abuse treatment. Likewise, mental health providers can identify, assess severity, and prompt users for medical and dental attention.

  14. Dental caries, parents educational level, family income and dental service attendance among children in Italy.

    Science.gov (United States)

    Cianetti, S; Lombardo, G; Lupatelli, E; Rossi, G; Abraha, I; Pagano, S; Paglia, L

    2017-03-01

    The aim of this study was to verify whether socioeconomic determinants, such as parents' educational level, family income and dental service attendance by children, are associated with the presence of caries among an Italian population of children. An observational retrospective study was carried out in a population of children aged 4-14 years who visited the Paediatric Dentistry Department of the University of Perugia, Italy. Children were stratified according to familial socioeconomic level (father's and mother's educational level, family income) and dental service attendance of children. Age- and sex- adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated by means of multivariate logistic regression models. A sample of 231 children (mean age 8.1 yrs, SD 2.6; 127 males, 104 females) was recruited. One hundred and sixty three (70.46%) children in the study had caries. Caries presence in children was higher in children where the mothers' educational level was lower (OR =6.1; 95% CI = 3.1 to 12.7), in children where the fathers' educational level was lower (OR =2.9; 95% CI =1.6 to 5.5) and in children with lower family income (OR = 9.9; 95% 95% CI = 5.1 to 20.1). No statistically significant difference were observed in terms of caries presence between the children who were visited at least once by a dentist and children who were not previously seen by a dental practitioner (OR = 0.8; 95% CI = 0.4 to 1.6). Socioeconomic level was an important predictor of caries presence among children. Both low income and low parental educational level were related to an increased presence of caries, whereas previous dental visits experience did not affect caries presence in children.

  15. A brief intervention is sufficient for many adolescents seeking help from low threshold adolescent psychiatric services

    Directory of Open Access Journals (Sweden)

    Laukkanen Eila

    2010-09-01

    Full Text Available Abstract Background There has been a considerable increase in the need for psychiatric services for adolescents. Primary health care practitioners have a major role in detecting, screening and helping these adolescents. An intervention entitled SCREEN is described in this article. The SCREEN intervention was developed to help practitioners to detect and screen adolescent needs, to care for adolescents at the primary health care level and to facilitate the referral of adolescents to secondary care services in collaboration between primary and secondary health care. Secondly, the article presents the background and clinical characteristics of youths seeking help from the SCREEN services, and compares the background factors and clinical characteristics of those patients referred and not referred to secondary care services. Methods The SCREEN intervention consisted of 1 to 5 sessions, including assessment by a semi-structured anamnesis interview, the structured Global Assessment Scale, and by a structured priority rating scale, as well as a brief intervention for each adolescent's chosen problem. Parents took part in the assessment in 39% of cases involving girls and 50% involving boys. During 34 months, 2071 adolescents (69% females entered the intervention and 70% completed it. The mean age was 17.1 years for boys and 17.3 years for girls. Results For 69% of adolescents, this was the first contact with psychiatric services. The most common reasons for seeking services were depressive symptoms (31%. Self-harming behaviour had occurred in 25% of girls and 16% of boys. The intervention was sufficient for 37% of those who completed it. Psychosocial functioning improved during the intervention. Factors associated with referral for further treatment were female gender, anxiety as the main complaint, previous psychiatric treatment, self-harming behaviour, a previous need for child welfare services, poor psychosocial functioning and a high score in the

  16. Predicting incarceration of clients of a psychiatric probation and parole service.

    Science.gov (United States)

    Solomon, Phyllis; Draine, Jeffrey; Marcus, Steven C

    2002-01-01

    This study assessed the extent to which clinical characteristics, psychiatric status, and use of mental health services explain incarceration for technical violations of probation or parole rather than incarceration for new offenses. A total of 250 clients of an urban psychiatric probation and parole service were screened for psychiatric diagnoses and monitored with a 12-month data collection protocol. Longitudinal analysis was used to explain incarceration on new charges, incarceration on technical violations of probation and parole, or absence of incarceration. Eighty-five individuals (34 percent) were incarcerated during the follow-up period. Forty-four (18 percent) were incarcerated for a new offense, and 41 (16 percent) were incarcerated for a technical violation. Participation in mental health treatment was associated with a lower risk of incarceration for a technical violation. Intensive monitoring by mental health providers, such as through case management and medication management, were significant risk factors for incarceration for a technical violation. Clients who were incarcerated for a technical violation were more than six times as likely to have received intensive case management services. The role of mental health services in reducing the risk of incarceration remains mixed. Providing services that emphasize monitoring tends to increase the risk of incarceration for technical violations of criminal justice sanctions. However, any participation in treatment and motivation to participate in treatment appears to reduce the risk of incarceration.

  17. Predictors of aggression on the psychiatric inpatient service.

    Science.gov (United States)

    Serper, Mark R; Goldberg, Brett R; Herman, Kristine G; Richarme, Danielle; Chou, James; Dill, Charles A; Cancro, Robert

    2005-01-01

    Patients with severe mental illness are at increased risk to commit acts of aggression in the inpatient hospital setting. Aggressive behaviors have severe negative consequences for the patient, victims, clinical staff, and the therapeutic community as a whole. While risk factors of community and inpatient aggression overlap, many predictive factors diverge between the two settings. For example, while medication noncompliance has been a robust predictor of community aggression, this factor has little predictive value for inpatient settings where patients' pharmacotherapy is closely monitored. Relatively fewer investigators have examined a wide range of predictive factors associated with aggressive acts committed on the psychiatry inpatient service, often with conflicting results. The present study examined demographic, clinical, and neurocognitive performance predictors of self, other, object, and verbal aggressiveness in 118 acute inpatients. Results revealed that the arrival status at the hospital (voluntary vs involuntary), female gender, and substance abuse diagnosis were predictors of verbal aggression and aggression against others. Impaired memory functioning also predicted object aggression. Fewer symptoms, combined with higher cognition functioning, however, were significant predictors of self-aggressive acts committed on the inpatient service. The need for relating predictors of specific types of aggressiveness in schizophrenia is discussed.

  18. Mediators between education and dental pain: a cross-sectional study to assess the role of dental services utilization.

    Science.gov (United States)

    Constante, Helena M; Peres, Marco A; Schroeder, Fernanda C; Bastos, João L

    2016-02-01

    This study tested whether the pattern of dental services utilization and the reason for the last dental visit mediate the association between educational attainment and dental pain. This is a cross-sectional analysis (n = 1099) based on data from a prospective cohort study in adults, southern Brazil. The mediating effects were assessed by including interaction terms in logistic regression models and by the KHB method, which estimated the direct, mediated, and total effects of education on dental pain. The prevalence of dental pain was 17.5%. Individuals with less than 12 yr of study who visited the dentist to solve dental problems had a 20% higher odds of reporting dental pain than those with 12 or more years of study, who sought the dentist for preventive reasons. Dental services should also focus on preventive measures, especially if less-educated individuals visit the dentist only to treat problems; this may help reduce the frequency of negative oral health outcomes, including dental pain. © 2015 Eur J Oral Sci.

  19. Dental service rates: age, period, and cohort effects.

    Science.gov (United States)

    Brennan, D S; Ryan, P; Spencer, A J; Szuster, F S

    2000-06-01

    Variation in dental service provision over time has been related to changes in factors such as oral health and demographics. Dentist factors such as age and cohort effects are also potential sources of influence. The aim of the study was to examine the operation of age, period, and cohort factors on variation in service rates. data were collected by a mailed survey of a random sample of 10% of male and 40% of female dentists from each state/territory of Australia in 1983-84, 1988-89. and 1993-94 with response rates of 73, 75 and 74% respectively. Data on main areas of service were obtained from a log of service items provided on a typical day. Poisson regressions of rates for the 10 main areas of service over time showed increased rates over the study period for diagnostic, preventive, endodontic, crown and bridge, general/miscellaneous and orthodontic services, and decreased rates of prosthodontic services. Goodness-of-fit tests indicated that models for periodontal and endodontic services had a good fit. However, only endodontic services were readily interpretable in terms of descriptive trends. While the age-period-cohort model was preferred, age-period and age-cohort models were also examined because of problems of identification with age-period-cohort models. Endodontic rates were higher among younger dentist birth cohorts, and increased over the 10-year study period for most cohorts of dentists. If these effects for dentist cohorts were extrapolated over the next 10-year interval, the distribution of services would alter, with endodontic services emerging as a dominant area behind restorative, diagnostic, and preventive services.

  20. Psychiatric service users' experiences of emergency departments: a CERQual review of qualitative studies.

    Science.gov (United States)

    Carstensen, Kathrine; Lou, Stina; Groth Jensen, Lotte; Konstantin Nissen, Nina; Ortenblad, Lisbeth; Pfau, Margarete; Vedel Ankersen, Pia

    2017-05-01

    There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users' experiences regarding general EDs is limited. To identify and summarize current, qualitative evidence regarding service users' experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries. Screening by title/abstract identified 57 studies and, after full text assessment, nine studies were included. The included studies were critically appraised using CASP. Thematic synthesis was applied for data extraction and identification of findings. The CERQual approach was utilized to assess the confidence of the findings. The results of the review showed moderate confidence in the findings that service users experience meeting caring and judgmental ED staff, and that waiting times and a stressful environment are integral to their ED experiences. In contrast, low-to-very low confidence was seen in the findings that service users experience having their symptoms ignored and that EDs are used due to a lack of alternatives. A companion may improve service users experience and outcome of ED visits. Service users experience stress and discomfort in the ED. Service users highly appreciate knowing staff who can ease the discomfort. Overall, the results of this review speak in favour of integrated EDs where service users' needs are more likely to be recognized and accommodated.

  1. Adults with Learning Disabilities Experiences of Using Community Dental Services: Service User and Carer Perspectives

    Science.gov (United States)

    Lees, Carolyn; Poole, Helen; Brennan, Michelle; Irvine, Fiona

    2017-01-01

    Background: The government alongside other health and social care organisation have identified the need to improve the care provided for people with learning disabilities. Materials and Methods: This service evaluation aimed to explore the experiences of people with learning disabilities and their carers who accessed community dental services…

  2. 38 CFR 3.381 - Service connection of dental conditions for treatment purposes.

    Science.gov (United States)

    2010-07-01

    ... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for treatment purposes. (a) Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses... dental conditions for treatment purposes. 3.381 Section 3.381 Pensions, Bonuses, and Veterans' Relief...

  3. Community emergency psychiatric service in Israel: a one-year experience.

    Science.gov (United States)

    Khawaled, Razek; Bauer, Arie; Rosca, Paola; Helman, Dafna; Shai, Uzi; Grinshpoon, Alexander; Ponizovsky, Alexander M

    2009-01-01

    In 2005 the Forensic Psychiatry Department of Mental Health Services at the Ministry of Health launched a pilot project: the Community Emergency Psychiatric Service (CEPS). The purpose was to offer community-based emergency response to acute psychiatric conditions during after-hours periods, including Saturdays and holidays. The project was implemented in the Tel Aviv, Central and Southern districts. Advertisements were posted in mass circulating newspapers announcing the launching of the new program for the general public in the participating districts. The public was invited to call the hotline of the medical emergency service, Magen David Adom (MDA), in the event of psychiatric distress or emergency. MDA personnel were instructed to give the callers a telephone number of an on-call psychiatrist. The Ministry of Health engaged a pool of seven licensed psychiatrists to be available on-call one per shift. The psychiatrists offered crisis intervention over the phone or house visits when necessary. Data were obtained from the Tel Aviv, Central and Southern Districts. The results show that there were 1,472 calls between May 2005 and June 2006. In 198 cases (13.5%) clients were referred for treatment and follow-up to local outpatient clinics, while in 116 of the cases (7.8%) a home visit by the on-call psychiatrist was carried out, resulting in 50 voluntary and 16 involuntary hospitalizations. An examination of records of calls received by the on-call psychiatrists (N=97) during August 2006 suggests that most callers fit the following profile: female, ranging in age 19-35, unmarried, with diagnosis of schizophrenia, with no previous psychiatric hospitalizations, and presenting no danger to herself or others. A limited response team, comprised of one on-call psychiatrist per shift, can provide a viable service for psychiatric emergencies in a population center of approximately 2.7 million. The findings also suggest that such a service may increase the number of

  4. Measuring service quality of public dental health care facilities in Kelantan, Malaysia.

    Science.gov (United States)

    John, Jacob; Yatim, Fekriah Mohd; Mani, Shani Ann

    2011-09-01

    This study investigates patients' expectations and perceptions of service quality in public dental health care and measures their "satisfaction gap." This descriptive study involved 481 dental outpatients in Kelantan, Malaysia. A modified SERVQUAL 20-item instrument was used to assess patients' expectations before and perceptions after receiving dental treatment. The "satisfaction gap" was then measured. showed that patients visiting for management of dental pain were more satisfied (P = .007) than those visiting with appointment. The most significant service quality dimensions were related to responsiveness, assurance, and empathy of the dental health care providers. There was a significant difference between the patients' expectations and their perceptions of service provided (P < .01) with regard to all dimensions. In conclusion, dental service providers should give emphasis to the compassionate and emotional aspects of care and to remember that they are integral components of quality service.

  5. Association Between Employee Dental Claims, Health Risks, Workplace Productivity, and Preventive Services Compliance.

    Science.gov (United States)

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B

    2017-08-01

    This study examined differences in health risks and workplace outcomes among employees who utilized preventive dental services compared with other employees. A retrospective observational study of employees of a large financial services corporation, with data from health risk appraisal questionnaires, medical claims, pharmacy claims, and dental claims. Employees with no dental claims were significantly more likely to have a variety of health risk factors (such as obesity and tobacco use), health conditions (such as diabetes), absenteeism, and lost on-the-job productivity, and were significantly less likely to be compliant with clinical preventive services compared with those with preventive dental claims. Employees with preventive dental claims had fewer health risks and medical conditions and better health and productivity measures. Study employees underutilized free dental care; employers should incorporate preventive dental care awareness into their worksite wellness programs.

  6. The provision of dental implants in the National Health Service Hospital dental services--a national questionnaire.

    Science.gov (United States)

    Butterworth, C J; Baxter, A M; Shaw, M J; Bradnock, G

    2001-01-27

    To assess the activity of consultants in restorative dentistry in the United Kingdom in the provision of osseointegrated dental implants within the National Health Service Hospital service and to evaluate their attitudes concerning the relevant medical and oral factors considered in patient selection for implant treatment. Anonymous postal questionnaire in the United Kingdom. Consultants in restorative dentistry. Out of the sample of 145, 109 consultants (75%) completed the questionnaire in 1999. 54 of the 109 consultants (49.5%) are involved in the provision of osseointegrated implant treatment, treating an average of 29 cases/year (range 2-150). However, over one third of the respondents treated 10 or less cases/year. 89% worked with oral surgeons as an implant team. 68% used Branemark (Nobel Biocare) implants as their main system. The majority of consultants felt that smoking, psychoses and previous irradiation were the most important medical factors that contra-indicated implant retained restorations whilst untreated periodontitis, poor oral hygiene and uncontrolled caries were the most important oral contra-indications. Many centres were experiencing significant problems with the funding of implant treatment with one centre receiving no funding. The implications for patient care and specialist training are discussed. There is a marked variation in the number of patients treated with endosseous dental implants within the United Kingdom National Health Service hospitals. Many consultants treat 10 or fewer patients each year. In the main, there is agreement about the factors that contra-indicate implant treatment; these are in line with national guidelines.

  7. Psychiatric Emergency Services for the U.S. Elderly: 2008 and Beyond

    OpenAIRE

    Walsh, Patrick G.; Currier, Glenn; Shah, Manish N.; Lyness, Jeffrey M.; Friedman, Bruce

    2008-01-01

    In 2011 the oldest baby boomers will turn age 65. Although healthcare researchers have started to examine the future preparedness of the healthcare system for the elderly, psychiatric emergency services (PES) have been widely overlooked. Research is needed to address PES need and demand by older patients, assess the consequences of this need/demand, and establish recommendations to guide PES planning and practice. The authors examined journal articles, review papers, textbooks, and electronic...

  8. Identifying service quality strengths and weaknesses using SERVQUAL: a study of dental services.

    Science.gov (United States)

    Kaldenberg, D; Becker, B W; Browne, B A; Browne, W G

    1997-01-01

    The goal of this study was to examine responses among dental patients to the most recent version of SERVQUAL, and to evaluate that instrument as a tool for measuring satisfaction in a dental practice. Items on the reliability and responsiveness dimensions produced the lowest satisfaction ratings, while improvements in providing services as promised and instilling confidence have the greatest potential for producing higher satisfaction among patients. Finally, using open-ended questions, we identified a number of patient events or experiences which caused either high or low scores on individual SERVQUAL items.

  9. Demonstrating the impact and model of care of a Statewide psychiatric intensive care service.

    Science.gov (United States)

    Lee, Stuart; Hollander, Yitzchak; Scarff, Lisa; Dube, Ryan; Keppich-Arnold, Sandra; Stafrace, Simon

    2013-10-01

    To characterise patients and their outcomes following referral to a Statewide psychiatric intensive care service. This study conducted a medical audit for patients referred to the Statewide service during the first four years of operation (2007-2011). Demographics and the presence of alcohol and other drug and forensic comorbidities were documented along with the treatment received prior to and during admission. In the first four years of operation, 58 referrals were received, 41 resulting in admission and seven in secondary consultation delivered to the referring inpatient psychiatry service. Admitted patients were most commonly experiencing a psychotic illness, had high levels of substance comorbidities and antisocial personality traits, required lengthy admissions (mean days = 41.5), and were in most cases successfully discharged back to the referring inpatient psychiatry service or the community. Significant reductions in clinician-rated difficulties measured via the Health of the Nations Outcome Scale were found at discharge, and despite the significant presenting aggression risk, few attempted or actual assaults occurred. Improved outcomes were achieved with patients deemed unsafe for psychiatric care in high dependency units in other Victorian acute mental health services through management by an acute service that has developed special expertise in this area.

  10. Psychiatric social workers in legal aid services in hospitals: Exploring roles in Indian context

    Directory of Open Access Journals (Sweden)

    Priya Treesa Thomas

    2017-01-01

    Full Text Available Mental health and legal problems are interlinked in many ways. People facing legal issues may develop mental health problems, and people with mental illness and family also face legal issues. In India, Legal Services Authorities Act, 1987 gives provision for free legal aid services for the poor sections of society. Authors explain the roles of psychiatric social workers in legal aid services in hospitals. Social case work as a method of social work is suitable in legal aid services. Counseling, referrals, collateral contacts, advocacy and networking are major services from the social work perspective. Knowledge about laws and mental illness is essential for social workers to work in legal aid clinics (LACs.

  11. Description of comprehensive dental services supported by the Medicare Chronic Disease Dental Scheme in the first 23 months of operation.

    Science.gov (United States)

    Palfreeman, Vera; Zoellner, Hans

    2012-02-01

    Australia's Medicare universal insurance system has supported comprehensive dental service through the Chronic Disease Dental Scheme (CDDS) since November 2007. Public debate opposing CDDS includes claims of over-servicing, calls for expansion to universal eligibility, and government threat of closure. Here we examine CDDS services over the first 23 months of operation. CDDS statistics on patient age, gender and item numbers claimed from November 2007 to December 2009 from Medicare were subjected to analysis. The distribution of 404,768 total CDDS patients varied across Australia from 3.6% of the population in NSW to 0.07% in NT, while uptake increased over time. The average patient had 7.58 dental treatments, and the most common were: direct restorations (2.27), preventive and periodontal services (1.46), diagnostic services (1.43), extractions (0.77), and new dentures (0.53). Crown and bridgework appeared over-represented (0.48). Although data do suggest over-servicing in crown and bridgework, there also appears to be significant community need for the CDDS. Clear guidelines for dental clinical diagnosis and treatment planning, as well as a pre-approval process for crown and bridgework is suggested to improve the CDDS, and this could form the basis for expansion to universal eligibility for dental Medicare. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  12. Patient satisfaction against the quality of dental health services at dental polyclinic of Tenriawaru general hospital in Bone regency

    Directory of Open Access Journals (Sweden)

    Fuad Husain Akbar

    2016-06-01

    Full Text Available Patient satisfaction against the quality of dental health services was a comparison between the perception of care received by expectation before getting treatment. The research was conducted  at Tenriawaru general hospital in Bone regency  based on the five dimensions of service quality, they were the assurance, empathy, responsiveness, physical appearance, and medical services by using Likert scale. The study was descriptive with a sample of 65 people. The research subjects were all visitors (patient dental polyclinic of Tenriawaru general hospital in Bone regency. Results showed patient satisfaction on dimensions of assurance 84.6% falling into the category satisfied. On the dimensions of empathy showed 81.5% of patients satisfied. On the dimensions of responsiveness showed 36.9% of patients satisfied. On the dimensions of physical appearance showed 84.6% of patients satisfied. On the dimensions of medical services showed 72.3% of patients satisfied. Based on the result of patient satisfaction against the quality of dental health services at the dental polyclinic of Tenriawaru general hospital in Bone regency which reviewed from five dimensions showed patients satisfied against the quality of dental health services at Tenriawaru general hospital in Bone regency.

  13. Longevity of posterior resin composite restorations in permanent teeth in Public Dental Health Service

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan W V; Halken, Jette

    2013-01-01

    To investigate in a prospective follow up the longevity of posterior resin composites (RC) placed in permanent teeth of children and adolescents attending Public Dental Health Service.......To investigate in a prospective follow up the longevity of posterior resin composites (RC) placed in permanent teeth of children and adolescents attending Public Dental Health Service....

  14. Profile and activities of a rural home-based psychiatric treatment service in Ireland.

    Science.gov (United States)

    Nwachukwu, Izu; Nkire, Nnamdi; Russell, Vincent

    2014-06-01

    This study described the profile, activities and patient-related outcomes of a long-established home-based treatment (HBT) service in Ireland. A retrospective descriptive study design was adopted to review and describe the activities of the Cavan HBT team over a 5-year period. Data including demographics, referral details, duration of admissions and outcome/disposal were retrospectively collected from the home treatment team mental health register of admissions between 2006 and 2010. Data were analysed using SPSS version 15 for windows. A total of 783 patients were referred to the team over the study period, of which 722 were admitted for home treatment. Most referrals (51%) were from General Practitioners and the commonest reason for referral/admission for home treatment was low mood (26%). While 10% required stepped-up care to the psychiatric inpatient unit, 77% were successfully discharged to the out-patient clinic for routine follow-up care. Common psychiatric illnesses can be safely and effectively managed with HBT within the context of a spectrum of therapeutic options in a community psychiatric service.

  15. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ... HUMAN SERVICES Health Resources and Services Administration Lists of Designated Primary Medical Care... geographic areas, population groups, and facilities designated as primary medical care, mental health, and... (primary medical care, dental, psychiatric, vision care, podiatric, pharmacy, and veterinary care). The...

  16. Inpatient treatment of major depression in Austria between 1989 and 2009: impact of downsizing of psychiatric hospitals on admissions, suicide rates and outpatient psychiatric services.

    Science.gov (United States)

    Vyssoki, B; Willeit, M; Blüml, V; Höfer, P; Erfurth, A; Psota, G; Lesch, O M; Kapusta, N D

    2011-09-01

    During the last 20 years Austrian psychiatric services underwent fundamental changes, as a focus was set on downsizing psychiatric hospitals. Little is known about how restructuring of mental health services affected patients with major depression and suicide rates. Monthly hospital discharges from all hospitals in Austria with the diagnosis of unipolar major depression as primary reason for inpatient treatment were obtained for the time period between 1989 and 2008. These data were correlated with relevant parameters from the general health system, such as number of hospital beds, suicide rate, density of psychotherapists and sales of antidepressants. While the number of psychiatric beds was reduced by almost 30%, the total annual numbers of inpatient treatment episodes for depression increased by 360%. This increase was stronger for men than for women. Further on this development was accompanied by a decrease in the suicide rate and an improvement in the availability of professional outpatient mental health service providers. Only aggregated patient data and no single case histories were available for this study. The validity of the correct diagnosis of unipolar major depression must be doubted, as most likely not all patients were seen by a clinical expert. Our data show that although inpatient treatment for unipolar major depression dramatically increased, reduction of psychiatric beds did not lead to an increase of suicide rates. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Exploring registered Psychiatric Nurses' responses towards Service Users with a diagnosis of borderline personality disorder.

    LENUS (Irish Health Repository)

    McGrath, Bridget

    2012-01-01

    This study explored registered psychiatric nurses\\' (RPNs\\') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the "staff-patient interaction response scale" (SPIRS). Four themes emerged following data analysis: "challenging and difficult," "manipulative, destructive and threatening behaviour," "preying on the vulnerable resulting in splitting staff and other service users," and "boundaries and structure." Additionally, low levels of empathy were evident in the majority of participants\\' responses to the SPIRS. The findings provide further insight on nurses\\' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.

  18. Exploring Registered Psychiatric Nurses' Responses towards Service Users with a Diagnosis of Borderline Personality Disorder

    Directory of Open Access Journals (Sweden)

    Bridget McGrath

    2012-01-01

    Full Text Available This study explored registered psychiatric nurses' (RPNs' interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD. A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the “staff-patient interaction response scale” (SPIRS. Four themes emerged following data analysis: “challenging and difficult,” “manipulative, destructive and threatening behaviour,” “preying on the vulnerable resulting in splitting staff and other service users,” and “boundaries and structure.” Additionally, low levels of empathy were evident in the majority of participants' responses to the SPIRS. The findings provide further insight on nurses' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.

  19. The Crisis at Christmas Dental Service: a review of an annual volunteer-led dental service for homeless and vulnerably housed people in London.

    Science.gov (United States)

    Doughty, J; Stagnell, S; Shah, N; Vasey, A; Gillard, C

    2018-01-01

    Background The UK charity Crisis originated in 1967 as a response to the increasing numbers of homeless people in London, and the first Crisis at Christmas event for rough sleepers was established in 1971. Since then, Crisis has provided numerous services over the Christmas period to the most vulnerable members of society. One of these is the Crisis at Christmas Dental Service (CCDS) which provides emergency and routine dental care from 23-29 of December each year. The charity is entirely dependent on voluntary staffing and industry donations including materials and facilities. This paper aims to assess the impact of the service over the last six years of clinical activity from 2011-2016.Method Anonymised data were collected from the annual CCDS delivered over the last six consecutive years. Services included: dental consultations; oral hygiene instruction; scale and polishes; permanent fillings; extractions; and fluoride varnish applications. In addition, anonymised patient feedback was collected after each dental attendance.Results On average, 80-85% of the patients were male and the majority were between 21 and 60 years of age. The most common nationality was British (46%). Over the six-year data collection period intervention treatments (restorations and extractions) remained fairly consistent, while the number of fluoride varnish applications and oral hygiene instruction have increased. The majority of patients reported positive satisfaction with their treatment and would have recommended the service to others. Approximately 75% of patients did not regularly attend a dentist outside of Crisis and a similar proportion were given information on where to access year round dental services for homeless people in London. The majority of dental volunteers felt that they enjoyed the experience and would consider volunteering again for Crisis in the future.Conclusion The Crisis at Christmas Dental Service has emerged as a valuable asset to the portfolio of resources

  20. Patient satisfaction against the quality of dental health services at dental polyclinic of Tenriawaru general hospital in Bone regency

    Directory of Open Access Journals (Sweden)

    Fuad Husain Akbar

    2016-12-01

    Full Text Available Patient satisfaction against the quality of dental health serviceswas a comparison between the perception of care received by expectation before getting treatment. The Research was conducted at Tenriawaru General Hospital in Bone Regency based on the five dimensions of service quality, they were the assurance, empathy, responsiveness, physical appearance, and medical services by using Likert scale. The study was descriptive with a sample of 65 people. The research subjects were all visitors (patient Dental Polyclinic of Tenriawaru General Hospital in Bone Regency. Results showed patient satisfaction on dimensions of assurance 84.6% falling into the category satisfied. On the dimensions of empathy showed 81.5% of patients satisfied. On the dimensions of responsiveness showed 36.9% of patients satisfied. On the dimensions of physical appearance showed 84.6% of patients satisfied. On the dimensions of medical services showed 72.3% of patients satisfied. Based on the result of patient satisfaction against the quality of dental health services at the Dental Polyclinic of Tenriawaru General Hospital in Bone Regency which reviewed from five dimensions showed patients satisfied against the quality of dental health services at Tenriawaru General Hospital in Bone Regency.

  1. Estimating the costs of psychiatric hospital services at a public health facility in Nigeria.

    Science.gov (United States)

    Ezenduka, Charles; Ichoku, Hyacinth; Ochonma, Ogbonnia

    2012-09-01

    Information on the cost of mental health services in Africa is very limited even though mental health disorders represent a significant public health concern, in terms of health and economic impact. Cost analysis is important for planning and for efficiency in the provision of hospital services. The study estimated the total and unit costs of psychiatric hospital services to guide policy and psychiatric hospital management efficiency in Nigeria. The study was exploratory and analytical, examining 2008 data. A standard costing methodology based on ingredient approach was adopted combining top-down method with step-down approach to allocate resources (overhead and indirect costs) to the final cost centers. Total and unit cost items related to the treatment of psychiatric patients (including the costs of personnel, overhead and annualised costs of capital items) were identified and measured on the basis of outpatients' visits, inpatients' days and inpatients' admissions. The exercise reflected the input-output process of hospital services where inputs were measured in terms of resource utilisation and output measured by activities carried out at both the outpatient and inpatient departments. In the estimation process total costs were calculated at every cost center/department and divided by a measure of corresponding patient output to produce the average cost per output. This followed a stepwise process of first allocating the direct costs of overhead to the intermediate and final cost centers and from intermediate cost centers to final cost centers for the calculation of total and unit costs. Costs were calculated from the perspective of the healthcare facility, and converted to the US Dollars at the 2008 exchange rate. Personnel constituted the greatest resource input in all departments, averaging 80% of total hospital cost, reflecting the mix of capital and recurrent inputs. Cost per inpatient day, at $56 was equivalent to 1.4 times the cost per outpatient visit at

  2. Analysis of paediatric dental services provided at a regional hospital in Sweden. Dental treatment need in medically compromised children referred for dental consultation.

    Science.gov (United States)

    Arnrup, K; Lundin, S A; Dahllöf, G

    1993-01-01

    All inpatients at a regional hospital in Sweden referred for a paediatric dental consultation (n = 269) were studied retrospectively during a two-year period. The children were studied concerning their medical and oral condition and subsequent dental treatment. The most frequent medical condition among the referred children was insulin dependent diabetes mellitus (20%), asthma (9%) and epilepsy (7%). Children with asthma exhibited a significantly increased caries prevalence (p Gingivitis, disturbances in occlusal development and dental caries were the most commonly found diagnoses Acute dental or oral problems were diagnosed in 9% of the children. The mean time allocated for each patient was 60 minutes. Thirty percent of the children were subsequently treated at the paediatric dentistry specialist clinic. In conclusion the study emphasises the need of paediatric dental consultation services at regional hospitals.

  3. Income-Related Inequalities in Access to Dental Care Services in Japan

    Science.gov (United States)

    Nishide, Akemi; Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

    2017-01-01

    Background: This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods: The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results: Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions: There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system. PMID:28498342

  4. Optimizing the mix of basic dental services for Southern Thai schoolchildren based on resource consumption, service needs and parental preference.

    Science.gov (United States)

    Tianviwat, Sukanya; Chongsuvivatwong, Virasakdi; Birch, Stephen

    2009-08-01

    To identify the optimal levels and mix of basic dental services (sealants and fillings for permanent teeth and extraction of primary teeth) under two different dental settings: hospital-based and mobile dental clinics under specified resource constraints. A linear programming model is used based on explicit identification of system objectives and resource constraints. The objective was to maximize benefits as measured by parental willingness to pay (WTP) for basic dental services provided to schoolchildren subject to constraints on total resources, service need and parental preferences among different dental care settings. Optimization was identified to require 270, 180, 552, 828, 228 and 532 cases of hospital sealant, mobile sealant, hospital filling, mobile filling, hospital extraction and mobile extraction, respectively. The corresponding current service levels were 48, 281, 191, 170, 479, and 677 respectively. The optimal service configuration produced a total WTP of 485 860 baht which exceeded the WTP for the current service configuration by more than 75.4%. Mobile clinic fillings were the highest priority among basic dental services. The current service configurations fail to reflect the setting preferences and provide greater emphasis to extractions than the optimal configuration with less emphasis given to preventive and restorative services.

  5. Women's leadership in the Public Dental Service in Finland.

    Science.gov (United States)

    Alestalo, Paula; Widstrom, Eeva

    2012-06-01

    This study aimed to examine how leadership positions in the Public Dental Service (PDS) were distributed between women and men and how the female and male lead dentists perceived themselves as managers or leaders and whether their superiors, the leading doctors and municipal decision makers or their subordinates, the public dentists, found differences between female and male lead dentists as leaders. Gender aspects on the leadership qualities of the lead dentists in the Public Dental Service were evaluated by four professional groups using a questionnaire. The groups surveyed were: lead dentists (in charge of the municipal PDS clinics), leading doctors (lead dentists'line managers), the directors of municipal health boards, and the PDS dentists (subordinates to the lead dentists). Factor analysis, chi-square and non-parametric tests were used to analyse the data gathered. Women made up 50% (96/192) of the lead dentists, 80% (211/263) of the public dentists, 31% (47/152) of the leading doctors, and 27% (33/124) of directors of the municipal health boards (Pmanagers (Pmanagers, people-oriented leaders (both medians= 3.2 on a scale from 1 to 4), and their ability (median=3.5) to take care of their tasks. Their decision authority, power in municipal decision-making (median=2.8), was considered weaker. Most, 67% (70/105), of the PDS dentists evaluated their female superiors and 50% (75/150) their male superiors good as goal-oriented managers (P<0.001), and 51% (54/105) considered their female superiors and 35% (53/150) their male superiors good as people-oriented leaders (P<0.05). Female dentists had not become lead dentists in proportion to their numbers in the PDS. Those who had a leading position felt that they were good leaders, their superiors considered them as good as their male colleagues, and their subordinates felt they were better.

  6. The United States Army Medical Department Journal. The United States Army Dental Corps: A Century of Commitment, Service, and Care

    Science.gov (United States)

    2011-03-01

    Washington, DC. 1 November 1993 – The US Army Dental Command (DENCOM) was provisionally activated in San Antonio, Texas, as a major subordinate element...first commander. (On 2 October 1994, provisional status was removed.) This action established Army dental service delivery under a dental command with...period includes prophies ( dental cleanings ) comprising 14% of the nonexamination dental procedures. TF MED policy was that all dental providers spend

  7. Prevalence of dental caries in 5-year-old Greek children and the use of dental services: evaluation of socioeconomic, behavioural factors and living conditions.

    Science.gov (United States)

    Mantonanaki, Magdalini; Koletsi-Kounari, Haroula; Mamai-Homata, Eleni; Papaioannou, William

    2013-04-01

    To assess dental caries and use of dental services experience in 5-year-old children attending public kindergartens in Attica, Greece and to examine the influence of certain socioeconomic factors and living conditions as well as dental behaviours and attitudes. In this cross-sectional study, a random and stratified sample of 605 Greek children was examined using decayed, missing, filled tooth surfaces and simplified debris indices. The use of dental services was measured by children's dental visits (any dental visit up to the age of 5 years). Care Index was also calculated. Risk indicators were assessed by a questionnaire. Zero-inflated Poisson and Logistic Regression Analysis were generated to test statistical significant associations. The prevalence of dental caries was 16.5%. Care Index was 32% and dental visits were reported for the 84% of the children. Medium Socio-Economic Level (SEL) was associated with no detectable caries. High SEL was related to decreased decayed, missing, filled teeth values, while female gender and rented houses had the opposite effect. The age of the mother (35-39 years) and the higher SEL were related to higher levels of dental services use. It is suggested that there are differences in the experience of dental caries and use of dental services among preschool children in Attica, which are related to demographic, socioeconomic factors and living conditions. Dental public polices should focus on groups with specific characteristics in order to improve oral health levels of disease-susceptible populations. © 2013 FDI World Dental Federation.

  8. Patient satisfaction with dental services rendered at School of ...

    African Journals Online (AJOL)

    Aim: To determine patient satisfaction among dental patients treated at the School of Dentistry, MUHAS. Study design: Cross-sectional clinic based study. Study participants and methods: Two hundred twelve dental patients aged 18 years and above who attended the oral surgery and restorative dental clinics were given a ...

  9. 76 FR 72003 - Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Science.gov (United States)

    2011-11-21

    ... BUDGET Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by... the cost of outpatient medical, dental, and cosmetic surgery services furnished by military treatment... outpatient medical, dental, and cosmetic surgery services rates referenced are effective upon publication of...

  10. Dental technology services and industry trends in New Zealand from 2010 to 2012.

    Science.gov (United States)

    Alameri, S S; Aarts, J M; Smith, M; Waddell, J N

    2014-06-01

    To provide a snapshot of the New Zealand dental technology industry and influencing factors. Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry. A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees. The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems. Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.

  11. Self reported use of dental services among employed adults in Sri Lanka.

    Science.gov (United States)

    Ekanayake, Lilani; Mendis, R

    2002-06-01

    To determine the patterns and variables associated with self-reported use of dental services among employed adults in Sri Lanka. A cross sectional study using a self-administered questionnaire. Five representative public sector institutions in the city of Kandy, Sri Lanka. A total of 210 employees. Ninety per cent of the employees had used dental services, the majority for symptomatic reasons. Of the respondents, 63% had visited a dentist in the preceding 24 months. According to the logistic regression analysis, gender and presence of pain within the past six months were significant predictors of dental utilisation. Andersen and Newman's behavioural model of health services utilisation was of limited value in explaining dental utilisation of this sample of employed adults as only one predisposing factor and a single factor related to need were significant predictors of the use of dental services.

  12. Mental health recovery for psychiatric inpatient services: perceived importance of the elements of recovery.

    Science.gov (United States)

    Siu, B W M; Ng, B F L; Li, V C K; Yeung, Y M; Lee, M K L; Leung, A Y H

    2012-06-01

    OBJECTIVES. To develop a questionnaire for measuring the perceived importance of the elements of mental health recovery in psychiatric inpatients in Hong Kong and to test the psychometric properties of the questionnaire. METHODS. Thematic content analysis of identified literature on mental health recovery was performed to identify the elements related to mental health recovery. A questionnaire was developed to assess the perceived importance of the identified elements. An expert panel was set up to evaluate the content validity and patient focus group's face validity of the questionnaire. Participants were recruited from medium-stay and rehabilitation wards of Castle Peak Hospital. RESULTS. A total of 101 psychiatric inpatients completed the questionnaire, the majority of whom suffered from schizophrenia (75%). Having meaning in life was rated by 91% of the participants as an important element of recovery, followed by hope (86%) and general health and wellness (85%). Cronbach's alpha for internal consistency was 0.91. Explorative factor analysis yielded 7 factors and intraclass correlation coefficients revealed a fair-to-good test-retest reliability. CONCLUSIONS. The results supported the psychometric properties of the questionnaire for measurement of mental health recovery and serve as a basis for the future development of recovery-oriented services in the psychiatric inpatient settings in this locality.

  13. Mental Health Services Use Across the Life Course in Adults with Psychiatric Disorders and Prior Suicidal Behavior

    Science.gov (United States)

    Byers, Amy L.; Lai, Amy X.; Arean, Patricia; Nelson, Craig; Yaffe, Kristine

    2015-01-01

    Objective Little is known about mental health services use by adults with prior suicidal behavior and current (12-month) psychiatric disorders. This study determined nationally representative prevalence estimates of current mental health services use by these adults, examining racial/ethnic, age, and gender differences. Methods Services use was examined across the life course using 1139 adults with history of suicidal behavior and current mood or anxiety disorders in the Collaborative Psychiatric Epidemiology Surveys (CPES, 2001–2003). Results Overall services use was 47.3%. Across the life course, African Americans showed greater use that increasingly paralleled that by white non-Hispanics and Hispanics/Others, whose use decreased in the latter half of the life course (p interaction=.01). Conclusions Adults with prior suicidal behavior and current psychiatric disorders have low mental health services use. Findings of racial/ethnic disparities in use can help identify those in need of care. PMID:26766753

  14. Dental pain, use of dental services and oral health-related quality of life in southern Brazil.

    Science.gov (United States)

    Cavalheiro, Charles Henrique; Abegg, Claides; Fontanive, Victor Nascimento; Davoglio, Rosane Silvia

    2016-08-18

    This study aimed at assessing the relationship between dental pain and the reason for using dental services and oral health quality of life in people aged 50 to 74 years in southern Brazil. A cross-sectional population-based study was conducted with 720 individuals aged 50 to 74 years, living in three health districts in the city of Porto Alegre. Dental impacts on daily life and sociodemographic data were assessed using structured interviews. The Oral Impacts on Daily Performance - OIDP instrument was used to measure oral impacts. The information was analyzed by Poisson regression with robust variance adjustment, taking into account cluster sampling. Dental pain was present in 32.5% of those reporting an oral impact on their daily activities. Dental pain most frequently affected talking (37.6%), cleaning teeth and gums (37.0%) and enjoying the companionship of people (36.5%). After adjustments to the multivariate analysis, the reason for dental visits due to dental pain was found to have a high impact on daily activities [RP 1.68 (1.11 - 2.54].

  15. Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study.

    Science.gov (United States)

    Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

    2018-12-01

    Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

  16. Can the development of new dental caries in Danish schoolchildren be predicted from surveillance data in the School Dental Service?

    DEFF Research Database (Denmark)

    Jeppesen, Berit Anna; Foldspang, Anders

    2006-01-01

    Background:  Dental screening programmes for Danish children generally target all children, irrespective of their individual caries risk. The standard screening interval is approximately 12 months. A valid systematic screening tool based on routine information sources is however indispensable......, if more selective screening strategies should be developed to target the children at highest risk. Objective:  To estimate the precision with which Danish schoolchildren at high risk for developing dental caries within 1 year can be identified based on information from routine registers. Methods:  Based...... on data from the Danish National Board of Health's Recording System for the Danish Child Dental Services and from the Central Office of Civil Registration, 3705 schoolchildren aged 7–12 years were followed through 1994–1996. Dental health information as of 1994 and changes 1994–1995 were applied...

  17. Neighbourhood deprivation and dental service use: a cross-sectional analysis of older people in England.

    Science.gov (United States)

    Lang, I A; Gibbs, S J; Steel, N; Melzer, D

    2008-12-01

    Appropriate dental care is an important part of maintaining good oral health. We examined the relationship between socioeconomic status, neighbourhood deprivation levels and older people's dental service use. We used logistic regression analysis to assess the relationship between self-reported dental service use and neighbourhood deprivation, adjusting for individual socioeconomic and health factors, in individuals aged 65+ in the 2005 Health Survey for England (n = 4240). Among dentulous respondents, 69.9% reported attending for regular check-ups, 6.2% occasional check-ups, 18.4% only saw a dentist when in trouble and 5.6% never went to a dentist. In our adjusted model age, sex, region, education level, occupational social class, self-reported health and smoking status, but not degree of urbanization, were associated with use of dental services. Following adjustment for these other factors those living in the most deprived 20% of neighbourhoods, compared with those in the least deprived, had a relative risk ratio of 2.25 (95% confidence interval 1.59-3.17) of using dental services only when symptomatic, rather than going for regular or occasional check-ups. When alternative outcomes of reporting having recently seen a doctor or been a hospital inpatient were assessed these deprivation-related patterns in service use were not evident. Levels of neighbourhood deprivation are associated with the use of dental services by older people. Action is needed to ensure older people in deprived communities access appropriate and comprehensive dental services.

  18. The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities

    Science.gov (United States)

    2012-01-01

    Introduction Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS) that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. Results These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering “culture” in the presentation and expression of mental distress. The narratives reveal an overall “culture of understanding cultural issues” and specific “cultures of care”. These emerged as necessary foci of intervention to improve service user outcomes. Conclusion Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery. PMID:23020856

  19. The role of health services research in the renaissance of the dental profession.

    Science.gov (United States)

    Grembowski, D

    1997-01-01

    Health services research may play a critical role in achieving the recommendations of the IOM study. Toward this end, the field of health services research is defined. Applications of health services research to health outcomes, patient care, and other IOM directives are reviewed. Alternative approaches to building the capacities of dental schools to conduct health services research are presented.

  20. Productive efficiency and its determinants in the Community Dental Service in the north-west of England.

    Science.gov (United States)

    Hill, H; Birch, S; Tickle, M; McDonald, R; Brocklehurst, P

    2017-06-01

    To assess the efficiency of service provision in the Community Dental Services and its determinants in the North-West of England. 40 Community Dental Services sites operating across the North-West of England. A data envelopment analysis was undertaken of inputs (number of surgeries, hours worked by dental officers, therapists, hygienists and others) and outputs (treatments delivered, number of courses of treatment and patients seen) of the Community Dental Services to produce relative efficiency ratings by health authority. These were further analyzed in order to identify which inputs (determined within the Community Dental Services) or external factors outside the control of the Community Dental Services are associated with efficiency. Relative efficiency rankings in Community Dental Services production of dental healthcare. Using the quantity of treatments delivered as the measure of output, on average the Community Dental Services in England is operating at a relative efficiency of 85% (95% confidence interval 77%- 99%) compared to the best performing services. Average efficiency is lower when courses of treatment and unique patients seen are used as output measures, 82% and 68% respectively. Neither the input mix nor the patient case mix explained variations in the efficiency across Community Dental Services. Although large variations in performance exist across Community Dental Services, the data available was not able to explain these variations. A useful next step would be to undertake detailed case studies of several best and under-performing services to explore the factors that influence relative performance levels. Copyright© 2017 Dennis Barber Ltd.

  1. Police referral to psychiatric emergency services and its effect on disposition decisions.

    Science.gov (United States)

    Watson, M A; Segal, S P; Newhill, C E

    1993-11-01

    Some clinicians and researchers have questioned the appropriateness of police referrals to psychiatric emergency services and have suggested that police exercise undue influence on hospital admission decisions. The purpose of this study was to test these assertions. Research clinicians in nine emergency services in California observed staff evaluations of 772 cases and rated patients' symptom severity, danger to self or others, and grave disability. They also reviewed the criminal justice records of these patients both before and for 18 months after the index evaluation. A total of 186 patients referred by police were compared with 577 patients not referred by police. Patients brought by police were more likely to be subsequently hospitalized, but they were also more psychiatrically disturbed. They were more dangerous to others and more gravely disabled. They were no more likely to have a criminal record than patients not referred by police. Police did not exercise undue influence on dispositions nor were the patients they brought in more "criminal" than others.

  2. Do persons with severe mental illness who consume the psychiatric rehabilitation basket of services in Israel have better outcomes than those who do not?

    Science.gov (United States)

    Roe, David; Werbeloff, Nomi; Gelkopf, Marc

    2010-01-01

    Since the implementation of the legislation of the Rehabilitation of the Mentally Disabled in the Community Law a decade ago, an increasing number of people have been receiving the psychiatric rehabilitation 'basket of service', yet the impact of these services has barely been studied. The purpose of the present study is to examine whether people with severe mental illness in Israel who consume psychiatric rehabilitation services report better outcomes than people with severe mental illness who are eligible and have applied for psychiatric rehabilitation services but have not yet utilized them. 1,191 persons with severe mental illness (595 psychiatric rehabilitation service users and 596 nonusers) completed face-to-face interviews. Differences in quality of life, general satisfaction and psychiatric symptoms between psychiatric rehabilitation service users and non-users were examined using Analysis of Covariance controlling for the potential confounding effects of age and marital status. Adjusted comparisons of quality of life, general satisfaction and psychiatric symptoms revealed that psychiatric rehabilitation service users had better outcomes than non-users: they reported better quality of life and greater satisfaction alongside fewer psychiatric symptoms. The most striking difference between the groups was found in the domain of employment and income, with non-psychiatric rehabilitation service users scoring 0.9 effect sizes below psychiatric rehabilitation service users. The current study, based on a relatively large sample, provides support for the effectiveness of the psychiatric rehabilitation 'basket of services'. Future studies including clinicians ratings of more objective aspects of functioning may provide a broader picture of the association between psychiatric rehabilitation service utilization and outcome.

  3. Community orientation of services for persons with a psychiatric disability. Comparison between Estonia, Hungary and the Netherlands

    NARCIS (Netherlands)

    Prof. dr. Jean Pierre Wilken; Zsolt Bugarszki; Karin Hanga; Dagmar Narusson; Koidu Saia; Marju Medar

    2017-01-01

    This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the

  4. Economic Impact of Childhood Psychiatric Disorder on Public Sector Services in Britain: Estimates from National Survey Data

    Science.gov (United States)

    Snell, Tom; Knapp, Martin; Healey, Andrew; Guglani, Sacha; Evans-Lacko, Sara; Fernandez, Jose-Luis; Meltzer, Howard; Ford, Tamsin

    2013-01-01

    Background: Approximately one in ten children aged 5-15 in Britain has a conduct, hyperactivity or emotional disorder. Methods: The British Child and Adolescent Mental Health Surveys (BCAMHS) identified children aged 5-15 with a psychiatric disorder, and their use of health, education and social care services. Service costs were estimated for each…

  5. [Everything OK?! Introduction of quality management in the social psychiatric service in Berlin].

    Science.gov (United States)

    Gagel, D E; Rottig, M

    2011-02-01

    With the help of a structured quality report (SQR) the first assessment on the quality of task fulfillment in the 12 social psychiatric services (SPS) in Berlin was carried out. 102 standardised questions in 10 dimensions were posed. The results show that in the important dimensions which depict the core tasks of the SPS, in general a good quality was documented. At the same time deficiencies and deficits were mentioned (e. g., lack of check-lists, poor cooperation with the clinics, inadequate supervision). For the further development of SQR an adaptation to the Berlin situation as well as progress documentation in the individual SPS will be of major importance. Furthermore, a modification for other services in the public health-care system such as, e. g., child and adolescent health care should be considered. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Involuntary Psychiatric Admissions and Development of Psychiatric Services as an Alternative to Full-Time Hospitalization in France.

    Science.gov (United States)

    Gandré, Coralie; Gervaix, Jeanne; Thillard, Julien; Macé, Jean-Marc; Roelandt, Jean-Luc; Chevreul, Karine

    2017-09-01

    The development of alternatives to full-time hospitalization in psychiatry is limited because consensus about the benefits of such alternatives is lacking. This study assessed whether the development of such alternatives in French psychiatric sectors was associated with a reduction in involuntary inpatient care, taking into account other factors that are potentially associated with involuntary admission. Data on whether a patient had at least one involuntary full-time admission in 2012 were extracted from the French national discharge database for psychiatric care. The development of alternatives to full-time hospitalization was estimated as the percentage of human resources allocated to these alternatives out of all human resources allocated to psychiatry, measured at the level of the hospital hosting each sector. Other factors potentially associated with involuntary admission (characteristics of patients, health care providers, and the environment) were extracted from administrative databases, and a multilevel logistic model was carried out to account for the nested structure of the data. Significant variations were observed between psychiatric sectors in rates of involuntary inpatient admissions. A large portion of the variation was explained by characteristics of the sectors. A significant negative association was found between involuntary admissions and the development of alternatives to full-time hospitalization, after adjustment for other factors associated with involuntary admissions. Findings suggest that the development of alternatives to full-time hospitalization is beneficial for quality of care, given that it is negatively associated with involuntary full-time admissions. The reduction of such admissions aligns with international recommendations for psychiatric care.

  7. Patient aggression in psychiatric services: the experience of a sample of nurses at two psychiatric facilities in Nigeria.

    Science.gov (United States)

    James, B O; Isa, E W; Oud, N

    2011-05-01

    Aggression is a common feature in psychiatric in-patient units in Africa. The attitudes of psychiatric nurses and their perceptions of the frequency of in-patient aggression have not been explored in the Nigerian context. Using a crosssectional study design, two self-report questionnaires (the Attitudes toward Aggression Scale (ATAS) and the Perception of the Prevalence of Aggression Scale (POPAS)) were administered to nursing staff (n=73) at two psychiatric facilities in Benin City, Nigeria. Overall, nurses viewed aggression as offensive, destructive and intrusive. They were less likely to view it as a means of communication or serving protective functions. Verbal aggression was the commonest type of aggression experienced while sexual intimidation and suicide attempts were least common. Male nurses were more likely to experience physical violence and aggressive 'splitting' behaviours, while nurses with over a decade of professional experience were more likely to experience verbal and humiliating aggressive behaviours. In contrast to previous studies, fewer nurses required days off work due to aggressive behaviour. Aggression is commonly experienced by nurses in in-patient units in Nigeria. Their views were predominantly negative. Training programmes are required to change staff attitudes as well as research on the cultural factors mediating these attitude dispositions.

  8. Patterns of dental service utilization following nontraumatic dental condition visits to the emergency department in Wisconsin Medicaid.

    Science.gov (United States)

    Pajewski, Nicholas M; Okunseri, Christopher

    2014-01-01

    To examine patterns of dental service utilization for adult Medicaid enrollees in Wisconsin following nontraumatic dental condition (NTDC) visits to the emergency department (ED). This is a retrospective, observational study of claims for NTDC visits to the ED and dental service encounters from the Wisconsin Medicaid Evaluation and Decision Support database (2001-2009). We used competing risk models to predict probabilities of returning to the ED versus obtaining follow-up care from a dentist. We observed a 43 percent increase in the rate of NTDC visits to the ED, with most of this increase occurring from 2001 to 2005. Within 30 days of an NTDC visit to the ED, ∼29.6 percent of enrollees will first visit a dentist office, while ∼9.9 percent will return to the ED. Young to middle-aged adults (18 to dental providers were more likely to return to the ED following a NTDC visit. Among the enrollees that first visited a dental office following an ED visit, 37.6 percent had an extraction performed at this visit. Almost one in five adult Medicaid enrollees will subsequently return to the ED following a previous NTDC visit. The provision of definitive care for these individuals appears to primarily consist of extractions. © 2012 American Association of Public Health Dentistry.

  9. Effects of the State Children's Health Insurance Program on access to dental care and use of dental services.

    Science.gov (United States)

    Wang, Hua; Norton, Edward C; Rozier, R Gary

    2007-08-01

    To provide national estimates of implementation effects of the State Children's Health Insurance Program (SCHIP) on dental care access and use for low-income children. The 1997-2002 National Health Interview Survey. The study design is based on variation in the timing of SCHIP implementation across states and among children observed before and after implementation. Two analyses were conducted. The first estimated the total effect of SCHIP implementation on unmet need for dental care due to cost in the past year and dental services use for low-income children (family income below state SCHIP eligibility thresholds) using county and time fixed effects models. The second analysis estimated differences in dental care access and use among low-income children with SCHIP or Medicaid coverage and their uninsured counterparts, using instrumental variables methods to control for selection bias. Both analyses controlled for child and family characteristics. When SCHIP had been implemented for more than 1 year, the probability of unmet dental care needs for low-income children was lowered by 4 percentage points. Compared with their uninsured counterparts, those who had SCHIP or Medicaid coverage were less likely to report unmet dental need by 8 percentage points (standard error: 2.3), and more likely to have visited a dentist within 6 or 12 months by 17 (standard error: 3.7) and 23 (standard error: 3.6) percentage points, respectively. SCHIP program type had no differential effects. Consistent results from two analytical approaches provide evidence that SCHIP implementation significantly reduced financial barriers for dental care for low-income children in the U.S. Low-income children enrolled in SCHIP or Medicaid had substantially increased use of dental care than the uninsured.

  10. Use of VA and Medicare services by dually eligible veterans with psychiatric problems.

    Science.gov (United States)

    Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L

    2008-08-01

    To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans.

  11. Patient satisfaction analysis on service quality of dental health care based on empathy and responsiveness.

    Science.gov (United States)

    Dewi, Fellani Danasra; Sudjana, Grita; Oesman, Yevis Marty

    2011-10-01

    Transformation of health care is underway from sellers' market to consumers' market, where the satisfaction of the patients' need is a primary concern while defining the service quality. Hence, commitment to provide a high-quality service and achieving patients' satisfaction becomes an important issue for dental health care provider. The aim of this research is to investigate the quality of dental health care service based on empathy and responsiveness aspects. A total of 90 questionnaires were completed by the dental patients who came to dental polyclinic located in Government Hospital, West Java, Indonesia. The questionnaire was concerned on two dimensions of service quality model, i.e. empathy and responsiveness. The obtained data were analyzed using inferential statistics (t test) and also descriptive statistics with importance-performance analysis. All the attributes tested by t test showed that perception and expectation differed significantly, except for responsiveness, i.e. ability of dental assistants in assisting the dentist (t test 0.505important factor in evaluating patient satisfaction is the response given by administration staff related to long waiting time (t test 5.377), followed by dental assistant's knowledge about the patient's need during treatment (t test 4.822) and explanation that was given by dentist (t test 4.700). It can be inferred from IPA that priority should be given to dentist's communication and dental assistant's knowledge toward patient's needs to enhance the service quality.

  12. 78 FR 62709 - Calendar Year 2013 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Science.gov (United States)

    2013-10-22

    ... BUDGET Calendar Year 2013 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by... the cost of outpatient medical, dental and cosmetic surgery services furnished by military treatment... Outpatient Medical, Dental, and Cosmetic Surgery rates referenced are effective upon publication of this...

  13. Reducing the use of seclusion and restraint in psychiatric emergency and adult inpatient services- improving patient-centered care.

    Science.gov (United States)

    Wale, Joyce B; Belkin, Gary S; Moon, Robert

    2011-01-01

    The reduction of seclusion and restraint (S/R) use has been given national priority by the US government, The Joint Commission, and patient advocacy groups. It is associated with high rates of patient and staff injuries and is a coercive and potentially traumatizing intervention. The New York City Health and Hospitals Corporation (HHC) is the largest municipal health care system in the country, with 11 HHC facilities operating psychiatric emergency services and inpatient psychiatric services. HHC operates 1117 adult inpatient psychiatric beds with an average length of stay of 22.2 days that generated over 19,000 discharges in 2009. In 2009, there were over 36,000 psychiatric emergency services visits. HHC's Office of Behavioral Health provides strategic leadership, planning, and support for the operations and quality objectives of these services. In January 2007, the corporate office initiated the Seclusion and Restraint Reduction Initiative, with a sequenced, intensive series of interventions and strategies to help focus the behavioral health leadership and staff on the need for continued culture change toward a more patient-centered and safe system of psychiatric emergency and adult inpatient care. From 2007 to 2009, there was a substantial decline in HHC's overall rate of S/R incidents in inpatient units. The more substantial impact was in the reduced overall time spent in S/R; the reduced frequency of use of S/R; and the reduced likelihood of patient injury from S/R use.

  14. Utilization of dental services among secondary school students in ...

    African Journals Online (AJOL)

    Data were collected on their demographic characteristics, visit(s) to the dentist in the previous 12 months, reasons for these dental visits, factors preventing subsequent dental visit and barriers to visiting the dentist for those who made no previous visit. The data collected were analyzed with an SPSS version 11.5 using Chi ...

  15. Mobile and Portable Dental Services Catering to the Basic Oral ...

    African Journals Online (AJOL)

    /pla/files/2011_ISDB(2).pdf. [Last cited 2013 Sept 12]. 21. Dental equipment and supply [Internet Source]. Office of Medical History, US Army Medical. Department. Available from: http://history.amedd. army.mil/corps/dental/wwii/chapterv_wwii.

  16. Treatment needs, diagnoses and use of services for acutely admitted psychiatric patients in northwest Russia and northern Norway

    Directory of Open Access Journals (Sweden)

    Sørgaard Knut W

    2013-01-01

    Full Text Available Abstract Background We compared demography, diagnoses and clinical needs in acutely admitted psychiatric hospital patients in northwest Russia and northern Norway. Method All acutely admitted psychiatric patients in 1 psychiatric hospital in north-west Russia and 2 in northern Norway were in a three months period assessed with HoNOS and a Norwegian form developed to study acute psychiatric services (MAP. Data from a total of 841 patients were analysed (377 Norwegian, 464 Russian with univariate and multivariate statistics. Results Russian patients were more often males who had paid work. 2/3 were diagnosed with alcohol and organic disorders, and 70% reported problems related to sleep. Depression was widespread, as were problems associated with occupation. Many more Norwegian patients were on various forms of social security and lived in community supported homes. They had a clinical profile of affective disorders, use of drugs, suicidality and problems with activities involved of daily life. Slightly more Norwegian patients were involuntary admitted. Conclusion Acutely admitted psychiatric patients in North West Russia and Northern Norwegian showed different clinical profiles: alcohol, depression and organic disorders characterised Russian patients, affective disorders, suicidality and use of drugs characterised the Norwegians. Whereas Norwegian patients are mainly referred from GPs the Russians come via 1.line psychiatric services (“dispensaries”. Average length of stay for Russian patients was 2.5 times longer than that of the Norwegian.

  17. Political or dental power in private and public service provision: a study of municipal expenditures for child dental care

    DEFF Research Database (Denmark)

    Andersen, L. B.; Bech, M.; Lauridsen, J.

    2012-01-01

    Both professionals and politicians may affect expenditures for highly professional services provided in the public and private sector. We investigated Danish publicly financed child dental care with a special focus on the influence of politicians and dentists on the expenditure level. By studying...... from 1996 to 2001 for 226 Danish municipalities, thus allowing for the control for heterogeneity between municipalities and for intra-municipal correlations across time. The results point to differences in expenditures between municipalities with privately and publicly produced dental care. Furthermore...

  18. A Longitudinal Analysis of the Influence of a Peer Run Warm Line Phone Service on Psychiatric Recovery.

    Science.gov (United States)

    Dalgin, Rebecca Spirito; Dalgin, M Halim; Metzger, Scott J

    2017-08-22

    This article focuses on the impact of a peer run warm line as part of the psychiatric recovery process. It utilized data including the Recovery Assessment Scale, community integration measures and crisis service usage. Longitudinal statistical analysis was completed on 48 sets of data from 2011, 2012, and 2013. Although no statistically significant differences were observed for the RAS score, community integration data showed increases in visits to primary care doctors, leisure/recreation activities and socialization with others. This study highlights the complexity of psychiatric recovery and that nonclinical peer services like peer run warm lines may be critical to the process.

  19. Assessing the need for anesthesia and sedation services in Kuwaiti dental practice.

    Science.gov (United States)

    Abdulwahab, Mohammad; Al-Sayegh, Fatima; Boynes, Sean G; Abdulwahab, Hawra; Zovko, Jayme; Close, John

    2010-01-01

    The objective of this study was to examine the public health relevance of the prevalence of dental fear in Kuwait and the resultant barrier that it creates regarding access to dental care. The study analysis demonstrated a high prevalence of dental fear and anxiety in the Kuwaiti population and a perceived need for anesthesia services by dental care providers. The telephone survey of the general population showed nearly 35% of respondents reported being somewhat nervous, very nervous, or terrified about going to the dentist. In addition, about 36% of the population postponed their dental treatment because of fear. Respondents showed a preference to receive sedation and anesthesia services as a means of anxiety relief, and they were willing to go to the dentist more often when such services were available. People with high fear and anxiety preferred to receive some type of medication to relieve their anxiety. In conclusion, the significance and importance of the need for anesthesia services to enhance the public health of dental patients in Kuwait has been demonstrated, and improvements are needed in anesthesia and sedation training of Kuwaiti dental care providers.

  20. Improvements in dental care using a new mobile app with cloud services.

    Science.gov (United States)

    Lin, Chia-Yung; Peng, Kang-Lin; Chen, Ji; Tsai, Jui-Yuan; Tseng, Yu-Chee; Yang, Jhih-Ren; Chen, Min-Huey

    2014-10-01

    Traditional dental care, which includes long-term oral hygiene maintenance and scheduled dental appointments, requires effective communication between dentists and patients. In this study, a new system was designed to provide a platform for direct communication between dentists and patients. A new mobile app, Dental Calendar, combined with cloud services specific for dental care was created by a team constituted by dentists, computer scientists, and service scientists. This new system would remind patients about every scheduled appointment, and help them take pictures of their own oral cavity parts that require dental treatment and send them to dentists along with a symptom description. Dentists, by contrast, could confirm or change appointments easily and provide professional advice to their patients immediately. In this study, 26 dentists and 32 patients were evaluated by a questionnaire containing eight dental-service items before and after using this system. Paired sample t test was used for statistical analysis. After using the Dental Calendar combined with cloud services, dentists were able to improve appointment arrangements significantly, taking care of the patients with sudden worse prosthesis (p better relationship between them. It also helps dentists to arrange appointments for patients with sudden worsening of prosthesis function. Copyright © 2014. Published by Elsevier B.V.

  1. Ansiedade ao tratamento odontológico em atendimento de urgência Dental anxiety in an emergency dental service

    Directory of Open Access Journals (Sweden)

    Kazue Kanegane

    2003-12-01

    Full Text Available OBJETIVO: Avaliar a freqüência de pacientes com ansiedade ou medo do tratamento odontológico em um setor de urgência. MÉTODOS: Participaram do estudo 252 pacientes, com 18 anos ou mais, que compareceram ao setor de urgência de uma faculdade de odontologia, de São Paulo, SP, entre agosto e novembro de 2001. Para avaliar a ansiedade, foram utilizadas a Modified Dental Anxiety Scale (MDAS, e a Escala de Medo de Gatchel. O grupo estudado respondeu a questões sobre: tempo decorrido desde a última visita ao dentista e desde o início dos sintomas, escolaridade, renda familiar e história prévia de trauma. Os resultados foram analisados pelos testes estatísticos (chi2 e Teste Exato de Fisher. RESULTADOS: Foram identificados 28,2% de indivíduos com algum grau de ansiedade, segundo a MDAS, na qual as mulheres foram consideradas mais ansiosas que os homens (chi2=0,01; e 14,3% de pacientes com alto grau de medo segundo a Escala de Medo de Gatchel. Em 44,4% da amostra a demora para procura de alívio dos sintomas foi > sete dias. Mulheres ansiosas procuraram atendimento mais rapidamente e em maior número. Experiência traumática anterior ocorreu em 46,5% dos pacientes ansiosos. Não foi possível relacionar escolaridade e renda familiar com ansiedade e/ou medo. CONCLUSÕES: Pacientes ansiosos, com destaque para as mulheres, são freqüentes no atendimento odontológico de urgência. Experiência prévia traumática mostrou-se importante para o desenvolvimento da ansiedade em relação ao atendimento odontológico.OBJECTIVE: The purpose of the study was to assess the frequency of dental anxiety and/or fear among patients in an emergency dental service. METHODS: Research was based on interviews with 252 patients, aged 18 years old and over, attended at an emergency dentistry service of São Paulo, Brazil, from August to November, 2001. Two methods were used to measure dental anxiety: the Modified Dental Anxiety Scale (MDAS and the Gatchel Fear

  2. Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    LENUS (Irish Health Repository)

    Agyapong, Vincent Israel Opoku

    2012-04-17

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  3. Shared care between specialised psychiatric services and primary care: the experiences and expectations of General Practitioners in Ireland.

    Science.gov (United States)

    Agyapong, Vincent Israel Opoku; Jabbar, Faiza; Conway, Catherine

    2012-10-01

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  4. Experiences from the Merger of Clinics in the Swedish Public Dental Service - the Employee Perspective.

    Science.gov (United States)

    Gustafsson, Christina Hassel; Östberg, Anna-Lena

    2017-01-01

    The purpose of this study was to investigate the experiences of employees regarding the merger of clinics within the Public Dental Service (PDS), Västra Götaland Region, Sweden. Employees (dentists, dental hygienists, dental nurses) affected by both administrative and geographical mergers of dental clinics answered a web-based survey about experiences and effects of the merger process (n = 99, 47%). The Swedish short-form version of "The Nordic Questionnaire for Psychological and Social Factors at Work" (QPSNordic), the QPSNordic-34+ was used. Chi-squared tests and logistic regression analyses were used. Two thirds of the participants were aged ≥ 50 years. The respondents stated that the reasons for the merger were often made clear (78%). Satisfaction with and involvement in the merger process received lower scores (45%). Work was often perceived as stressful, irrespective of the merger. Job demands and engagement scored positively, but control at work was given a low score (one fifth stated fairly high or high control). Dentists (OR 5.9; 95%, CI 1.1-32.3), but not dental hygienists (OR 2.8; 95%, CI 0.9-9.0), indicated stress significantly more often than dental nurses (reference) (adjusted for age and gender). Employees in the Public Dental Service (PDS) in a Swedish region had mainly positive experiences after the merger of clinics; however, their involvement in the process was low. Work demands were perceived as high. These findings should be considered when planning mergers in dental organizations.

  5. Determinants of the utilization of dental services in a community-dwelling elderly Japanese population.

    Science.gov (United States)

    Ohi, Takashi; Sai, Motoyuki; Kikuchi, Masahiko; Hattori, Yoshinori; Tsuboi, Akito; Hozawa, Atsushi; Ohmori-Matsuda, Kaori; Tsuji, Ichiro; Watanabe, Makoto

    2009-07-01

    Oral health care is not only an effective strategy for the prevention, early diagnosis, and treatment of orofacial disease and disorders, but also an essential component of general health promotion programs. The current study aimed to identify the determinants of the utilization of dental services in an elderly population in Japan. A community-based comprehensive geriatric assessment, including the measurements of physical, mental, and social functioning, was conducted among elderly people aged >or= 70 years residing in a suburban area of Sendai, Japan. Oral health status and functioning, their impact on the quality of life, and dental utilization were also surveyed. Of the 1,170 participants, 418 subjects who had specific treatment needs for dental problems and reported irregular dental attendance were recommended a dental visit, and 1 year later, their compliance with the recommendation was assessed by using questionnaire. Multiple logistic regression analysis demonstrated that a higher number of remaining teeth and the use of removable dentures were significant predictors of dental utilization within 1 year. Regular utilization was associated with a higher number of remaining teeth, younger age, presence of systemic disease, absence of depressive symptoms, and higher educational attainment. Conversely, non-compliance with the treatment recommendations was associated with fewer remaining teeth, smoking, and non-utilization of dental services during the previous year. The differences in the determinants of dental attendance behavior, which may be partially associated with the insurance coverage for dental services, suggest the need for specific strategies for oral health promotion for different behavior of dental utilization.

  6. Human trafficking and severe mental illness: an economic analysis of survivors' use of psychiatric services.

    Science.gov (United States)

    Cary, Maria; Oram, Siân; Howard, Louise M; Trevillion, Kylee; Byford, Sarah

    2016-07-19

    Previous studies have found a high prevalence of depression and post-traumatic stress disorder (PTSD) among survivors of human trafficking. European countries are required to assist trafficked people in their psychological recovery, but there are no rigorous data on the costs of doing so. The objectives of this study were to quantify the use of secondary mental health services by survivors of human trafficking; to estimate the cost of survivors' use of secondary mental health services provided by the UK National Health Service (NHS); and to identify factors that predict higher costs of mental health service provision. Historical cohort study of psychiatric patients who had experienced human trafficking. The South London and Maudsley NHS Trust (SLaM) Biomedical Research Centre Case Register Interactive Search (CRIS) database was used to identify anonymised full patient records of patients who had experienced human trafficking and who had accessed SLaM mental health services between 2007 and 2012. Data were extracted on socio-demographic and trafficking characteristics and contacts with mental health services. Total costs were calculated by multiplying each resource use item by an appropriate unit cost. Factors that predicted high mental health service costs were analysed using regression models. One hundred nineteen patients were included in the analysis. Mean total mental health service costs per patient were £27,293 (sd 80,985) and mean duration of contact with services was 1490 (sd 757) days (approximately 4 years). Regression analysis showed that higher costs were associated with diagnosis of psychotic disorder (p trafficking violence (p = 0.06). Patients diagnosed with psychotic disorders cost approximately £32,635 more than patients with non-psychotic disorders/psychological distress but no formal diagnosis and patients whose clinical notes documented pre-trafficking violence cost £88,633 more than patients for whom pre-trafficking violence was not

  7. Delivery of comprehensive children's dental services using portable dental clinics in NYC public schools. A six-year analysis.

    Science.gov (United States)

    Herman, N G; Rosenthal, M; Franklin, D M

    1997-04-01

    In 1990, the Bureau of Dental Health Services of the New York City Department of Health launched a major initiative to modernize a network of school-based dental clinics located throughout the city. Since 1913, the bureau has provided dental care to public school children; however, the clinics were not properly maintained or upgraded, and were in a state of disrepair and obsolescence. Anticipating that the survival of the program was in question, the school program was converted to a fleet of state-of-the-art portable dental clinics permitting targeting of underserved, high-risk poor and immigrant populations. Demographics had changed dramatically over the years; the program could now situate services where they were needed most, and provide a broader array of care where access was a problem. This paper presents a six-year analysis of the program and builds a strong case to show that a portable delivery system can equal or in many ways surpass the effectiveness and capabilities of a fixed-state approach.

  8. NHS dental service utilisation and social deprivation in older adults in North West England.

    Science.gov (United States)

    McKenzie, K W; Goodwin, M; Pretty, I

    2017-07-21

    Objective To explore NHS dental service utilisation (attendance and treatment activity) of older adults.Design Retrospective analysis of dental treatment claim forms (FP17s) over a 15 month period.Population A total of 690,433 older adults in North West England.Results NHS dental care attendance decreased with increasing age; 49% in 65-74 years, 39% in 75-84 years and 23% in the over 85 years age group. Across all older age stratifications, the more deprived patients had a higher rate of examinations, extractions, dentures and preventative advice compared to the least deprived patients. However, the relationship was opposite for the rate of fillings and complex restorative treatment; the rate was higher for the least deprived older adult patients.Conclusions Despite 95% of older adults living in the community, the number of older adults accessing NHS dental care in this data set is thought-provoking. Additionally, there is a complex relationship between the type of treatment provided and the patient's IMD level. The authors acknowledge the major limitations of this dataset; affluent people are more likely to access private dental care and the availability of NHS dental services is likely to vary across different regions. However, the use of 'big data' is necessary to provide a pragmatic approach for future research in the management of older adults in general dental services.

  9. CONSUMER’S ORIENTED DENTAL SERVICE QUALITY ASSESSMENT USING THE SERVQUAL MODEL

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    Zaura Anggraeni

    2015-06-01

    Full Text Available Consumers oriented quality in dental health services has become more important in the era of free competition. Perceived quality by the community has been closely related with their previous experience level of satisfaction on the quality of services they received. The information on the perceived quality of dental services in Indonesia has been scarce. One of the reasons is lack of standardized method in measuring the consumer’s perspective on dental quality. Using the Service Quality (Servqual model cross-sectionally, this study is to investigate differences in patterns on perceived quality of different groups of Puskesmas (government owned and Syahid clinic (private owner consumers. The analysis of Servqual Kartesius diagram was carried out to assess the quality of service, based on various criteria namely Dimesntions of Physical Tangibles, Reliability, Responsiveness, Assurance and Empathy. Results showed differences in quality perception likely due to differences in level of education and income. It was concluded that the Servqual model has been adequately practical for assessing quality dental services based on level of consumer’s satisfaction and degree of importance as measured from the consumer’s perspective. Eventuallym the results of Servqual measurements can be used as guidance for quality improvements of dental services, based different characteristics of consumers.

  10. The effect of two publicly funded insurance programs on use of dental services for young children.

    Science.gov (United States)

    Brickhouse, Tegwyn H; Rozier, R Gary; Slade, Gary D

    2006-12-01

    The purpose of this study is to compare the use of dental services for preschool aged children enrolled in North Carolina Medicaid, a traditional program based on a fee-for-service schedule, and North Carolina Health Choice (NCHC), an State Children's Health Insurance Program (S-CHIP) dental insurance program structured similarly to private insurance. All children (165,858) 1-5 years of age enrolled in Medicaid and S-CHIP (NCHC) at some time during one study year (October 1, 1999-September 30, 2000). DATA SOURCES/EXTRACTION METHODS: Medicaid and NCHC enrollment and dental claims files were obtained for individual children. An observational study with a retrospective cohort design. Use of dental services for each child was measured as having at least one dental claim during the outcome period (October 1, 1999-September 30, 2000). Multivariable logistic regression models were developed to compare the effect of two differently administered insurance programs on the use of dental services, controlling for demographic, enrollment, and county characteristics. Children enrolled solely in S-CHIP (NCHC) were 1.6 times more likely (95 percent confidence intervals (CI)=1.50-1.79) to have a dental visit than those enrolled solely in Medicaid. Prediction models for children enrolled for 12 months indicated that those enrolled in S-CHIP (NCHC) had a significantly higher probability of having a dental visit (50 percent) than those enrolled in both plans (44 percent) or Medicaid only (39 percent), a trend found in all age groups. The S-CHIP (NCHC) program appears to provide children with increased access to dental care compared to children in the Medicaid program.

  11. [Gingival health of adolescents and the utilization of dental services, state of São Paulo, Brazil].

    Science.gov (United States)

    Antunes, José Leopoldo Ferreira; Peres, Marco Aurélio; Frias, Antonio Carlos; Crosato, Edgard Michel; Biazevic, Maria Gabriela Haye

    2008-04-01

    To evaluate the association between gingival health conditions and dental service utilization. An epidemiological survey of the oral health of 1,799 adolescents was carried out in 35 cities of the state of São Paulo, in 2002. Gingival health was assessed through the prevalence of gingival bleeding on probing and dental calculus (community periodontal index), and dental occlusion was assessed through the dental aesthetic index. The utilization of dental services was measured by means of the dental care index (F/DMFT) for each city. Multilevel logistic regression analysis was used to adjust explanatory models to factors associated with the outcome variables of interest. The prevalence of gingival bleeding on probing was 21.5%, whereas dental calculus was prevalent in 19.4%. Male participants, who were either black or dark-skinned, lived in crowded homes, in rural areas, and showed schooling delay, were at a significantly higher risk than their respective counterparts. The following dental occlusion characteristics were also associated with unhealthy gum: incisor segment crowding, vertical anterior open bite, and antero-posterior molar relationship. Cities with a higher utilization of dental services showed a smaller proportion of adolescents with gingival bleeding and dental calculus. The utilization of dental services was significantly associated with better gingival health conditions (gingival bleeding and dental calculus). This association did not depend on contextual and individual sociodemographic characteristics or dental occlusion.

  12. A new primary dental care service compared with standard care for child and family to reduce the re-occurrence of childhood dental caries (Dental RECUR): study protocol for a randomised controlled trial

    OpenAIRE

    Pine, Cynthia; Adair, Pauline; Burnside, Girvan; Robinson, Louise; Edwards, Rhiannon Tudor; Albadri, Sondos; Curnow, Morag; Ghahreman, Marjan; Henderson, Mary; Malies, Clare; Wong, Ferranti; Muirhead, Vanessa; Weston-Price, Sally; Whitehead, Hilary

    2015-01-01

    BackgroundIn England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a n...

  13. Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan

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    Åstrøm Anne

    2009-11-01

    Full Text Available Abstract Background HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics, enabling (knowledge, attitudes and perceived risk related to HIV and need related factors (oral health status predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Methods Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH and University of Science and Technology (UST during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH were examined clinically (DMFT and participated in an interview. Results A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5 were associated with lower odds and females were associated with higher odds (OR = 2.0 for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6 and higher HIV related experience (OR = 0.7 were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3 were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8. Conclusion Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to

  14. Reasons for Referral, Intervention Approaches and Demographic Characteristics of Clients with Intellectual Disability Attending Adult Psychiatric Outpatient Services in the Kingdom of Bahrain

    Science.gov (United States)

    Grey, I.; Al-Saihati, B. A.; Al-Haddad, M.; McClean, B.

    2015-01-01

    Background: Relatively little information is available regarding the use of psychiatric services by individuals with intellectual disability (ID) in Arab countries. The current study aimed to identify (1) the reasons for referral; (2) demographic characteristics of individuals referred; (3) previous contact with child psychiatric services; (4)…

  15. [Structure of dental services in a social security system: Córdoba, Argentina].

    Science.gov (United States)

    Reynoso Alvarez de Viotti, R A; Batellino, L J

    1994-01-01

    We describe here the results of a survey carried out to determine the nature, extent and distribution of the dental service provided by the Board of the University Personnel Social Assistance (Dirección de Asistencia Social del Personal Universitario [DASPU] From 1988 to 1990. Such survey was performed on the bases of a representative sample of assistance recipients. The greatest dental service demand was registered among the group of persons of 25-44 years-old (40.3% of the total), although the rendered services per person/years increased with the member's ages. Restorative Dental and Prosthesis registered the highest occurrence (50.2% of the total). Preventive Odontology practices were infrequent (1.2%) while Odontopediatric was the less demanded (0.3%). 31.8% of the assistance was provided by DASPU own services, Prothesis being the most predominant kind. As for external effectors (62.3%), the most frequent were those of Dental Operating. It is concluded that the demanded dental services were mainly curative and reparative. The reorganization of the Odontology Service may increase the system' performance efficiency and effectiveness.

  16. Knowledge, practice and utilization of dental services among pregnant women in the north of Jordan.

    Science.gov (United States)

    Malkawi, Zain A; Tubaishat, Reem S

    2014-05-01

    The aim of this study was to evaluate women's oral hygiene knowledge, practice, and use of dental services during pregnancy in the north of Jordan. Voluntary sample of 154 pregnant women of 18 to 40 years old were invited to participate in the study. They were asked to read a self-designated questionnaire and a cover letter which explained the purpose of the study. The questionnaire addressed self-reported demographics, knowledge, practice and use of dental services during pregnancy. Data were statistically analyzed using Chi-square test to determine statistically significant differences across knowledge, practice and use of dental services during pregnancy. The sample included 29.3% aged 20 to 24 years old; 33.1% having bachelor degree; and 66.9% were housewives. The majority of study sample 68.2% knew they need dental consultation during pregnancy; however, 39.5% received dental consultation during pregnancy. Majority 62.4% brushed their teeth regularly; however, 73.2% does not use auxiliary dental hygiene devices. Majority 44.5% visited dentist, when they feel pain. Statistically significant association were found between educational level and knowledge about need to dental consultation during pregnancy (p = 0.012); educational level and knowledge about link between pregnancy and periodontal diseases (p = 0.01); and economic status and use of auxiliary dental hygiene devices during pregnancy (p = 0.040). Pregnant women brushed their teeth regularly and visited dentist occasionally. Income was significantly associated with increase use of auxiliary dental hygiene devices. Educational level was significantly associated with mothers' knowledge about the need for consultation and possible link between pregnancy and periodontal diseases.

  17. Access and utilization of dental services by Alabama Medicaid-enrolled children: a parent perspective.

    Science.gov (United States)

    Al Agili, Dania E; Bronstein, Janet M; Greene-McIntyre, Mary

    2005-01-01

    The purposes of this survey were to assess barriers to utilization of dental services among Medicaid-enrolled Alabama children and identify families who used or did not use Medicaid-covered dental services. A random sample of 4,500 parents of Medicaid-eligible children ages 3 to 19 years was surveyed. Participants came from Medicaid enrollment data stratified by area of residence into 3 groups: (1) large urban; (2) town; and (3) rural. Univariate and multivariate analyses were conducted. The overall response rate was 40% (N = 1,766). Most respondents (71%) reported that their child had a dental visit in the past year. Compared to parents who had a dental visit, those who reported no visits were more likely to: (1) be non-Hispanic African American; (2) be less educated; (3) live in rural settings of Alabama; (4) have more children younger than 6 or older than 12; (5) have more children with disabling conditions; and (6) report poor perceived oral health. Respondents with no dental visits were grouped into 3 categories-those who: (1) believed they did not need dental care (46%); (2) thought dental care was hard to find (34%); and (3) tried but could not get dental care (20%). The first group had significantly less respondents with a high school or greater education, more reporting perceived good to excellent oral health, and more living in rural areas, compared to the other 2 groups. Families who did not use Medicaid-covered dental services include: (1) a group with high perceived need and barriers to care; and (2) a group with little perceived need. Interventions must target both groups.

  18. A future pattern of psychiatric services and its educational implications: some suggestions.

    Science.gov (United States)

    Crisp, A H; Hemsi, L K; Paykel, E S; Storey, P B; Beary, M D; Kerr, D L

    1984-03-01

    Psychiatry has expanded rapidly as a medical discipline in the last two decades but has not always been able to recruit sufficient young doctors of ability to its ranks. In view of recent governmental and professional reports on future medical practice we set up a study group comprising members from academic, NHS, sub-specialty, community and in-training psychiatry to examine the present tasks, attractions and constraints within a career in psychiatry and propose possible improvements for further consideration. In marrying these views to foreseeable developments we are sensitive to the requirement to take into account both the needs of the community and the job satisfaction of the future psychiatrist. To this end we indicate briefly our views concerning the attractions that a career in psychiatry currently has for the good graduate and ways in which the provision of interest and stimulation, educationally and professionally, can be increased so as to attract psychiatrists of high calibre both to general adult psychiatry and to areas of the specialist services which are at present unpopular. Finally, we propose a pattern of psychiatric services which we believe will embody both a useful and an attractive specialized job and interesting educational goal for future medical practitioners.

  19. Dental anxiety and the use of oral health services among people attending two HIV primary care clinics in Miami.

    Science.gov (United States)

    Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R

    2012-05-01

    We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals.

  20. Dental School Administrators' Attitudes Towards Providing Support Services for LGBT-Identified Students.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Morris, Dustin R

    2015-08-01

    A lack of curriculum time devoted to teaching dental students about the needs of lesbian, gay, bisexual, and transgendered (LGBT) health care patient needs and biases against LGBT students and faculty have been reported. Understanding dental school administrators' attitudes about LGBT students' needs might provide further insight into these long-standing issues. The aims of this study were to develop a survey to assess dental administrators' attitudes regarding the support services they believe LGBT-identified students need, to identify dental schools' current diversity inclusion policies, and to determine what types of support dental schools currently provide to LGBT students. A survey developed with the aid of a focus group, cognitive interviewing, and pilot testing was sent to 136 assistant and associate deans and deans of the 65 U.S. and Canadian dental schools. A total of 54 responses from 43 (66%) schools were received from 13 deans, 29 associate deans, and 11 assistant deans (one participant did not report a position), for a 40% response rate. The findings suggest there is a considerable lack of knowledge or acknowledgment of LGBT dental students' needs. Future studies are needed to show the importance of creating awareness about meeting the needs of all dental student groups, perhaps through awareness campaigns initiated by LGBT students.

  1. Community-based preventive activities in the Public Dental Service in Norway.

    Science.gov (United States)

    Widström, E; Tillberg, A; Byrkjeflot, L I; Stein, L; Skudutyte-Rysstad, R

    2017-12-13

    The purpose of this study was to describe community-based preventive interventions undertaken by the dental team outside the dental clinics in Norway, from the dental hygienists' and the dentists' perspective, with the main focus on target groups and existing guidelines and routines for these activities. A secondary aim was to identify the personnel responsible for developing the local guidelines and the knowledge sources for the guidelines. With the assistance of the Chief Dental Officers in 15 Public Dental Service (PDS) regions, questionnaires were emailed to the local clinics (n = 421). In each, the most experienced dental hygienist and dentist were asked to respond; 215 dentists and 166 and dental hygienists responded (60%). Almost 40% of the respondents reported that their clinic had guidelines on community-based activities conducted outside the clinics. Dental hygienists and local chief dentists were responsible for planning them. The main target groups were young children and the dependent elderly; the majority of the activities were carried out at child welfare centres and for personnel at nursing homes or for home care nurses. At the regional and local level, a more strategic and coordinated approach to the provision of community-based activities is needed, including assessment of oral health needs among population groups. Continuous documentation and evaluation of results are necessary for optimal use of available resources and to facilitate an evidence-based approach. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Differences Among Older Adults In The Types Of Dental Services Used In The United States

    Science.gov (United States)

    Manski, Richard J.; Hyde, Jody Schimmel; Chen, Haiyan; Moeller, John F.

    2016-01-01

    Objective The purpose of this article is to explore differences in the socioeconomic, demographic characteristics of older adults in the United States with respect to their use of different types of dental care services. Methods The 2008 Health and Retirement Study (HRS) collected information about patterns of dental care use and oral health from individuals in the U.S. aged 55 years and older. We analyze these data and explore patterns of service use by key characteristics before modeling the relationship between service use type and those characteristics. Results The most commonly used service category was fillings, inlays or bonding, reported by 43.6 percent of those with any utilization. Just over one-third of those with any utilization reported a visit for a crown, implant or prosthesis, and one-quarter reported a gum treatment or tooth extraction. The strongest consistent predictors of use type are denture, dentate, and oral health status along with dental insurance coverage and wealth. Conclusions Our results provide insight into the need for public policies to address inequalities in access to dental services among an older US population. Our findings that showed lower income, less wealthy elderly with poor oral health are more likely to not use any dental services rather than using only preventive dental care, and that cost prevents most non-users who say they need dental care from going to the dentist, suggest a serious access problem and one that ultimately produces even worse oral health and expensive major procedures for this population in the future. PMID:27284127

  3. The effectiveness of out-of-hours dental services: I. Pain relief and oral health outcome.

    Science.gov (United States)

    Anderson, R; Thomas, D W; Phillips, C J

    2005-01-22

    To compare the effectiveness of four types of out-of-hours emergency dental service, including both 'walk-in' and telephone-access services. Questionnaire survey of patients attending weekend emergency dental services, with measurement of self-reported oral health status and dental pain (at attendance and follow-up) and retrospective judgements of change in oral health status. Two health authorities in South Wales, UK. A total of 783 patients who completed questionnaires at attendance, and 423 who completed follow-up questionnaires. For patients who saw a dentist there were no consistent differences in the effectiveness of the four services, whether measured as pain relief, oral health gain or using patients' retrospective transition judgements about feeling better after their episode of emergency dental care. The proportion of patients reporting no improvement (transition judgements), either an hour after or the day after seeing the dentist, was surprisingly high (30-40% and 23-38% respectively). Although the 'rotas for all' - a telephone-access GDP-provided service for both registered and unregistered patients - achieved both the highest reductions in pain scores and the greatest improvements in dental health status between attendance and follow-up, this effect may reflect health gains due to care received after the episode of emergency dental care. Neither the setting where emergency dental patients are seen, nor the type of dentist who sees them, appear to have any significant effect on patient-reported health outcomes. Although further exploration of the factors that predict poor pain relief or low oral health gain is required, future research on these services should focus on the process of care and accessibility.

  4. Improvements in dental care using a new mobile app with cloud services

    Directory of Open Access Journals (Sweden)

    Chia-Yung Lin

    2014-10-01

    Conclusion: Our new mobile app, Dental Calendar, in combination with cloud services, provides efficient service to both dentists and patients, and helps establish a better relationship between them. It also helps dentists to arrange appointments for patients with sudden worsening of prosthesis function.

  5. Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland.

    Science.gov (United States)

    Carlisle, Karen; Larkins, Sarah; Croker, Felicity

    2017-01-01

    The oral health of rural Australians continues to lag behind that of those living in metropolitan areas. Research has shown that people living in rural areas are more likely to suffer from dental caries (decay), visit the dentist less often and have poorer access to oral health services. The purpose of the study was to examine hospitalisations for dental conditions and utilisation of public dental services in three rural communities in Queensland compared with the whole of Queensland. Aggregated hospitalisation data for dental conditions and counts of public outpatient service data were requested for residents of three rural communities in Queensland and for the whole of Queensland for the calendar year 2013. Hospitalisation rates per 1000 and risk ratios were calculated to examine the risk of hospitalisation for dental procedures for those living in the selected rural communities and the rest of Queensland. Data were grouped by gender, age and Indigenous status and comparisons made between Queensland and the rural communities. Outpatient service data were converted to percentage of all services delivered to allow comparisons between groups of different sizes. Population data were grouped into age cohorts and compared with the proportion of public oral health services delivered to each age cohort. Residents of the rural communities were twice as likely to be hospitalised and children aged 0-14 years living in the communities were three times more likely to be hospitalised for dental conditions compared to residents of the rest of Queensland. Outpatient oral service data showed that the proportion of services delivered to children aged up to 14 years living in the rural communities was less than the whole of Queensland. Interestingly, in one rural community where the public dental service was open to all, the distribution of public oral health services aligned with the age distribution of the population. The study showed that residents of these rural communities

  6. Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service?

    Science.gov (United States)

    Martins, Andréa Maria Eleutério de Barros Lima; Jardim, Lorena Amaral; Souza, João Gabriel Silva; Rodrigues, Carlos Alberto Quintão; Ferreira, Raquel Conceição; Pordeus, Isabela Almeida

    2014-01-01

    This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2 test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

  7. Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service?

    Directory of Open Access Journals (Sweden)

    Andréa Maria Eleutério de Barros Lima Martins

    2014-03-01

    Full Text Available This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2test and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7% evaluated the provided services negatively (very poor or poor. Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

  8. [Characteristics associated with the use of dental services by the adult Brazilian population].

    Science.gov (United States)

    Pinto, Rafaela da Silveira; Matos, Divane Leite; de Loyola Filho, Antônio Ignácio

    2012-02-01

    The scope of this study was to investigate the factors related to the use of dental services by Brazilian adults. Data were collected from 13,356 adults (35 to 44 years of age), participating in a nationwide epidemiological survey of oral health (SB-BRASIL 2003 Project). Data analysis was based on Poisson regression, which produced estimates of Prevalence Ratios as a measure of association. Data analysis showed that the use of dental services by adults was associated with: female gender, low education and income, living in the Northeastern and Southern regions and in small cities, complaints of toothache or gum pain, need for partial/total prosthesis, a greater amount of permanent teeth requiring treatment, demand for service due to some dental problems and evaluation of dental care received on a regular basis. These results showed that the population attended by the public service was socio-economically less privileged and had greater need for treatment. This situation reflects an historical abandonment of the adult population by the dental healthcare system in Brazil and poses a major challenge to the Unified Health Service, in light of its intended role to reduce inequalities and provide universal access to comprehensive care.

  9. A Care Pathway for Children Unable to Accept Dental Care Within the General Dental Services Involving the Use of Inhalation Sedation and General Anaesthesia.

    Science.gov (United States)

    Shepherd, Allyson R; Ali, Halimah

    2015-05-01

    Dental treatment is the commonest reason for a child to be in hospital in the UK. This is a shocking statistic for a preventable disease. How can we reduce the high numbers of dental general anaesthetics? It is essential that dental treatment under general anaesthesia (GA) is fully justifiable, ensuring that the right patients receive the right treatment. Guidance for general dental practitioners on when to refer a child for a dental GA is discussed. Treatment planning for this dentally high-risk group of children requires a holistic approach. It is complex and requires an experienced and competent clinical team, including dental care professionals with additional postgraduate qualifications. Often, alternative treatments are successful and a GA can be avoided. An audit of 85 patients referred for GA with Oldham Community Dental Service demonstrated 35% of patients accepted treatment with local anaesthesia only, 25% required inhalation sedation and only 25% were actually referred on for GA. Treatment for this group of patients must include the availability and provision of appropriate alternative treatment modalities, with the right staff and facilities, including those for dental general anaesthetic sessions. Ongoing follow-up within the general dental services is essential for this group of patients.

  10. High-acuity GIS mapping of private practice dental services in New Zealand: does service match need?

    Science.gov (United States)

    Kruger, Estie; Whyman, Robin; Tennant, Marc

    2012-04-01

    New Zealand is a country with a relatively small population (4 million people) distributed unevenly over a relatively large land area. Adult oral health services in New Zealand are almost all delivered through a market-driven, private practice model and are funded directly by patient payments. Little attention has been given to the distribution of these services. This study reports the findings of a high-acuity examination of the distribution of private dental practices in New Zealand, using modern geographic information system (GIS) tools. A total of 1,045 private dental practices in New Zealand were geocoded. These dental practices overlaid 1,909 area units. The highest practice: adult population ratios found in this study reflected the areas with the highest population densities of Maori and Pacific Islander people. Oral health has a substantial impact on health-related quality of life and the utilisation of dental care services can contribute to its improvement. As such, it is expected that access to care should be focused on the population groups with the highest degree of need. However, in a market-driven, mostly private practice model, such as that in New Zealand, available care is concentrated largely in areas of high socioeconomic status and in populations with lower levels of oral disease. © 2012 FDI World Dental Federation.

  11. Shared care between specialized psychiatric services and primary care: the experiences and expectations of consultant psychiatrists in Ireland.

    Science.gov (United States)

    Agyapong, Vincent I O; Conway, Catherine; Guerandel, Allys

    2011-01-01

    Internationally, there has been a growing interest in the pursuit of collaborative forms of care for patients with enduring mental health difficulties. The study aims to explore the views of consultant psychiatrists in Ireland on shared care between specialized psychiatric services and primary care for patients with mental health difficulties. A self-administered questionnaire was designed and posted to 470 consultant psychiatrists who are members of the College of Psychiatry of Ireland. Stamped self-addressed envelopes were included for the return of completed questionnaires. Overall, 213 questionnaires were returned, giving a response rate of 45%. Of the respondents, 194 (91%) reported that they would support a general policy on shared care between primary care and specialized psychiatric services for patients who are stable on their treatment. However, 181 (85%) reported that they foresaw difficulties for patients in implementing such a policy including: increased financial burden on some patients (141, 66%); some patients may lack confidence in GP care (100, 47%); primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (128, 60%); primary care providers are not adequately trained to provide psychiatric care (111, 52%); and lack of adequate cooperation between primary care and specialized mental health services (96, 45%). The Irish government and the Colleges of General Practitioners and Psychiatrists in Ireland need to work together to remove the bottlenecks that hinder the active involvement of primary care in the management of patients with enduring mental health difficulties. Also, the health care systems need to be organized along a shared care model to facilitate effective collaboration between primary and specialized psychiatric services.

  12. Influence of self-perceived oral health and socioeconomic predictors on the utilization of dental care services by schoolchildren

    OpenAIRE

    Piovesan, Chaiana; Antunes, José Leopoldo Ferreira; Guedes, Renata Saraiva; Ardenghi, Thiago Machado

    2011-01-01

    The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index). Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured i...

  13. Dental service utilization and neighborhood characteristics in young adults in the United States: a multilevel approach.

    Science.gov (United States)

    Okunseri, Christopher; Garcia, Raul I; Okunseri, Elaye; Visotcky, Alexis; Szabo, Aniko

    2015-01-01

    To investigate the association between neighborhood level factors and dental visits in young adults in the United States after adjusting for individual level factors. The National Longitudinal Study of Adolescent Health Wave 1 (1994-1995) to Wave III (2001-2002) was analyzed. The primary outcome of having had at least one dental visit in the previous 12 months was analyzed via a multilevel random-effects logistic model accounting for geographic clustering in Wave III and survey design clustering from Wave I. Neighborhood level covariates were defined at the census tract level. Overall rate of dental visits was 57 percent, highest among 18-20 year olds (65 percent) and lowest in 23-26 year olds (52 percent). Increased proportion of African-Americans (≤5 percent to ≥20 percent) and Hispanics (≤5 percent to ≥20 percent) in a neighborhood corresponded with a decrease in dental visits (60 percent versus 52 percent) and (58 percent versus 51 percent), respectively. Neighborhoods with a high proportion of college-educated residents had a higher percentage of dental visits. Similar differences were found when comparing the lowest and highest tertiles defined by poverty level and unemployment with dental visits. Neighborhood education was significantly associated with dental service utilization after adjustment for individual level factors and dental utilization in adolescence (Waves I and II) in the random effects model. This study demonstrates that the education level of residents within a neighborhood was associated with dental service utilization in young adults in the United States. © 2015 American Association of Public Health Dentistry.

  14. Mental health service use types among Asian Americans with a psychiatric disorder: considerations of culture and need.

    Science.gov (United States)

    Nguyen, Duy; Bornheimer, Lindsay A

    2014-10-01

    Despite levels of need that are comparable with other groups, relatively few Asian Americans receive mental health care. While studies have described the tendency for Asian Americans to delay care until mental health symptoms are severe, relatively little research has examined how the severity of symptoms impact mental health service use. This study uses publicly available data from the National Latino and Asian American Study (NLAAS) and focuses solely on Asian American respondents with a psychiatric disorder (n = 230). Unexpectedly, few Asian Americans with a psychiatric disorder received care in a medical setting. The perception of mental health needs increased the likelihood of using mental health specialist care. Social and systemic barriers together hinder mental health service use. Implications for addressing Asian American mental health service use within a changing health care environment are discussed.

  15. Outsourcing mental health care services? The practice and potential of community-based farms in psychiatric rehabilitation.

    Science.gov (United States)

    Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

    2015-02-01

    Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were analysed across 214 care farms retrieved from a national database. Qualitative insights were provided by five case descriptions, selected from 34 interviews. Institutional care farms were significantly larger and older than private care farms (comprising 88.8% of all care farms). Private, independent care farms provide real-life work conditions to users who are relatively less impaired. Private, contracted care farms tailor the work activities to their capacities and employ professional supervisors. Institutional care farms accommodate for the most vulnerable users. We conclude that collaborations with independent, contracted and institutional care farms would provide mental health care organizations with a diversity in services, enhanced community integration and a better match with users' rehabilitation needs.

  16. [History of psychiatric service in Brazil: the case of Colônia Juliano Moreira (1940-1954)].

    Science.gov (United States)

    Venancio, Ana T A; Pereira Cassilia, Janis A

    2011-01-01

    The article analyzes the history of Colônia Juliano Moreira (Juliano Moreira Colony) during the 1940s and early 1950s, in order to understand the relationship between mental health services and Brazilian national health policy at that time. Charts, newsletters, and medical reports of the institution are used as primary sources, as well as official documents issued by the office then in charge of psychiatric service, the Serviço Nacional de Doenças Mentais do Ministério da Educação e Saúde (Mental Disease National Service, under the Ministry of Education and Health). It observes how Colônia Juliano Moreira, created in 1924 as an agricultural colony, and based on praxitherapy as well as family therapy methods, has undergone an expansion of its physical and assistance resources within the Brazilian psychiatric health policy.

  17. Caries management decision: influence of dentist and patient factors in the provision of dental services.

    Science.gov (United States)

    Doméjean-Orliaguet, S; Léger, S; Auclair, C; Gerbaud, L; Tubert-Jeannin, S

    2009-11-01

    Little is known about how dentists implement caries management and provide restorative dental services in everyday practice. This study explored whether or not recent concepts in caries management were implemented in practice by private practitioners. The influence of patient and practitioner characteristics on the provision of restorative dental services was also investigated through multidimensional analyses. A sample of French general private dental practitioners was asked to record the characteristics of 35 preventive or restorative treatments made on vital permanent teeth. The data collection form was designed to explore dentists' attitudes towards caries management and their use of minimally invasive therapies. Twenty-six practitioners recorded the characteristics of 921 treatments performed on 457 patients. Results indicate that participants rarely performed non-invasive treatments. They used an inappropriate detection tool, as most of decisions to treat were based on visual inspection frequently associated with probing. Multidimensional analysis showed that dentists provided different restorative treatments depending on patient characteristics, with minimally invasive, esthetic restorations preferentially performed for healthy, young and well-insured patients. Restorative treatments and detection tools also varied markedly among practitioners. These variations in service patterns were not related to a specific patient profile in each dental practice. Results indicate that recent concepts in caries management have not yet been adopted in everyday practice. Patient and dentist characteristics influence the provision of restorative dental services. Decision-making in caries management not only depends on pathophysiology but also seems to be influenced by many other factors.

  18. Out-of-pocket expenditure by private households for dental services - empirical evidence from Austria.

    Science.gov (United States)

    Sanwald, Alice; Theurl, Engelbert

    2016-12-01

    Dental services differ from other health services in several dimensions. One important difference is that a substantial share of costs of dental services-especially costs beyond routine dental treatment-is paid directly by the patient out-of-pocket. This study analyses the socio-economic determinants of out-of-pocket expenditure for dental services (OOPE) in Austria at the household level. Cross-sectional information on OOPE and household characteristics provided by the Austrian household budget survey 2009/10 was analysed. A two-part model (Logit/GLM) and one-part GLM was applied. The probability of OOPE is strongly affected by the life cycle (structure) of the household. It is higher for higher age classes, higher income, and partially higher levels of education. The type of public insurance has an influence on expenditure probability while the existence of private health insurance has no significant effect. In contrast to the highly statistically significant coefficients in the first stage, the covariates of the second stage remain predominantly insignificant. According to the results, the level of expenditure is driven mainly by the level of education and income. The results of the one-part GLM confirm the results of the two-part model. The results allow new insights into the determinants of OOPE for dental care. The household level turns out to be an adequate basis to study the determinants of OOPE, although caution should be applied before jumping to conclusions for the individual level.

  19. Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services.

    Science.gov (United States)

    Blomqvist, Marjut; Sandgren, Anna; Carlsson, Ing-Marie; Jormfeldt, Henrika

    2018-02-01

    It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness. © 2017 Australian College of Mental Health Nurses Inc.

  20. Sociodemographic And Clinical Profile Of Men Assisted In A Psychiatric Detoxification Service In Natal, Rn, Brazil

    Directory of Open Access Journals (Sweden)

    Romeika Carla Ferreira de Sena

    2017-05-01

    Full Text Available Introduction: The male population has a high probability of abandoning treatment, avoidance of health services, great exposure to violence, mainly due to abusive use of alcohol and other drugs, and high crime rates also associated with this problem. Objective: To characterize the sociodemographic and clinical profile of men admitted to a Psychiatric Detoxification Hospital Unit for alcohol and drug abuse. Method: It is a cross-sectional and retrospective study, with data collection in 2015, with a temporal cut in patients´ records between 2008 and 2014, reaching a sample of 1,152 medical records. The data collection instrument was composed of a structured form. The data were analyzed in a descriptive way. Results: Regarding the age, the age group between 21 and 50 years old had 30.73% between six and ten days hospitalized, and 11.98% had readmissions. The main diagnoses for this disorders were linked to the use of opiates, cannabinoids, sedatives and hypnotics. Conclusion: The profile of internal and assisted men was characterized such as adults of productive age, residents of the metropolitan area of the city, with long periods of hospitalization, generally with improved type discharge, low readmission and diagnoses of mental disorders related to the excessive use of alcohol and other drugs.

  1. Service quality implications of dental undergraduate outreach teaching for Primary Care Trusts in England, UK.

    Science.gov (United States)

    Elkind, Andrea; Blinkhorn, Fiona A; Mackie, Iain C; Tickle, Martin; Duxbury, Jacqueline T; Blinkhorn, Anthony S

    2006-06-01

    Primary Care Trusts (PCTs) assumed new responsibilities for dentistry in 2005. In dental education it has been suggested that more emphasis is made of primary care outreach schemes. The paper considers the service quality implications of dental outreach teaching for PCTs with particular reference to access and acceptability. RESEARCH DESIGN AND CLINICAL SETTING: A pilot of outreach teaching for Manchester undergraduates in relation to adult dental care began in 2001. Six groups of eight students, working in pairs, spent one day per week in one of three community dental clinics in socially deprived areas. The evaluation of the first year used data from 908 patient treatment summaries, 139 patient questionnaires, and records of patient attendance. Access and acceptability measured by patients' demographic characteristics, patients' attendance at the clinics; patients' reasons for attendance, use of services and satisfaction with the service. In terms of access, the new service was used by local patients. Their main reasons for attending were convenience, a dental problem, free treatment, lack of access to a dentist, and lay referral. Some 41 percent attended initially because of an emergency, 30 percent said that if they had not attended the clinic they would have gone nowhere or did not know where they would have gone, and 49 percent had not attended a dentist for more than two years. In terms of acceptability most patients were positive about being treated by a student, 96 percent thought the quality of care excellent or good, and the same percentage said they would return to the clinic. The main areas of criticism were waiting times and appointments. Students can provide an accessible and acceptable local primary care dental service for adult patients in socially deprived areas as part of their undergraduate learning, and in a way that complements the existing services.

  2. Costs of a school-based dental mobile service in South Africa.

    Science.gov (United States)

    Molete, M P; Chola, L; Hofman, K J

    2016-10-19

    The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale. In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters. The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %. Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.

  3. Dental health service utilisation by resident doctors/medical officers in the University College Hospital, Ibadan, Oyo State, Nigeria.

    Science.gov (United States)

    Opeodu, O I; Dosumu, E B; Arowojolu, M O

    2012-09-01

    Dental disease is still a serious health problem universally possibly because dental health awareness and dental service utilization is still very low. The reported prevalence of dental diseases, especially periodontal disease, is higher among the black race while their rate of dental service utilization is lower in comparison to Caucasians. The aim of this study was to assess the rate of dental service utilization and identify the factors influencing such utilization by medical doctors and dentists in the University College Hospital, Ibadan. Two hundred 26-item questionnaires were distributed among the resident doctors/medical officers in the University College Hospital, Ibadan, Oyo state. The questionnaire sought to know if there is any previous dental visits, the reason for such visits and any other follow-up visits afterward. One hundred and ninety of the doctors returned the filled questionnaires giving a response rate of 95%. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 14.0. Level of statistical significance was set at p dental visit but only 25.3% was within the last one year of the study. Among those that had visited a dentist before, 59.7% did so for the symptomatic treatment of one ailment or the other and only 13.7% of them went back for the follow-up appointment after the resolution of their symptoms. There was a statistically significant difference between the rate of dental service utilization and the gender of the respondents (p dental service utilization and age of the respondents. The study showed that the rate of dental service utilization is low when compared with that of developed countries. Some factors identified as contributing to the lack of dental service utilization among the participants include prolonged and repeated dental appointments and the demand of their work.

  4. Nonuse of dental service by schoolchildren in Southern Brazil: impact of socioeconomics, behavioral and clinical factors.

    Science.gov (United States)

    da Costa, Vanessa Polina Pereira; Goettems, Marília Leão; de Oliveira, Luísa Jardim Corrêa; Tarquinio, Sandra Beatriz Chaves; Torriani, Dione Dias; Correa, Marcos Britto; Demarco, Flávio Fernando

    2015-05-01

    To assess clinical, behavioral and socioeconomic factors associated with nonuse of dental services by schoolchildren. A cross-sectional school-based study with 1211 children aged 8-12 years was carried out in Pelotas, Brazil. The outcome (never having had a dental appointment) and independent variables were collected through interview with parents and children, including sex, age, parent's schooling, family income, self-perception about oral health, and dental fear. Dental caries was assessed by clinical examination performed at schools. 291 (24.3 %; 95 % CI 22.0-26.9) of the children had never visited a dentist. Multivariate Poisson regression analysis showed that the outcome was associated with children from mothers with little education (≤0.001), from public schools (≤0.001), from crowded households (≤0.001), who had no caries (≤0.001), who had dental fear (≤0.001), and who started oral hygiene later (0.04). Despite the extensive increase in oral health coverage, especially in the public system in the last years in Brazil, there is still an unassisted portion of the population of schoolchildren. It was observed that socioeconomic, behavioral, and clinical factors influenced the nonuse of dental services.

  5. The Effects of Economic Crisis on the Demand and Supply of the Dental Services in Greece.

    Science.gov (United States)

    Kostas, Diamantopoulos; Dimitris, Niakas

    2017-01-01

    This paper attempts to explore the impact of the economic crisis on the supply and demand of dental care services by listing the changes in costs for dental care as well as by the use of a questionnaire administered to dentists. The Health Accounts System, the Household Budget Surveys of the Greek Statistical Authority, and a questionnaire distributed to dentists working as self-employed were used as analysis tools. The survey involved a total of 361 dentists from all the regions of the country. During the period of the economic crisis, the household expenses for dental care decreased by 57% according to the Health Accounts System and by 59.38% according to the Household Budget Surveys. Regarding public expenditures, the direct government expenses decreased (excluding social insurance) by 57.55% and social insurance by 91.04%. On the demand side, the majority of respondents indicate a reduction in quantity and prices of dental procedures. An increase is noted in the number of extractions and changes are not reflected in the number of fillings and surgical extractions. For root canal treatments, the percentage of dentists stating decrease in the number is almost equal to the percentage indicating increase. On the supply side, respondents notice an increase in professional costs due to an increase taxes and materials. Dental expenditures and private income for dentists collapsed during the Greek economic crisis, and demand for dental services remained stable only for emergency cases and pain management.

  6. Mental Health Service Use Across the Life Course Among Adults With Psychiatric Disorders and Prior Suicidal Behavior.

    Science.gov (United States)

    Byers, Amy L; Lai, Amy X; Arean, Patricia; Nelson, J Craig; Yaffe, Kristine

    2016-04-01

    Little is known about mental health service use by adults with prior suicidal behavior and current mood or anxiety disorders. This study determined nationally representative prevalence estimates of current mental health service use by these adults, examining racial-ethnic, age, and gender differences. Service use across the life course was examined with Collaborative Psychiatric Epidemiology Survey data from 1,139 adults with a history of suicidal behavior and current mood or anxiety disorders. Overall service use was 47.3%. Across the life course, African Americans showed increasing service use that paralleled use by non-Hispanic whites, Hispanics, and others, whereas use by these three groups decreased in the latter half of the life course (p interaction=.01). Adults with prior suicidal behavior and current mood or anxiety disorders have low mental health service use. Findings of racial-ethnic disparities in use can help identify those in need of care.

  7. Utilisation of oral health services provided by non-dental health practitioners in developed countries: a review of the literature.

    Science.gov (United States)

    Barnett, T; Hoang, Ha; Stuart, J; Crocombe, L; Bell, E

    2014-12-01

    People who have limited access to dental care may present to non-dental health practitioners for dental treatment and advice. This review synthesised the available evidence regarding the use of non-dental health practitioners for oral health problems and the services provided by non-dental health practitioners to manage such presentations. PubMed and CINAHL databases were searched using key search terms to identify all relevant quantitative and qualitative English-language studies published between 1990 and March 2014. Snowballing techniques were then applied whereby the reference lists of retrieved articles were searched for other relevant citations. Grey literature was searched via Google using the same search terms to identify unpublished work and government reports. Of the 43 papers which met the review criteria, 25 papers reported on the use of non-dental health practitioners for oral health problems and 18 on dental care education and training for non-dental health practitioners. Four reports were located from the grey literature on the involvement of non-dental health practitioners in the management of oral health care. The review of literature showed that both children and adults utilise non-dental health practitioners for oral health problems. Despite this, Emergency Department medical staff, medical practitioners and pharmacists generally lacked training and knowledge in the maragement of oral health. Services from non-dental health practitioners mainly focussed on children. The literature on education and training for non-dental health practitioners was limited.

  8. Health services research, the Agency for Health Care Policy and Research, and Dental Practice.

    Science.gov (United States)

    Maas, W R; Garcia, A I

    1994-01-01

    Recent findings of research supported by the Agency for Health Care Policy and Research (AHCPR) confirm the need for additional health services research on the effectiveness and appropriateness of dental care, and the way in which dental care is provided and financed. This paper presents an overview of relevant AHCPR programs, gives examples of dental health services research supported by the Agency, and describes ways in which Fellows of the American College of Dentists could participate in the development and dissemination of health services research. New knowledge generated by dental health services research will be useful to dentists in meeting many of their professional obligations. Translating that knowledge into improved quality of care will depend directly upon the best collaborative efforts of dentists in all professional settings and may include collaboration with academic researchers. As leaders in the profession, Fellows of the American College of Dentists are regarded as instrumental in conveying the findings of health services research to their colleagues, stimulating critical review, and making recommendations to guide research in the future.

  9. 76 FR 15349 - Fiscal Year 2010 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Science.gov (United States)

    2011-03-21

    ... From the Federal Register Online via the Government Publishing Office OFFICE OF MANAGEMENT AND BUDGET Fiscal Year 2010 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by... the cost of outpatient medical, dental and cosmetic surgery services furnished by military treatment...

  10. A Comparative Study of United States Service Members With and Without a History of Inpatient Psychiatric Hospitalization on Post Deployment Trauma, Depression, and Hazardous Alcohol Use Symptoms

    Science.gov (United States)

    2014-01-01

    regression analyses were conducted to test study hypotheses. Results: Previously psychiatrically hospitalized service members demonstrated...predicting positive Two-Item Conjoint Screen (TICS) from history of inpatient psychiatric hospitalization (N = 492...positive Two-Item Conjoint Screen (TICS) in inpatient cases (Group 1; N = 246) . 63 Table 6. Summary of logistic regression model predicting positive Two

  11. Political or dental power in private and public service provision: a study of municipal expenditures for child dental care.

    Science.gov (United States)

    Andersen, Lotte Bøgh; Bech, Mickael; Lauridsen, Jørgen

    2012-07-01

    Both professionals and politicians may affect expenditures for highly professional services provided in the public and private sector. We investigated Danish publicly financed child dental care with a special focus on the influence of politicians and dentists on the expenditure level. By studying spatial patterns in expenditure levels across municipalities, we are able to test the influences of these two main actors and the networks through which learning is achieved. Four hypotheses on the existence of different spatial spillover effects are tested. The empirical analysis is based on annual data from 1996 to 2001 for 226 Danish municipalities, thus allowing for the control for heterogeneity between municipalities and for intra-municipal correlations across time. The results point to differences in expenditures between municipalities with privately and publicly produced dental care. Furthermore, dentists appear to be the most important actors for the spatial spillover effects, and these effects are especially strong for municipalities situated in the same county that use private dental clinics. There is no evidence of political spatial spillover effects between municipalities.

  12. Medication adherence, work performance and self-esteem among psychiatric patients attending psychosocial rehabilitation services at Bangalore, India

    OpenAIRE

    Sailaxmi Gandhi; Rajitha Pavalur; Sivakumar Thanapal; Nirmala B Parathasarathy; Geetha Desai; Poornima Bhola; Mariamma Philip; Santosh K Chaturvedi

    2014-01-01

    Context: Work benefits mental health in innumerable ways. Vocational rehabilitation can enhance self-esteem. Medication adherence can improve work performance and thereby the individuals’ self-esteem. Aim: To test the hypothesis that there would be a significant correlation between medication adherence, work performance and self-esteem. Setting and Design: A quantitative, descriptive correlational research design was adopted to invite patients attending psychiatric rehabilitation services to ...

  13. A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake.

    Science.gov (United States)

    Grelotti, David J; Lee, Amy C; Fils-Aimé, Joseph Reginald; Jean, Jacques Solon; Therosmé, Tatiana; Petit-Homme, Handy; Oswald, Catherine M; Raviola, Giuseppe; Eustache, Eddy

    2015-01-01

    Worldwide, there is a gap between the burden of mental distress and disorder and access to mental health care. This gap is particularly large in low- and middle-income countries (LMICs). After the 2010 earthquake in Haiti, the international health care organizations Partners in Health and Zanmi Lasante worked to expand local mental health services in rural Haiti. The aims of this study are to describe clinical characteristics of the patients served during a pilot project to deliver community-based psychiatric services in rural Haiti and to show how this experience complements the Mental Health Gap Action Programme ("mhGAP"), a tool developed by the World Health Organization to support mental health care delivery by nonspecialists in LMICs. The pilot was conducted in March 2011. A visiting psychiatrist traveled to rural Haiti and paired with local clinicians to evaluate patients and to support quality improvement practices in psychiatric care. Patients received a standard neuropsychiatric evaluation. mhGAP was an important clinical reference. To assess the experience, we conducted a retrospective chart review of outpatient encounters. Sixty-five patients presented with a wide range of common psychiatric, neurologic, and general medical conditions. Forty-nine of these patients (75%) reported primary problems subsumed by an mhGAP module. Fifteen patients (23%) reported headache as their chief complain, a condition that is not currently covered by mhGAP. Surprisingly, only 3 patients (5%), reported earthquake-related distress. Our clinical data reinforce the need for provision of standard psychiatric and neurologic services in LMICs. Such services ought to accompany interventions targeted specifically at disaster-related problems. Clinical situations falling outside existing mhGAP modules inspired the development of supplemental treatment protocols. These observations informed coordinated efforts at Zanmi Lasante to build a sustainable, integrated mental health system

  14. Oral health comparisons between children attending an Aboriginal health service and a Government school dental service in a regional location.

    Science.gov (United States)

    Parker, Eleanor J; Jamieson, Lisa M

    2007-01-01

    Indigenous children in Australia have higher dental caries levels than their non-Indigenous counterparts. Indigenous communities in South Australia's mid-north region have identified dental health as one of their top health priorities. In response to this, an oral health program based at the Pika Wiya Health Service in Port Augusta was established, with a dentist providing care for adults, and a dental therapist providing care for children, 2 days per week each. The purpose of this article is to compare the socio-demographic and oral health characteristics of children attending for care at the Pika Wiya Health Service Dental Clinic with those of their counterparts attending the general Port Augusta School Dental Service (SDS). Both Indigenous and non-Indigenous children were included. Data were obtained from the South Australian Dental Service (SADS), which routinely collects socio-demographic and dental information from patients seen through their system. Examinations were conducted by SADS-employed dental professionals. A full enumeration of children attending for care at Pika Wiya and the Port Augusta SDS from March 2001 to March 2006 was included. Surface level tooth data was captured using the EXACT treatment charting and management information system. The Socio-Economic Indices For Areas (SEIFA) were used to determine socio-economic status, and the dmft (sum of decayed, missing and filled teeth in the deciduous dentition) and DMFT (sum of decayed, missing and filled teeth in the permanent dentition) indices were used to assess oral health outcomes. Both measures were used for children aged 6-10 years because in such age groups children have a mixed dentition (both primary and permanent teeth are present). Caries prevalence (dmft/DMFT>0) and severity (mean dmft/DMFT) were calculated, as well as the Significant Caries Index (SiC) and Significant Caries Index 10 (SiC 10). The SiC is the mean dmft/DMFT of the one-third of the sample with the highest caries score

  15. The use of psychiatric services by young adults who came to Sweden as teenage refugees: a national cohort study.

    Science.gov (United States)

    Manhica, H; Almquist, Y; Rostila, M; Hjern, A

    2017-10-01

    To investigate the patterns of use of different forms of psychiatric care in refugees who settled in Sweden as teenagers. Cox proportional hazards models were used to estimate the use of different forms of psychiatric care from 2009 to 2012 in a population of 35 457 refugees, aged from 20 to 36, who had settled in Sweden as teenagers between 1989 and 2004. These findings were compared with 1.26 million peers from the same birth cohorts in the general Swedish population. Unaccompanied and accompanied refugees were more likely to experience compulsory admission to a psychiatric hospital compared with the native Swedish population, with hazard ratios (HRs) of 2.76 (1.86-4.10) and 1.89 (1.53-2.34), respectively, as well as psychiatric inpatient care, with HRs of 1.62 (1.34-1.94) and 1.37 (1.25-1.50). Outpatient care visits by the young refugees were similar to the native Swedish population. The longer the refugees had residency in Sweden, the more they used outpatient psychiatric care. Refugees born in the Horn of Africa and Iran were most likely to undergo compulsory admission, with HRs of 3.98 (2.12-7.46) and 3.07 (1.52-6.19), respectively. They were also the groups who were most likely to receive inpatient care, with HRs of 1.55 (1.17-2.06) and 1.84 (1.37-2.47), respectively. Our results also indicated that the use of psychiatric care services increased with the level of education in the refugee population, while the opposite was true for the native Swedish population. In fact, the risks of compulsory admissions were particularly higher among refugees who had received a secondary education, compared with native Swedish residents, with HRs of 4.72 (3.06-7.29) for unaccompanied refugees and 2.04 (1.51-2.73) for accompanied refugees. Young refugees received more psychiatric inpatient care than the native Swedish population, with the highest rates seen in refugees who were not accompanied by their parents. The discrepancy between the use of inpatient and outpatient care

  16. Dental students and faculty members' attitudes towards care for underserved patients and community service: do community-based dental education and voluntary service-learning matter?

    Science.gov (United States)

    Volvovsky, Mariya; Vodopyanov, Dmitry; Inglehart, Marita R

    2014-08-01

    The objectives of this study were to explore 1) how students across the four years of a dental curriculum differed in attitudes towards underserved patients and community service at the beginning and end of each school year; 2) how these attitudes changed as a function of participating in required vs. voluntary community-based activities; and 3) what attitudes faculty members held about the effects of community service-learning on students. Surveys were distributed to 440 students at one dental school at the beginning and end of the school year. The overall response rate for those surveys was 75 percent, with variations among classes: first year, 94 percent; second year, 92 percent; third year, 69 percent; and fourth year, 43 percent. Survey data were also collected from twenty-two students (out of a possible forty-seven) who participated in voluntary service-learning and from fifty-four faculty members (out of approximately 150). The results showed that, at the beginning of the year, the first-year students' attitudes were more positive than the responses of students in all other cohorts. However, at the end of the year, their attitudes were less positive. Participating in voluntary service-learning improved students' attitudes towards treating underserved patients only in the short run, and experiencing ten weeks of community-based dental education did not improve their attitudes. The faculty respondents' attitudes, however, were quite positive. The decrease in students' positive attitudes towards treating underserved patients and participating in community service should raise questions about why this loss of idealism occurred.

  17. Short-term outcome following referral to a psychiatric emergency service.

    Science.gov (United States)

    Spooren, D; van Heeringen, K; Jannes, C

    1997-01-01

    The study described here is part of an evaluation of a pilot project concerning the implementation of three psychiatric crisis units in general hospitals in Belgium. The purpose was to evaluate the short-term outcome of a multidisciplinary crisis intervention for psychiatric patients referred to the emergency department. Patients were assessed with the General Health Questionnaire (GHQ-28) at the time of referral to the emergency department and again 1 month later. Patients referred for a psychiatric crisis intervention were compared with patients receiving short-term psychiatric inpatient treatment in another hospital. Patients referred to the emergency department showed a considerable degree of psychiatric disturbance. The General Health Questionnaire appeared to be a good measure for assessment of the "state" aspect of a psychiatric disturbance. The state of distress was significantly reduced one month after referral in both treatment conditions. Nevertheless, an important proportion of patients remained in a state of considerable distress. The results indicate that a short hospital-based crisis intervention approach is comparable with more traditional acute inpatient treatment. However, in the case of more severely distressed patients it may be insufficient. Several limitations of this study are also discussed (risk of overestimation of improvement, influence of time or pre-existing differences).

  18. Reform in the dental services area in Romania – objective necessity or second option

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    Cristian UŢĂ

    2011-09-01

    Full Text Available The article herein deals with a topic of current interest, not only because the latest economic and social phenomena within the context of globalized crisis in the world, but also from the perspective of the evolution and specific processes in the medical area in Romania. The writer accomplishes a journey into the various medical systems in national economies, by analyzing the features of each type of system and the opportunity for a ‘capitalist’ vision related to the healthcare services in general. The dental medical services share a series of characteristics that help them be better defined from the point of view of provider-customer relation. Thus, it becomes evident that, for Romania, the process initiated in 2006 meaning liberalization of practicing the dental doctor profession represents a natural way of developing the market specific to such services. From this perspective, this issue targets the mentalities level only – to impose quality standards on the market and to witness the offer-demand balance, both deriving from the specific nature itself of the dental services. The involvement of the authorities at Health Department into developing a health insurance policy in the dental field and the support of the private initiative in the underserved areas are the main targets of the ‘reform’.

  19. Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003-2008

    NARCIS (Netherlands)

    C. Monteiro (Camila); M.A. Beenackers (Marielle); Goldbaum, M. (Moisés); De Azevedo Barros, M.B. (Marilisa Berti); Gianini, R.J. (Reinaldo José); Cesar, C.L.G. (Chester Luiz Galvão); J.P. Mackenbach (Johan)

    2016-01-01

    markdownabstract__Background:__ Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the "Smiling Brazil" Program, the largest public oral health care program in the world, could have influenced this

  20. Mobile and portable dental services catering to the basic oral health ...

    African Journals Online (AJOL)

    The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries (adding each of these terms in a sequential order). Based on the ...

  1. Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

    Science.gov (United States)

    Kranz, Ashley M; Preisser, John S; Rozier, R Gary

    2015-07-01

    Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS. We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regression models estimated the association between number of visits with POHS and (1) decayed, missing, and filled primary teeth (dmft) and (2) untreated decayed teeth while adjusting for confounding. Kindergarten students with ≥4 POHS visits averaged an adjusted 1.82 dmft (95% confidence interval: 1.55 to 2.09), which was significantly less than students with 0 visits (2.21 dmft; 95% confidence interval: 2.16 to 2.25). The mean number of untreated decayed teeth was not reduced for students with ≥4 POHS visits compared with those with 0 visits. POHS provided by nondental providers in medical settings were associated with a reduction in caries experience in young children but were not associated with improvement in subsequent use of treatment services in dental settings. Efforts to promote oral health in medical settings should continue. Strategies to promote physician-dentist collaborations are needed to improve continuity of care for children receiving dental services in medical settings. Copyright © 2015 by the American Academy of Pediatrics.

  2. A portable dental image viewer using a mobile network to provide a tele-dental service.

    Science.gov (United States)

    Park, Wonse; Kim, Dong-Keun; Kim, Jung-Chae; Kim, Kee-Deog; Yoo, Sun K

    2009-01-01

    We tested three imaging devices for suitability in emergency dental situations for telemedicine. The three devices were a special-purpose oral camera, a digital single lens reflex (DSLR) camera, and the built-in camera of a mobile phone. A total of 20 subjects volunteered to take part in the study. We simulated five different conditions which could affect the quality of the image and measured image transmission times across two widely available mobile networks (a CDMA-based 3G network and a Wireless Broadband Network, WiBRO). The DSLR produced the best quality images, although it was a relatively large device and not easy to use. The oral camera failed to give satisfactory images under certain conditions (i.e. without extra lighting, out of focus and head motion). In contrast, the mobile phone based camera was very easy to use and to handle, and it gave good information for initial diagnosis, even at high compression ratios. If the image acquisition conditions are carefully set up, this device might be the best for emergency dental trauma situations.

  3. Use of newer technologies with existing service for family reintegration of unknown psychiatric patients: A case series.

    Science.gov (United States)

    Gowda, Guru S; Telang, Ashay; Sharath, Chandra Reddy; Issac, Thomas Gregor; Haripriya, Chintala; Ramu, Praveen Shivalli; Math, Suresh Bada

    2017-10-29

    Homeless Mentally Ill (HMI) patients pose a challenge in treatment, management and rehabilitation services. HMI patients are often difficult to engage in treatment, and associated with relapse and rehospitalization, even after recovery. Family plays an important role in treatment engagement and care of the mentally ill person in India. Here, we report two unknown psychiatric patients who were reintegrated to their families using newer technologies with existing service. Newer technologies have helped in early identification of HMI families and reintegration into them. The early reintegration reduced the unnecessary detention of HMI patients inside the hospital after recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Association of Bullying Behavior at 8 Years of Age and Use of Specialized Services for Psychiatric Disorders by 29 Years of Age.

    Science.gov (United States)

    Sourander, Andre; Gyllenberg, David; Brunstein Klomek, Anat; Sillanmäki, Lauri; Ilola, Anna-Marja; Kumpulainen, Kirsti

    2016-02-01

    Bullying and being exposed to bullying among children is prevalent, especially among children with psychiatric symptoms, and constitutes a major concern worldwide. Whether childhood bullying or exposure to bullying in the absence of childhood psychiatric symptoms is associated with psychiatric outcomes in adulthood remains unclear. To study the associations between bullying behavior at 8 years of age and adult psychiatric outcomes by 29 years of age. Nationwide birth cohort study of 5034 Finnish children with complete information about childhood bullying behavior was followed up from 8 to 29 years of age. Follow-up was completed on December 31, 2009, and data were analyzed from January 15, 2013, to February 15, 2015. Information about bullying, exposure to bullying, and psychiatric symptoms were obtained from parents, teachers, and child self-reports when children were 8 years of age. Use of specialized services for psychiatric disorders from 16 to 29 years of age was obtained from a nationwide hospital register, including outpatient and inpatient treatment. Among the 5034 study participants, 4540 (90.2%) did not engage in bullying behavior; of these, 520 (11.5%) had received a psychiatric diagnosis at follow-up; 33 of 166 (19.9%) who engaged in frequent bullying, 58 of 251 (23.1%) frequently exposed to bullying, and 24 of 77 (31.2%) who both frequently engaged in and were frequently exposed to bullying had received psychiatric diagnoses at follow-up. When analyses were adjusted by sex, family factors, and child psychiatric symptoms at 8 years of age, we found independent associations of treatment of any psychiatric disorder with frequent exposure to bullying (hazard ratio [HR], 1.9; 95% CI, 1.4-2.5) and being a bully and exposed to bullying (HR, 2.1; 95% CI, 1.3-3.4). Exposure to bullying was specifically associated with depression (HR, 1.9; 95% CI, 1.2-2.9). Bullying was associated with psychiatric outcomes only in the presence of psychiatric problems at 8 years

  5. Access to Interpreter Services at U.S. Dental School Clinics.

    Science.gov (United States)

    Simon, Lisa; Hum, Lauren; Nalliah, Romesh

    2016-01-01

    The number of Americans with limited English proficiency (LEP) is growing, and legal protections mandate that LEP individuals have equal access to health care services. The aim of this study was to determine the availability of interpretation services in U.S. dental school clinics and the kinds of instruction dental students are given regarding treatment of LEP patients. A survey was distributed to the academic deans of all U.S. dental schools; 35 completed the survey for a response rate of 58%. Respondents were asked to report on the number of LEP patients treated in their student clinics, the resources available to students working with LEP patients, and the extent of instruction offered. Descriptive statistics were calculated. The results indicated that the proportion of LEP patients treated at U.S. dental schools was perceived to be higher than that of the general population. The availability of interpreter services and the extent of student education about LEP individuals varied widely. Among the responding schools, the most common language spoken by LEP patients was Spanish, followed by Chinese (Mandarin and Cantonese) and Russian. Most of the responding dental schools reported offering fewer than two hours of instruction to their predoctoral students on treating LEP patients. Although almost 90% of the respondents indicated believing LEP patients received care equal in quality to that of non-LEP patients in their clinics, only 61.9% indicated that their students were adequately prepared to manage LEP patients following graduation. These findings suggest that dental schools should consider curricular innovations that will prepare students to work with LEP populations and improve the ability of LEP patients to receive care in the teaching clinic setting.

  6. Design in mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods.

    Science.gov (United States)

    Csipke, Emese; Papoulias, Constantina; Vitoratou, Silia; Williams, Paul; Rose, Diana; Wykes, Til

    2016-01-01

    Psychiatric ward design may make an important contribution to patient outcomes and well-being. However, research is hampered by an inability to assess its effects robustly. This paper reports on a study which deployed innovative methods to capture service user and staff perceptions of ward design. User generated measures of the impact of ward design were developed and tested on four acute adult wards using participatory methodology. Additionally, inpatients took photographs to illustrate their experience of the space in two wards. Data were compared across wards. Satisfactory reliability indices emerged based on both service user and staff responses. Black and minority ethnic (BME) service users and those with a psychosis spectrum diagnosis have more positive views of the ward layout and fixtures. Staff members have more positive views than service users, while priorities of staff and service users differ. Inpatient photographs prioritise hygiene, privacy and control and address symbolic aspects of the ward environment. Participatory and visual methodologies can provide robust tools for an evaluation of the impact of psychiatric ward design on users.

  7. Increasing use of dental services by children, but many are unable to secure needed care.

    Science.gov (United States)

    Waldman, H B; Ackerman, M B; Perlman, S P

    2014-01-01

    National studies indicate that an increasing proportion of children are receiving needed oral health care. However, this increase is not uniform throughout all populations of youngsters. Overall national study findings regarding the use of dental services mask the fact that, a significant subset of low-income, minority, medically and developmentally compromised and socially vulnerable children continue to lack access to care and suffer significant and consequential dental and oral disease. In addition, these same children will face continued difficulties in securing needed care as they reach their early adult years.

  8. Perceptions of primary health care service users regarding dental team practices in Brazil.

    Science.gov (United States)

    Baumgarten, Alexandre; Veiga, Rochelle Santos Da; Bulgarelli, Patricia Tavora; Diesel, Vitor Motta; Bulgarelli, Alexandre Favero

    2017-10-09

    The Unified Health System (SUS) is the Brazilian set of public health services that offers global access to health care and disease treatments for all citizens. These services have been evaluated by means of a national survey assessing the users' perceptions. Aim To explore and characterize the SUS users' perceptions regarding primary dental team practices in the five Brazilian geographical regions. Descriptive study. The sample consisted of 37 262 subjects. Data were collected by means of the Ministry of Health survey, conducted between 2012 and 2014. Variables used in the present study are associated with SUS users' perspectives of satisfaction, access, and use of services. The study utilized bivariate data analysis, and dichotomous variables were derived for analysis following 95% reliability. Findings This study observed similarities and proportionality of perceptions in the Brazilian territory. In most macro-regions, dental teams did not develop an active search for dental treatment absentees. However, the SUS users reported very good and good perceptions, which were homogeneously distributed across five Brazilian regions, thereby showing an overall positive perception of primary dental treatment.

  9. Information infrastructure for inter-organizational mental health services: an actor network theory analysis of psychiatric rehabilitation.

    Science.gov (United States)

    Timpka, Toomas; Bång, Magnus; Delbanco, Tom; Walker, Janet

    2007-08-01

    In the supply of mental health services to communities, data and information are managed not only by clinical organizations, but also by welfare state agencies and charities. The aim of this study is to use methods of analysis from actor network theory to identify organizational interventions necessary for the development of an information infrastructure for inter-organizational mental health services. Data was collected in a project aimed at developing an information system that supports inter-organizational psychiatric rehabilitation in a Swedish municipality. Three organizational interventions were identified: an integrated service policy defined by the national government, a common legal framework allowing sharing of high-level client data, and commissioned support for local inter-agency workspaces. It is concluded that organizational interventions must be regarded when configuring an information infrastructure for mental health services. Organizational interventions should also routinely be addressed in systems design methods to be used in inter-organizational settings.

  10. Influence of Mothers’ Dental Anxiety and Perception of Child’s OHRQoL Towards Utilization of Dental Services − A Questionnaire Study

    Directory of Open Access Journals (Sweden)

    Kruthika Murali

    2017-01-01

    Full Text Available Introduction: Dental caries is one of the most common oral health problems in childhood. As a child depends entirely on the parents, its dental visit could be influenced by various psychosocial factors such as parental perceptions of the child’s oral health and maternal anxiety. Aim: To assess the influence of children’s clinical condition, mothers’ dental anxiety and their use of dental services, maternal perception of child’s oral health-related quality of life (OHRQoL on the child’s utilization of dental services. Materials and Methods: A cross-sectional survey was conducted among 600 mothers of children between 2 and 5 years of age. The questionnaire included the background characteristics, mothers and child’s dental visit, mothers’ dental anxiety using Corah’s Dental Anxiety Scale and maternal perceptions of the child’s OHRQoL using Early Childhood Oral Health Impact Scale. Clinical examination for assessing the dental caries among the children was performed. The data were analyzed using the Statistical Package for the Social Sciences version 17.1 software. Results: Using the final model of Poisson regression analysis with robust variance and forward stepwise procedure, it was found that the age of mother, the age of child, the income of the family, poor OHRQoL, the presence of caries and pain in child significantly influenced the visit of the child to dentist (P ≤ 0.05. No statistically significant association was found between the anxiety of mother and the child’s visit. Conclusion: Lack of maternal knowledge, low socio-economic reasons and maternal perception of child’s oral health could be the important reasons for a child’s less number of dental visits.

  11. Dental Anxiety and the Use of Oral Health Services Among People Attending Two HIV Primary Care Clinics in Miami

    Science.gov (United States)

    Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R.

    2012-01-01

    Objectives We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Methods Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. Results The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). Conclusion A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals. PMID:22547875

  12. Self-reported oral health, dental self-care and dental service use among New Zealand secondary school students: findings from the Youth 07 study.

    Science.gov (United States)

    Areai, D M; Thomson, W M; Foster Page, L A; Denny, S J; Crengle, S; Clark, T C; Ameratunga, S N; Koopu, P I

    2011-12-01

    The primary aim was to describe New Zealand secondary school students' use of dental services and determine the nature and extent of any inequities by deprivation status and ethnicity. A secondary aim was to to describe their toothbrushing practices and self-reported dental pain experience, past restorative treatment and tooth loss. Secondary analysis of data from the cross-sectional Youth 07: National Survey of the Health and Wellbeing of New Zealand Secondary School Students. A representative sample of 9,098 secondary school students aged 13-17 years from 96 secondary schools across New Zealand took part, with a response rate of 73%. Self-report information about oral health care behaviour, past dental experiences and dental visiting pattern was collected. Data analysis took the complex survey design into account, and multivariate analysis was undertaken to examine the associations of dental service-use. A dental visit in the previous 12 months was reported by 72% of participants. The odds of having done so were higher among females, those who brushed at least twice daily, and those who had been kept awake at night by dental pain. Lower odds were seen among students identifying with Māori, Pacific or Asian people (and those in the 'Other' ethnic category) than among European students, and among those residing in medium- or high-deprivation areas than those in lo-deprivation areas. One in seven participants reported having lost a tooth due to oral disease. Having had a tooth filled was reported by almost three-quarters of the sample, and having been kept awake by dental pain at night was reported by just over one in five. Almost two-thirds reported brushing their teeth twice or more in the previous 24 hours, and a small minority had not brushed at all. Ethnic and socio-economic inequities in the use of dental services are apparent among New Zealand adolescents.

  13. Perceived and normative needs, utilization of oral healthcare services, and barriers to utilization of dental care services at peripheral medical centre: Poonjeri, Mamallapuram, India

    Directory of Open Access Journals (Sweden)

    Prabhu Subramani

    2017-01-01

    Full Text Available Introduction: Dental care utilization is limited, and teeth are often left untreated or extracted in India. Several barriers exist for the utilization of dental services. The present study was undertaken to assess the oral healthcare needs, utilization pattern of oral healthcare services, and barriers to utilization of oral healthcare services among the outpatients of Peripheral Medical Centre, Poonjeri, Mamallapuram, India. Materials and Methods: Simple random sampling was conducted among outpatients and their attenders reporting to the health centre; demographic profile of the patients were recorded followed by interviewer-administered questionnaire for recording the self-perceived dental needs and barriers in utilizing dental care services followed by Type II clinical examination to assess normative dental treatment needs. Results: N =282 study participants participated in the present study; majority of the study participants were from upper lower class and lower middle class. Among the study subjects n = 124 (44% have not accessed any dentist, n = 112 (39.7% had visited dentist for toothache. Common reason cited as Self – perceived barriers for dental care are n = 184 (65.2% – 'Unaware of the dental problems' and n = 118 (41.8% 'Fear of dental treatment'. Logistic regression showed that significant difference was seen in gender, socioeconomic status, and barriers to dental care (P < 0.05 in influencing the utilization pattern of dental care. Conclusion: Perceived and normative dental needs were high among the study population due to problem-oriented care, and it is influenced by various barriers such as unawareness of dental problems, fear, cost, accessibility, and time.

  14. A review of tobacco cessation services for youth in the dental clinic.

    Science.gov (United States)

    Vanka, A; Roshan, N M; Ravi, K S; Shashikiran, N D

    2009-01-01

    Tobacco use is one of the leading preventable causes of illness and death. The most powerful predictor of adult smoking is smoking during adolescence. While general and pediatric dentists have a positive attitude regarding tobacco cessation counseling, the same is not extrapolated into practice. Several barriers to counseling in the dental clinic have been identified and research into some of these has been conducted. Evidence-based cessation programs are still in the nascent stage, but this should not hinder dental professionals from rendering these services to the child and adolescent populations. Brief interventions, self-help materials, and nicotine replacement therapy for established nicotine dependence form the mainstay of therapy. The purpose of this paper is to identify the several barriers encountered in providing cessation and discuss the current status of its implementation in the dental clinic.

  15. [Instruments for the economical evaluation of psychiatric service systems: methodological foundations of the European standardisation and the German adaptation].

    Science.gov (United States)

    Kilian, R; Roick, C; Bernert, S; Matschinger, H; Mory, C; Becker, T; Angermeyer, M C

    2001-10-01

    In the project "Cost-effectiveness of psychiatric service systems. A European comparison" a German version of instruments for the assessment of needs for services (CAN-EU), service satisfaction (VSSS-EU) relatives' burden of care (IEQ-EU) and costs of psychiatric services (CSSRI-EU) was developed in close cooperation with the EPSILON Study group. The English original versions of the instruments were translated into German and a back-translation into the original language was carried out by a second translator. The back-translation was screened by the first author of the original version. The German versions of all instruments were tested for comprehensibility and practicability by means of focus groups. The internal consistency of all instruments were tested on a representative sample of 307 patients with schizophrenia according to ICD-10 F20. Test-retest reliability and inter-rater reliability was tested by a sub-sample of 50 patients. Psychometric properties of the translated instruments will be presented and discussed. Statistical methods for the assessment of the reliability coefficients were identical with those of the EPSILON study, therefore the psychometric properties of the German version of the CAN-EU are directly comparable with the other European versions of the instrument.

  16. Validation of the Maslach Burnout Inventory-Human Services Survey for Estimating Burnout in Dental Students.

    Science.gov (United States)

    Montiel-Company, José María; Subirats-Roig, Cristian; Flores-Martí, Pau; Bellot-Arcís, Carlos; Almerich-Silla, José Manuel

    2016-11-01

    The aim of this study was to examine the validity and reliability of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) as a tool for assessing the prevalence and level of burnout in dental students in Spanish universities. The survey was adapted from English to Spanish. A sample of 533 dental students from 15 Spanish universities and a control group of 188 medical students self-administered the survey online, using the Google Drive service. The test-retest reliability or reproducibility showed an Intraclass Correlation Coefficient of 0.95. The internal consistency of the survey was 0.922. Testing the construct validity showed two components with an eigenvalue greater than 1.5, which explained 51.2% of the total variance. Factor I (36.6% of the variance) comprised the items that estimated emotional exhaustion and depersonalization. Factor II (14.6% of the variance) contained the items that estimated personal accomplishment. The cut-off point for the existence of burnout achieved a sensitivity of 92.2%, a specificity of 92.1%, and an area under the curve of 0.96. Comparison of the total dental students sample and the control group of medical students showed significantly higher burnout levels for the dental students (50.3% vs. 40.4%). In this study, the MBI-HSS was found to be viable, valid, and reliable for measuring burnout in dental students. Since the study also found that the dental students suffered from high levels of this syndrome, these results suggest the need for preventive burnout control programs.

  17. Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers.

    Science.gov (United States)

    Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith; Hjern, Anders; Montgomery, Edith; Norredam, Marie

    2016-08-01

    Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country. This study compared 24,427 refugee children from Asia, The Middle East, Sub-Saharan Africa and former Yugoslavia, who obtained residency in Denmark between 1 January 1993 and 31 December 2010 with 146,562 Danish-born children, matched 1:6 on age and sex. The study looked at contacts with psychiatric hospitals as well as psychologists and psychiatrists in private practice. Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40-0.45) among refugee boys and 0.35 (95 % CI 0.33-0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. Refugee children used fewer psychiatric healthcare services than Danish-born children. This may indicate that refugee children experience barriers in accessing psychiatric healthcare systems and do not receive adequate assessment of their mental health and subsequent referral to specialist services.

  18. A new primary dental care service compared with standard care for child and family to reduce the re-occurrence of childhood dental caries (Dental RECUR): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Pine, Cynthia; Adair, Pauline; Burnside, Girvan; Robinson, Louise; Edwards, Rhiannon Tudor; Albadri, Sondos; Curnow, Morag; Ghahreman, Marjan; Henderson, Mary; Malies, Clare; Wong, Ferranti; Muirhead, Vanessa; Weston-Price, Sally; Whitehead, Hilary

    2015-11-04

    In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions. This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrollment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrollment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment. The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have

  19. Mental Disorders among Children and Adolescents Admitted to a French Psychiatric Emergency Service

    Directory of Open Access Journals (Sweden)

    Laurent Boyer

    2013-01-01

    Full Text Available The aim of this study was to describe the characteristics of children and adolescents admitted to the psychiatric emergency department (ED of a French public teaching hospital over a six-year study period (2001–2006. Data for all episodes of care in the psychiatric ED from January 1, 2001, to December 31, 2006, delivered to adolescents aged less than 18 years were retrospectively analyzed. During the six-year study period, 335 episodes of care in the psychiatric ED were experienced by 264 different adolescents. They accounted for 2.0% of the 16,754 care episodes of the ED; 164 patients (62.1 were female and the average age was 16.5 (SD = 1.6. The neurotic, stress-related, and somatoform disorders were the most frequent (25.4% and concerned mainly anxiety disorders (15.2%. The frequency of the absence of psychiatric diagnosis (22.7% was high. A total of 48 children and adolescents (18.2% benefited from more than one episode of care. Several factors were associated to a higher number of visits to the ED: substance use, schizophrenia, disorders of adult personality and behaviour, disorders occurring in childhood and adolescence, and dual diagnosis. In conclusion, mental health disorders in children and adolescents are a serious problem associated with several potentially modifiable factors.

  20. Do 'poor areas' get the services they deserve? The role of dental services in structural inequalities in oral health.

    Science.gov (United States)

    Harris, R V

    2016-06-01

    All over the world, we see that communities with the greatest dental need receive the poorest care--a truism first summarised by the Inverse Care Law in 1971. Despite efforts to attract dentists to under-served areas with incentives such as 'deprivation payments', the playing field is still uphill because of the fundamental inequalities which exist in society itself Deep-seated cultural values which are accepting of a power difference between the 'haves' and 'have nots', and that emphasise individualism over collectivism, are hard to shift. The marketization of health care contributes, by reinforcing these values through the commodification of care, which stresses efficiency and the transactional aspects of service provision. In response, practitioners working in deprived areas develop 'scripts' of routines that deliver 'satisfactory care', which are in accord with the wishes of patients who place little value on oral health but which also maintain the viability of the practice as a business. A compliance framework contrasting types of organisational (dental practice) power (coercive, utilitarian, normative) with types of patient orientation (alienative, calculative, moral) identifies where certain combinations 'work' (e.g. normative power--moral orientation), but where others struggle. Thus institutional structures combine with patients' and the wider community's demands, to generate a model of dental care which leaves little scope for ongoing, preventive dental treatment. This means that in poor areas, all too often, not only is less care available, it is of lower quality too--just where it is needed most.

  1. Informed consumer or unlucky visitor? A profile of German patients who received dental services abroad.

    Science.gov (United States)

    Panteli, Dimitra; Augustin, Uta; Röttger, Julia; Struckmann, Verena; Verheyen, Frank; Wagner, Caroline; Busse, Reinhard

    2015-10-01

    A common characteristic of sending countries in cross-border dental care is that of high costs and/or high copayments for dental services. This study aims to provide an insight into the characteristics of German patients receiving planned and emergency (unplanned) dental care abroad and their satisfaction with received services. The Europabefragung is a postal survey carried out by Techniker Krankenkasse for patients who are treated in EU/EEA countries. This study uses data from the Europabefragung 2012. The survey was sent to 45 189 individuals; descriptive statistics for the subset of respondents who received emergency (unplanned) or planned dental treatment are presented. There were 18 339 responses to the questionnaire, out of which 17 543 were deemed valid; 1416 respondents had received emergency (unplanned) (78%) or planned (22%) dental care and were included in the analysis. There were clear differences between unplanned and planned treatments regarding country and type of treatment as well as satisfaction with different aspects of treatment and the need for follow-up care. Overall, satisfaction with treatment was high for both groups; individuals who had received planned treatment were more satisfied on all aspects of care and reported a need for follow-up care less frequently. While German patients who received both emergency (unplanned) and planned services abroad are mostly satisfied with their experience, some concerns arise with regard to continuity of care. Types of information provided to patients seeking care abroad and dissemination modalities should be carefully planned. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Academic-service partnerships, research, and the South African dental academic.

    Science.gov (United States)

    Grossman, Elly S; Naidoo, Sudeshni

    2012-09-01

    In South Africa, academic dentistry is managed through joint agreements between the South African Department of Health (DoH) and each university, in a type of academic-service partnership. For this study, dental faculty members were surveyed to ascertain staff attitudes towards academic research in dental schools and to find out whether the joint arrangement impinges upon research activities. A survey was distributed to 200 members of the South African division of the International Association for Dental Research (SA IADR) and the academic staff of the four South African dental schools. One hundred and five responses were obtained for a response rate of 53 percent; most of the respondents were lecturers (26 percent), specialists (17 percent), heads of department (17 percent), or senior lecturers (13 percent). The majority were employed by the DoH (77 percent) and were members of the SA IADR (51 percent). Most reported feeling that research is an important issue in their school (83 percent) and perceived general research output had declined (59 percent). While 79 percent said they were concerned about the decline, many (71 percent) felt there was little they could do about it. The respondents mentioned the following as reasons for the decline: lackluster approach of DoH structures, weak university support, poor research equipment and facilities, inadequate funding, emphasis on service delivery, undergraduate teaching loads, onerous working conditions, and lack of vision, leadership, and governance by senior management. Faculty members' twin obligations of service delivery (required by the DoH) and teaching (required by their institutions) have severely impacted South African academic dental research.

  3. Teaching social responsibility through community service-learning in predoctoral dental education.

    Science.gov (United States)

    Brondani, Mario A

    2012-05-01

    Social responsibility refers to one's sense of duty to the society in which he or she lives. The Professionalism and Community Service (PACS) dental module at the University of British Columbia is based upon community service-learning and helps dental students to understand the challenges faced by vulnerable segments of the population as they actively reflect on experiences gathered from didactic and experiential activities. This article aims to illustrate the extent to which PACS has fostered awareness of social responsibility through the British Columbia Ministry of Education's Performance Standards Framework for Social Responsibility. Reflections were gathered from students in all four years of the D.M.D. program and were analyzed thematically in three categories of the framework: Contribution to the Classroom and Community, Value of Diversity in the Community, and Exercise of Responsibilities. The constant comparison analysis of the reflective qualitative data revealed that the students directly or indirectly addressed these three categories in their reflections as they synthesized their understanding of community issues and their collaborative roles as socially responsible members of the dental profession. Follow-up studies are needed to explore the impact of community-based dental education upon students' perceptions and understanding of social responsibility and professionalism regarding underserved communities.

  4. [Dental status and related factors in an occupational health service in Northern France].

    Science.gov (United States)

    Catteau, Céline; Blaizot, Alessandra; Duhamel, Alain; Delzenne, Antoine; Devillers, Annick; Frimat, Paul

    2013-01-01

    Few data are available concerning the dental health of adults in France. This study was designed to describe dental status, oral health behaviour and factors associated with caries among workers followed by an occupational health service in Northern France. A representative sample of workers was selected between May and July 2006. Data were collected by occupational health physicians using a questionnaire completed during a face-to-face interview and a dental examination. After descriptive analysis of the variables, two groups were defined according to the degree of caries as assessed by the Significant Caries Index. Factors associated with the degree of caries were investigated using logistic regression adjusted to age. 420 workers with a mean age of 34.6(±10.4) years were included. The mean DMFT (Decayed Missing Filled Teeth) score and the mean number of decayed teeth were 8.9 (± 6.5) and 1.3 (±2.8), respectively. Three independent factors associated with high caries rates were identified: level of education less than Baccalaureate (ORa = 1.85; p dental visit motivated by pain or a reason other than preventive care (ORa = 1.89; p < 0.05). This study showed a high need for care and oral health education in this population of workers. More oral health education programmes should be set up in the adult working population by occupational health services.

  5. Determining the optimal model for role-substitution in NHS dental services in the United Kingdom.

    Science.gov (United States)

    Brocklehurst, Paul; Birch, Stephen; McDonald, Ruth; Tickle, Martin

    2013-09-24

    Role-substitution describes a model of dental care where Dental Care Professionals (DCPs) provide some of the clinical activity previously undertaken by General Dental Practitioners. This has the potential to increase technical efficiency, the capacity to care and reduce costs. Technical efficiency is defined as the production of the maximum amount of output from a given amount of input so that the service operates at the production frontier i.e. optimal level of productivity. Academic research into technical efficiency is becoming increasingly utilised in health care, although no studies have investigated the efficiency of NHS dentistry or role-substitution in high-street dental practices. The aim of this study is to examine the barriers and enablers that exist for role-substitution in general dental practices in the NHS and to determine the most technically efficient model for role-substitution. A screening questionnaire will be sent to DCPs to determine the type and location of role-substitutive models employed in NHS dental practices in the United Kingdom (UK). Semi-structured interviews will then be conducted with practice owners, DCPs and patients at selected sites identified by the questionnaire. Detail will be recorded about the organisational structure of the dental team, the number of NHS hours worked and the clinical activity undertaken. The interviews will continue until saturation and will record the views and attitudes of the members of the dental team. Final numbers of interviews will be determined by saturation.The second work-stream will examine the technical efficiency of the selected practices using Data Envelopment Analysis and Stochastic Frontier Modeling. The former is a non-parametric technique and is considered to be a highly flexible approach for applied health applications. The latter is parametric and is based on frontier regression models that estimate a conventional cost function. Maximising health for a given level and mix of resources

  6. Using clinical and criminal involvement factors to explain homelessness among clients of a psychiatric probation and parole service.

    Science.gov (United States)

    Solomon, P; Draine, J

    1999-01-01

    This study sought to examine the rate of homelessness and the extent to which lifetime homelessness was associated with clinical factors, such as diagnosis and treatment history; or criminal factors, such as criminal behavior and arrest history, among psychiatric probationers and parolees. Nearly half of the clients screened had experienced homelessness in their lifetime. In a logistic regression model to explain lifetime homelessness, significant factors were younger age, less education, a greater number of lifetime arrests, a schizophrenia diagnosis, and reporting both an alcohol and drug problem. Implications for service delivery with this population are discussed.

  7. Patients' choice of payment system in the Swedish Public Dental Service--views on dental care and oral health.

    Science.gov (United States)

    Ostberg, Anna-Lena; Ahlström, Birgitta; Hakeberg, Magnus

    2013-01-01

    The aim of this study was to generate new knowledge of considerations and factors having impacted the patients' choice of payment system and their views on oral health. Moreover, their later attitudes to the prepaid risk-related payment system, having been enrolled or not, were explored. A qualitative design was chosen and data was collected through semi-structured interviews.Twenty patients in the Public Dental Service (PDS) in western Sweden were strategically sampled with reference to gender, age (older/younger adults), residence (rural/urban), and choice of payment system:fee-for-service or capitation plan.The interview guide covered areas concerning the payment systems, patient considerations before choosing system, views of their own oral health and experiences of received dental care within the chosen system.The analysis was performed according to basic principles of qualitative content analysis. The results revealed two themes expressing the latent content. In the theme "The individual's relation to the PDS", expectations of the care, feelings of safety and aspects of responsibility emerged.The theme"Health-related attitudes and perceptions" revealed that views on health and self-assessment of oral health influenced the patients' considerations. Moreover, the perceived influence on oral health and risk thinking emerged as important factors in this theme. The conclusion was that the individual's relation to the PDS together with his/her health-related attitudes and perceptions were the main factors impacting the choice of payment system in the PDS. A health promotion perspective should be applied, empowering the patients to develop their risk awareness and their own resources.

  8. Prevalence and Factors Associated with the Utilization of Dental Care Services among Factory Workers in Nava Nakorn Industrial Estate, Pathumthani Province, Thailand.

    Science.gov (United States)

    Jaidee, Jeeratip; Ratanasiri, Amornrat; Chatrchaiwiwatana, Supaporn; Soonthon, Surasak

    2015-07-01

    The present study aimed to find out the utilization prevalence of dental care services among factory workers over a period of one year and factors associated with utilization of dental care services. This was a cross-sectional analytic study. The study population was factory workers in Nava Nakorn Industrial Estate randomly sampled using Probability Proportion to Size Cluster Sampling Method. The tool was a questionnaire about utilization of dental care services. Among the sample group of 1,500 workers from 16 factories, almost 2/3 (63.9%) had never used any dental care services in the previous year while only 36.1% did. A multivariable logistic regression analysis showed that workplace, accommodation, tooth decay, toothache history, transportation, experience in using social security fund for dental care services, availability and accessibility of dental care services, brushing teeth regularly after meals, using dental care services regularly in a dental clinic, and agreement with the idea that a tooth extraction and medication by a dentist could reduce the risk of progression of disease, statistical significance (p-value dental care services at R2 (The Nagelkerke R Square) 0.38. That the prevalence of the factory workers who did not use dental care services during the last one year was 63.9 percent. This study identified three groups of factors associated with the utilization of dental care services as: 1) Predisposing factors, 2) Enabling factors, and 3) Need factors.

  9. Current Topics and Trends in Military Dental Research: A Tri-Service Panel Discussion

    Science.gov (United States)

    2016-05-09

    AIR FORCE • Current AFDS Research • Not coordinated I aligned • Episodic • Conducted primarily by residents in conjunction with training...59 MDW/SGVU SUBJECT: Professional Presentation Approval 9MAY2016 1. Your paper, entitled Current Topics and Trends in Military Dental Research : A...Tri- Service Panel Discussion presented at/published to SURF 2016 (San Antonio Military Health System & Universities Research Forum), UT San Antonio

  10. Rural–urban differences in dental service use among children enrolled in a private dental insurance plan in Wisconsin: analysis of administrative data

    Science.gov (United States)

    2012-01-01

    Background Studies on rural–urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural–urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI). Methods We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons. Results Approximately, 50%, 67% and 68 % of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions. Conclusions We found significant geographic variation in dental procedures received by children enrolled in DDWI. PMID:23259637

  11. Reforma psiquiátrica e serviços residenciais terapêuticos Psychiatric reform and assisted residential services

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Leal Vidal

    2008-01-01

    Full Text Available OBJETIVO: Apresentar os principais aspectos da reforma psiquiátrica ocorrida em diversos países e no Brasil, destacar a política de reinserção social dos pacientes e descrever os procedimentos da desospitalização ocorridos em Barbacena, Minas Gerais, com ênfase nas residências terapêuticas e nas intervenções de reabilitação psicossocial. MÉTODO: Pesquisa bibliográfica realizada nas fontes eletrônicas Medline e Lilacs (1990 a 2006, com os seguintes descritores: deinstitutionalization, psychiatric reform, community-based treatment, psychosocial rehabilitation. Descrição do processo de implantação das residências terapêuticas (RT por meio de consulta aos documentos da Prefeitura de Barbacena e de observação direta das residências. RESULTADOS: A maioria dos trabalhos selecionados indicou que pacientes desospitalizados apresentam melhora na autonomia, na interação social, no nível global de funcionamento e na qualidade de vida. A desospitalização implica a existência de serviços comunitários com diversos níveis de atenção e requer a presença de profissionais qualificados e programas de reabilitação efetivos. Em Barbacena, o processo de desospitalização teve início em 2000. Atualmente existem 24 RTs no município. CONCLUSÃO: Apesar das dificuldades na sua implantação, os tratamentos de base comunitária tornaram-se o modelo dominante de cuidados psiquiátricos. Para os pacientes desospitalizados, as RTs têm importante papel no processo de reinserção social.OBJECTIVE: The aim of this article is to show the more relevant aspects of psychiatric reform and the community insert of psychiatric patients around the world and in Brazil. It will be detached the procedures of discharge occurred in the city of Barbacena, emphasizing the residential services and the psychosocial approaches. METHODS: Databases Medline and Lilacs were searched between 1990 and 2006 using the following keywords: deinstitutionalization

  12. Dental needs and socioeconomic status associated with utilization of dental services in the presence of dental pain: a case-control study in children.

    Science.gov (United States)

    Villalobos-Rodelo, Juan José; Medina-Solís, Carlo Eduardo; Maupomé, Gerardo; Lamadrid-Figueroa, Hector; Casanova-Rosado, Alejandro José; Casanova-Rosado, Juan Fernando; Márquez-Corona, María de Lourdes

    2010-01-01

    To identify the effect of unmet dental treatment needs and socioeconomic and sociodemographic variables on the patterns of dental visits in the presence of dental pain in 6- to 12-year-old Mexican schoolchildren. A case-control study included 379 patients that had a dental visit because of dental pain in the 12 months preceding this study and 1,137 controls. Mothers and/or guardians supplied sociodemographic, socioeconomic, and oral health-related information through a questionnaire. The profiles of unmet dental needs and of oral hygiene were ascertained by means of a standardized dental examination administered to participating children. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated with logistic regression. Higher unmet dental needs and lack of health insurance were associated with the experience of dental visits because of dental pain in the preceding 12 months. Boys who attended public schools had a 70% (95% CI = 1.29 to 2.23) higher probability of having had a dental visit in which dental pain was one of the main reasons for attendance, compared to boys attending private schools. The effect for girls was only 28% (95% CI = 1.10 to 1.50) higher for girls attending a public school, compared to girls attending private schools. Older children had a higher occurrence of dental visits because of dental pain than younger children. While higher unmet dental needs and lack of health insurance were strong predictors of having had dental visits because of dental pain in the preceding 12 months, some socioeconomic variables and sociodemographic variables modified these relationships.

  13. A cross-sectional study about associations between personality characteristics and mental health service utilization in a Korean national community sample of adults with psychiatric disorders.

    Science.gov (United States)

    Park, Subin; Lee, Yeeun; Seong, Su Jeong; Chang, Sung Man; Lee, Jun Young; Hahm, Bong Jin; Hong, Jin Pyo

    2017-05-05

    Personality traits are not only associated with psychiatric symptoms, but also with treatment seeking behavior. Our purpose was to examine the relationship between mental health service utilization and personality characteristics in a nationwide community sample of Korean adults. Of the 6022 subjects aged 18-74 years who participated in the Korean Epidemiologic Catchment Area study, 1544 (25.6%) with a lifetime diagnosis of any DSM-IV psychiatric disorder were analyzed. Diagnostic assessments were based on the Composite International Diagnostic Interview and personality constructs were measured by Big Five Personality Inventory-10. Of the 1544 participants, 275 (17.8%) had used mental health services. Multivariate analyses revealed positive associations between mental health service utilization and both neuroticism and openness, and an inverse association between mental health service utilization and agreeableness. These findings suggest that specific personality traits may have a role in treatment-seeking behaviors for mental health problems independent of the psychiatric disorder.

  14. Dental health-care service utilisation and its determinants in West Iran: a cross-sectional study.

    Science.gov (United States)

    Rezaei, Satar; Woldemichael, Abraha; Zandian, Hamed; Homaie Rad, Enayatollah; Veisi, Navid; Karami Matin, Behzad

    2017-11-23

    Dental health care is not only an effective strategy for the prevention, early diagnosis and treatment of oral diseases but also contributes to the general health of communities. This study aimed to investigate the situation of dental health-care service utilisation and its determinants in Kermanshah city, western Iran, in 2015. A cross-sectional study on a total of 894 household heads was conducted. The participants were selected using a multistage sampling technique. A self-administered questionnaire was used to collect the data. Multiple logistic regression was performed to assess factors associated with utilisation of dental-care services and a negative binomial regression was carried out to identify the main factor associated with the frequency of visiting a dentist for dental health care. A statistically significant association was considered at a value of P < 0.05. All the analyses were performed using STATA version 12. Of the total household heads who participated in the study, 60.3% and 9.9% reported visiting a dentist for dental treatment in the past year and for 6-monthly dental check-ups, respectively. The average ± standard deviation number of visits by a respondent was 2.08 ± 2.97. Of the total number of respondents, 281 (31.4%) reported visiting a dentist once or twice in the last 12 months for dental health-care services, while 28.9% reported visiting a dentist more than twice in the same time period. Ageing, having dental insurance, higher income, being a university graduate, self-rated poor oral health and not regularly brushing own teeth were the main factors associated with utilisation of dental health-care services. Our study indicates that dental health-care utilisation among households in the study area was influenced by a number of factors, including being socio-economically disadvantaged, self-rated poor oral health and not regularly brushing own teeth. Therefore, in this setting, dental-intervention programmes, including dental health

  15. Psychological recovery and its correlates in adults seeking outpatient psychiatric services: An exploratory study from an Indian tertiary care setting.

    Science.gov (United States)

    Gandotra, Aditi; Mehrotra, Seema; Bharath, Srikala

    2017-10-01

    The study was designed to explore psychological recovery and its correlates in adults receiving outpatient mental health services for psychiatric disorders. It specifically aimed at examining the association of psychological recovery with symptomatic and functional recovery and with selected illness and treatment variables. The relationship of psychological recovery with perceived social support was also the focus of inquiry. The study utilized a cross sectional survey design with a sample of 90 participants diagnosed with severe and common mental illness who had been seeking outpatient psychiatric follow up services. The data was collected with the help of both clinician rated and self-rated measures. The study findings suggested that symptomatic, functional and psychological recovery are significantly correlated but not completely overlapping constructs. Nearly 40% of the sampled participants were at the lower stages of psychological recovery, despite the fact that a majority of them were rated by clinicians as having mild or lower severity of symptoms. With respect to socio-demographic variables, a significant association was found between higher levels of education and psychological recovery. The participants with common mental illness were significantly lower on self-reported improvement and higher on moratorium subscale of psychological recovery (as compared to those with severe mental illness), indicating their struggle in dealing with a sense of loss and despair. Findings also suggested that higher levels of overall perceived social support is likely to facilitate psychological recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Perspectives on providing good access to dental services for elderly people: patient selection, dentists' responsibility and budget management.

    Science.gov (United States)

    Grytten, Jostein; Holst, Dorthe

    2013-06-01

    To suggest a model for organizing and financing dental services for elderly people so that they have good access to services. There are few studies on how dental services for elderly people should be organized and financed. This is surprising if we take into consideration the fact that the proportion of elderly people is growing faster than any other group in the population, and that elderly people have more dental diseases and poorer access to dental services than the rest of the adult population. In several countries, dental services are characterized by private providers who often operate in a market with competition and free price-setting. Private dentists have no community responsibility, and they are free to choose which patients they treat. Literature review and critical reasoning. In order to avoid patient selection, a patient list system for elderly people is recommended, with per capita remuneration for the patients that the dentist is given responsibility for. The patient list system means that the dentist assumes responsibility for a well-defined list of elderly people. Our model will lead to greater security in the dentist/patient relationship, and patients with great treatment needs will be ensured access to dental services. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  17. Inequalities in the dental health needs and access to dental services among looked after children in Scotland: a population data linkage study.

    Science.gov (United States)

    McMahon, Alex D; Elliott, Lawrie; Macpherson, Lorna Md; Sharpe, Katharine H; Connelly, Graham; Milligan, Ian; Wilson, Philip; Clark, David; King, Albert; Wood, Rachael; Conway, David I

    2018-01-01

    There is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to compare dental treatment needs and access to dental services (as an exemplar of wider health and well-being concerns) among children and young people who are looked after with the general child population. Population data linkage study utilising national datasets of social work referrals for 'looked after' placements, the Scottish census of children in local authority schools, and national health service's dental health and service datasets. 633 204 children in publicly funded schools in Scotland during the academic year 2011/2012, of whom 10 927 (1.7%) were known to be looked after during that or a previous year (from 2007-2008). The children in the looked after children (LAC) group were more likely to have urgent dental treatment need at 5 years of age: 23%vs10% (n=209/16533), adjusted (for age, sex and area socioeconomic deprivation) OR 2.65 (95% CI 2.30 to 3.05); were less likely to attend a dentist regularly: 51%vs63% (n=5519/388934), 0.55 (0.53 to 0.58) and more likely to have teeth extracted under general anaesthesia: 9%vs5% (n=967/30253), 1.91 (1.78 to 2.04). LAC are more likely to have dental treatment needs and less likely to access dental services even when accounting for sociodemographic factors. Greater efforts are required to integrate child social and healthcare for LAC and to develop preventive care pathways on entering and throughout their time in the care system. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. [The social value of teeth and access to dental health services].

    Science.gov (United States)

    Fonseca, Luciara Leão Viana; Nehmy, Rosa Maria Quadros; Mota, Joaquim Antônio César

    2015-10-01

    Oral healthcare provided by the Unified Health System (SUS) faces the challenge of attending the epidemiological profile of Brazil's adult population. Qualitative research using semi-structured interviews was conducted to understand the experiences, expectations and perception of SUS users to services in Diamantina, State of Minas Gerais, and content analysis was used to assess the data. Discussion of the results was based on dialogue between the symbolic interactionism of Goffman and Bourdieu's concept of habitus. The results show that the users did not give importance to dental care during childhood and adolescence because care was unknown to them. There was no offer of treatment besides dental extraction. Today, they value teeth and suffer the embarrassment caused by rotten teeth. However, access to dental restoration via SUS is not possible. For their children, they perceive better access to information and care, but for specialized procedures there are barriers. They express resignation both in relation to the poor state of the teeth and the difficulties of access to dental care, which can be understood by the constant exclusion experienced by them in the past, shaping their actions in the present. It was concluded that oral health in SUS should incorporate the social value and the aesthetic dimension of teeth as a social right.

  19. Stigma, Social Structure, and the Biomedical Framework: Exploring the Stigma Experiences of Inpatient Service Users in Two Belgian Psychiatric Hospitals.

    Science.gov (United States)

    Sercu, Charlotte; Bracke, Piet

    2017-07-01

    The study discusses the stigma experiences of service users in mental health care, within the debate on the role of the biomedical framework for mental health care and power relations in society. Interview data of inpatient users ( n = 42) and care providers ( n = 43) from two Belgian psychiatric hospitals were analyzed using a constructivist grounded theory approach: Findings offer insight into how stigma experiences are affected by social structure. Stigma seemed to be related to the relation between care providers and service users their social position. The concept "mental health literacy" is used to frame this finding. In paying attention to the specific cultural and normative context, which influences the relationship between mental health literacy and stigma, it is further possible to cast some light on the meaning of the biomedical model for the construction and maintenance of power relations in mental health care and broader society.

  20. Identifying and prioritising areas of child dental service need: a GIS-based approach.

    Science.gov (United States)

    Alsharif, A T; Kruger, E; Tennant, M

    2016-03-01

    To identify and prioritise areas of high need for dental services among the child population in metropolitan Western Australia. All children hospitalised due to an oral-condition from 2000 to 2009, at metropolitan areas of Perth were included in the analysis of a 10-year data set. QGIS tools mapped the residential location of each child and socioeconomic data in relation to existing services (School Dental Service clinics). The tables and maps provide a clear indication of specific geographical areas, where no services are located, but where high hospital-admission rates are occurring, especially among school-age children. The least-disadvantaged areas and areas of high rates of school-age child hospital-admissions were more likely to be within 2km of the clinics than not. More of high-risk-areas (socio-economically deprived areas combined with high oral-related hospital admissions rates), were found within 2km of the clinics than elsewhere. The application of GIS methodology has identified a community's current service access needs, and assisted evidence based decision making for planning and implementing changes to increase access based on risk.

  1. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people.

    LENUS (Irish Health Repository)

    Young, Robert

    2011-11-18

    Abstract Background Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc) with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services) and to determine if such associations remain after adjusting for social circumstances. Methods A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15) followed up in early adulthood (age 19). At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc.) and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts) and at ages 19 (self-harm, psychiatric service use). In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.). Results Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84) to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. Conclusions While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications) on later psychiatric problems, or at least higher than expected contact

  2. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people

    Directory of Open Access Journals (Sweden)

    Young Robert

    2011-11-01

    Full Text Available Abstract Background Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services and to determine if such associations remain after adjusting for social circumstances. Methods A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15 followed up in early adulthood (age 19. At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc. and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts and at ages 19 (self-harm, psychiatric service use. In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.. Results Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84 to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. Conclusions While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications on later psychiatric problems, or at least higher than

  3. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people.

    Science.gov (United States)

    Young, Robert; Riordan, Vincent; Stark, Cameron

    2011-11-18

    Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc) with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services) and to determine if such associations remain after adjusting for social circumstances. A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15) followed up in early adulthood (age 19). At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc.) and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts) and at ages 19 (self-harm, psychiatric service use). In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.). Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84) to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications) on later psychiatric problems, or at least higher than expected contact with psychiatric service.

  4. Increased public reimbursement for prophylactic visits with dentists associated with increased receipt of preventive dental services in children.

    Science.gov (United States)

    Fisher-Owens, Susan A; Amendola, Louis; Featherstone, John D B; Inge, Ronald E; Flaherman, Valerie J

    2017-06-01

    To determine whether higher reimbursement for children's preventive dentistry correlates with greater utilization of preventive dental care. A cross-sectional analysis of National Survey of Children's Health 2011/2012 was conducted, combined with state Medicaid reimbursement rates for preventive dentistry. Analyses included prevalence, unadjusted odds ratios, and multivariable logistic regression for receipt of preventive dental services. Of all surveyed American children 1-17 years, almost 20 percent had not received preventive dental care in prior year; this percentage is even higher in those with public insurance. Each $10 increase in state reimbursement was associated with a 17 percent decrease in odds of children not receiving preventive services. Higher state reimbursement for preventive services may increase children's receipt of preventive dental care. © 2017 American Association of Public Health Dentistry.

  5. Dentists' views on the effects of changing economic conditions on dental services provided for children and adolescents in Iceland.

    Science.gov (United States)

    Sveinsdottir, E G; Wang, N J

    2014-12-01

    In 2008, Iceland experienced a major financial crisis, with serious effects on the economy of the country and its inhabitants. To describe the opinions of dentists in Iceland regarding the influence of economic changes on the demand for dental health services for children and adolescents, aged 0-18 years, and also to describe the preventive dental care the dentists reported providing for children and adolescents. Questionnaires were sent by electronic mail to all dentists in Iceland in January 2013. Of the dentists working with children, 161 (62%) returned the questionnaire. Important findings were that 119 (74%) of the respondents reported increased caries experience in children and adolescents and 150 (93%) reported that decreased reimbursement for dental treatment of children in recent years had affected the dental health of most or some children and adolescents. Most dentists reported reduced parental demand for most aspects of caries prevention and treatment, apart from treatment for acute dental pain. The mean interval between dental visits was reported to be 9.4 months (sd 2.8) and the mean maximal interval 12.1 months (sd 2.8). The mean proportion of working time allocated for caries preventive services was reported to be 31% (sd 21). The results indicate a contrast between increased need for children's dental care perceived by the dentists and reduced demand for care from the parents. This may be a temporary phenomenon, as the economic crisis passes, reimbursement for dental care may increase.

  6. Training to Care for Limited English Proficient Patients and Provision of Interpreter Services at U.S. Dental School Clinics.

    Science.gov (United States)

    Simon, Lisa; Hum, Lauren; Nalliah, Romesh

    2017-02-01

    Legal protections in the United States mandate that individuals with limited English proficiency (LEP) have equal access to health care. However, LEP populations are at higher risk of poor health. Dental school clinics offer lower cost care by supervised dental students and often provide care for LEP patients. The aims of this study were to survey dental students about their clinical experience with LEP patients, the interpreter resources available at their dental school clinics, and the extent of instruction on these topics. Academic deans at 19 dental schools (30.6% of 62 invited schools) distributed the survey to their students, and the survey was completed by 325 students (4.2% of students at the 19 participating schools). Among the responding students, 44% reported their dental school clinic lacked formal interpreter services, and most of the respondents reported receiving minimal instruction on caring for LEP patients. Only 54% of the responding students reported feeling adequately prepared to manage LEP patients following graduation. These results suggest there is limited access to interpreter services for students while in dental school. A large proportion of these dental students thus reported feeling unprepared to treat LEP patients after graduation.

  7. Gender in relation to work motivation, satisfaction and use of day center services among people with psychiatric disabilities.

    Science.gov (United States)

    Eklund, Mona; Eklund, Lisa

    2017-05-01

    Day centres can prepare for open-market employment, and attendees' work motivation is key in this. Adopting a gender perspective, this study investigated (1) motivation for day centre attendance, satisfaction with the day centre services, number of hours spent there, and number and type of occupations performed; and (2) whether those factors were related with motivation for open-market employment. Women (n = 164) and men (n = 160) with psychiatric disabilities completed self-report questionnaires. There were no gender differences regarding satisfaction with the day centre services or number of hours spent there, but women engaged in more occupations. More women than men performed externally-oriented services and textile work, while men were in the majority in workshops. Externally oriented services, working in workshops, and low satisfaction with the day centre services were associated with higher motivation for employment. Women and men were equally motivated for employment. Women scored higher on motivation for attending the day centre, something that may deter transition into open-market employment. For men, less motivation for attending day centres may reduce their possibilities of gaining skills that can facilitate transitioning to open-market employment. Thus, the possibility for transitioning from day centre activities to open-market employment may be gendered.

  8. Comparing the profile of child patients attending dental general anaesthesia and conscious sedation services.

    Science.gov (United States)

    Hariharan, S; Hosey, M T; Bernabe, E

    2017-05-12

    Aims To compare the profile of paediatric patients receiving dental treatment under general anaesthesia (GA) or conscious sedation (CS). A second aim was to explore whether there is an overlap between the two patient groups.Design This service evaluation study was based on sociodemographic and clinical data extracted from clinical records of patients attending dental appointments for GA or CS services at King's College Hospital. Sociodemographic and clinical differences between GA and CS groups were explored using logistic regression models.Results Data from 113 children (58 GA and 55 CS) were analysed. There were differences between groups in terms of age and numbers of quadrants and teeth treated, but not in terms of sex, ethnicity or deprivation scores. In the adjusted model, older children and those having more teeth treated were more likely to be in the GA than in the CS group. An overlap between the GA and CS groups was found, with 50% of children aged four to nine years having two to four teeth treated in both groups.Conclusion Age and number of teeth treated were the main characteristics associated with receiving care under GA or CS. Some overlap between children receiving dental treatment under GA or CS existed despite demographic and clinical differences between both groups.

  9. General anaesthetic service for adult dental extractions: an 'À La Carte Menu'? Survey results.

    Science.gov (United States)

    Hong, B; Baker, A

    2017-02-24

    The case selection for adult dental extraction under general anaesthesia (GA) is inevitably subjective. A culture of overprescription has implications for patient safety as well as for the limited resources of the National Health Service. We explored the current perceptions and opinions of clinicians in oral and maxillofacial surgery (OMFS) units throughout the UK on various aspects of adult dental extraction under general anaesthesia (DGA) service. An email with an electronic survey link was sent to members of the British Association of Oral and Maxillofacial Surgeons and postgraduate dental deaneries. An institutional response rate of 67.3% was reached (241 clinicians of varying grades from 107 out of 159 oral and maxillofacial surgery units in the UK). There was a general consensus that the culture of demand-driven adult DGA exists and needs to be addressed. However, opinions were divided and varied on how this could be achieved. A small majority (58.1%) were in favour of adult DGA guidelines and this group provided suggestions for selection criteria. Those that did not feel such guidelines would improve the situation were pessimistic of the potential for change in patients' attitude towards DGA. This group cited the poor adherence to other existing guidelines, or suggested alternative ideas to guidelines.

  10. The importance of the evaluation of expectations and perceptions to improve the dental service quality.

    Science.gov (United States)

    Rocha, Juliana; Pinto, Andres; Batista, Marilia; Paula, Janice Simpson de; Ambrosano, Glaucia

    2017-07-10

    Purpose The purpose of this paper is to evaluate the use of SERVQUAL to assess service quality in Dentistry, by evaluating patients' expectations and perceptions of dental care and their association to patients' sociodemographic data. Design/methodology/approach The sample constituted of 379 subjects in the first assessment and 155 in the second phase. All employees of the companies that were clients of the dental insurance participated, a total of four companies in two states (São Paulo and Minas Gerais) of Brazil. SERVQUAL questionnaires about expectations and sociodemographic data were dispatched in the first phase, and in a second phase SERVQUAL questionnaires about perceptions. Those who had not yet received dental treatment and had agreed to participate filled out their survey in the first phase. In the second phase, the respondents had to have completed their treatment. Findings When the value gap is considered, Reliability (as a dimension) had the smallest score (-3.71). This means that it was the worst result, i.e. there is a higher difference between expectations and perceptions, and problems can be identified here. t-test confirmed that all the dimensions had some statistically significant difference with pservice. Moreover, the use of SERVQUAL was extremely relevant for the oral health service, because it assessed the users' subjective perceptions.

  11. The utilization of dental care services according to health insurance coverage in Catalonia (Spain).

    Science.gov (United States)

    Pizarro, Vladimir; Ferrer, Montse; Domingo-Salvany, Antonia; Benach, Joan; Borrell, Carme; Pont, Angels; Schiaffino, Anna; Almansa, Josue; Tresserras, Ricard; Alonso, Jordi

    2009-02-01

    The aim of this study was to assess the relationship of dental care service use with health insurance and its evolution. The Catalan Health Interview Survey is a cross-sectional study conducted in 1994 (n = 15 000) and 2001-2 (n = 8400) by interviews at home to a representative sample of Catalonia (Spain). All the estimates were obtained by applying weights to restore the representativeness of the Catalonia general population. In the bivariate analysis, age, gender, social class and health insurance coverage were statistically associated with a dental visit in the previous year (P social class). However, the falling trend of differences by health insurance coverage is of note (adjusted OR = 2.2 and 1.5 at 1994 and 2002, respectively); as well as the positive evolution of the overall rate of dental service care use in the previous year, from 26.7% in 1994 to 34.3% in 2002. Future studies will be needed to monitor this tendency.

  12. Social inequality in use of dental services: relief of pain and extractions.

    Science.gov (United States)

    Roberts-Thomson, Kaye F; Luzzi, Liana; Brennan, David S

    2008-10-01

    The aim of this study was to assess social inequality in use of dental services by examination of visiting for relief of pain and receipt of extractions. Data were collected in the period of 2004-06, from a stratified clustered sample of Australians aged 15+ years, using a computer-aided telephone interview. Analysis was restricted to n=10,099 dentate adults. Visiting for relief of pain varied by age, country of birth, education and income with lower odds (Odds ratio, 95%CI) among 55-74 (0.43, 0.35-0.54) and 75+ year-olds (0.22, 0.15-0.33) compared to the 15-34 year-olds, lower odds among Australian-born persons (0.82,0.69-0.98) compared to those born overseas, higher odds for those with no post-secondary education (1.31, 1.07-1.61) and with TAFE, trade or other qualifications (1.34, 1.09-1.66) compared to university qualified, and for those in the dental services and suggest an urgent need for the dental profession and governments to address this inequality.

  13. Influence of self-perceived oral health and socioeconomic predictors on the utilization of dental care services by schoolchildren

    Directory of Open Access Journals (Sweden)

    Chaiana Piovesan

    2011-04-01

    Full Text Available The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index. Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured interviews. These associations were assessed using Poisson regression models (prevalence ratio; 95% confidence interval. The prevalence of regular use of dental service was 47.8%. Children from low socioeconomic backgrounds and those who rated their oral health as "poor" used the service less frequently. The distribution of the kind of oral healthcare assistance used (public/private varied across socioeconomic groups. The better-off children were less likely to have used the public service. Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren.

  14. Influence of self-perceived oral health and socioeconomic predictors on the utilization of dental care services by schoolchildren.

    Science.gov (United States)

    Piovesan, Chaiana; Antunes, José Leopoldo Ferreira; Guedes, Renata Saraiva; Ardenghi, Thiago Machado

    2011-01-01

    The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index). Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured interviews. These associations were assessed using Poisson regression models (prevalence ratio; 95% confidence interval). The prevalence of regular use of dental service was 47.8%. Children from low socioeconomic backgrounds and those who rated their oral health as "poor" used the service less frequently. The distribution of the kind of oral healthcare assistance used (public/private) varied across socioeconomic groups. The better-off children were less likely to have used the public service. Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren.

  15. Consultation-Liaison psychiatric service delivery : results from a European study

    NARCIS (Netherlands)

    Huyse, FJ; Herzog, T; Lobo, A; Malt, UF; Opmeer, BC; Stein, B; de Jonge, P; van Dijck, R; Creed, F; Crespo, MD; Cardoso, G; Guimaraes-Lopes, R; Mayou, R; van Moffaert, M; Rigatelli, M; Sakkas, P; Tienari, P

    2001-01-01

    The reported Endings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from ZI European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized,

  16. Development and usability testing of a web-based decision support for users and health professionals in psychiatric services.

    Science.gov (United States)

    Grim, Katarina; Rosenberg, David; Svedberg, Petra; Schön, Ulla-Karin

    2017-09-01

    Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  17. Dental students' HIV/AIDS-related knowledge, attitudes, and intentions: impact of the U.S. Health Resources and Services Administration's community-based dental partnership program.

    Science.gov (United States)

    Hamershock, Rose A; Rajabiun, Serena; Fox, Jane E; Mofidi, Mahyar; Abel, Stephen N; York, Jill A; Kunzel, Carol; Sanogo, Moussa; Mayfield, Theresa G

    2014-08-01

    Access to oral health care for vulnerable populations is one of the concerns addressed by the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Community-Based Dental Partnership Program (CBDPP). The program introduces dental students and residents at several dental schools to care for vulnerable patients through didactic and clinical work in community-based dental settings. This study of the dental students and residents in this program answered three questions: 1) What are their HIV knowledge, attitudes, and behaviors? 2) How has participation in the CBDPP impacted their knowledge, attitudes, and behaviors? 3) Has the intervention affected their work placement decisions and attitudes after graduation, particularly with respect to treating people living with HIV and other underserved populations? A total of 305 first- through fourth-year dental students and first- and second-year residents at five dental schools across the United States completed surveys before and after a community-based rotation and following graduation. Response rates at each of the five schools ranged from 82.4 to 100 percent. The results showed an increase in the participants' knowledge and positive attitudes regarding treatment for patients with HIV and other vulnerable populations post-rotation compared to pre-rotation. Results after graduation found that most respondents were practicing in private settings or in academic institutions as residents but were willing to treat a diverse patient population. These findings support the role of training programs, such as the CBDPP, for expanding the dental workforce to treating vulnerable populations including people living with HIV/AIDS.

  18. Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

    Science.gov (United States)

    Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

    2011-11-01

    Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

  19. The influence of gender, patient volume and time on clinical diagnostic decision making in psychiatric emergency services.

    Science.gov (United States)

    Muroff, Jordana R; Jackson, James S; Mowbray, Carol T; Himle, Joseph A

    2007-01-01

    We investigated the effects of limited time and high patient pressures on the role of gender and other nonpsychiatric factors in diagnostic decision making in psychiatric emergency services (PES). We reviewed the records of 1236 adult psychiatric patients treated by 75 clinicians (e.g., psychiatrists, social workers, nurses and psychologists) in an urban university and community PES in early 2000. Patient records were sampled according to each clinician's level of busyness and load, controlling for the average number of patients typically seen and the actual volume of patients seen by the particular clinician during that shift. Multinomial logistic regression analyses reveal that clinicians are more likely to make a bipolar diagnosis when under low patient load [odds ratio (OR)=1.738, 95% confidence interval (CI)=1.186-2.546, P=.005] or when they have more time (OR=1.111, 95% CI=1.017-1.212, Psocial stereotypes may be more influential. The results have important implications for the use of antidepressant medications with female patients.

  20. Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

    Directory of Open Access Journals (Sweden)

    Grimholt Tine K

    2012-04-01

    Full Text Available Abstract Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867 over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI, Beck Hopelessness Scale (BHS, and Generalized Self-Efficacy Scale (GSE were used. The participation rate was 28% (n = 242; mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe. The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.

  1. Prevalence and correlates of psychiatric disorders among residents of a juvenile Remand Home in Nigeria: implications for mental health service planning.

    Science.gov (United States)

    Atilola, O

    2012-01-01

    Research has established that psychiatric disorders are common among children and adolescents within thejuvenile justice system. However, the bulk of these researches had been from the developed countries, with very limited data from sub-Sahara Africa. In a region like sub-Sahara Africa with acute shortage of mental healthcare resources, availability of data on mental health needs of children within the juvenile justice system is about the only way to ensure that they are not excluded from needed services. This study aims to determine the pattern, prevalence and correlates of psychiatric disorders among the residents of a juvenile justice facility in Nigeria and to speculate appropriate policy responses. Using a cross-sectional comparative study design, 60 consecutive residents of the Ibadan juvenile Remand home and 60 randomly selected age- and gender-matched school going adolescents were evaluated for the presence of current and lifetime psychiatric disorders. The Kiddies Schedule for Affective Disorders and Schizophrenia was used to assess psychiatric disorders. Logistic regression was done to determine sociodemographic variables that were independently associated with the presence of lifetime psychiatric disorders. Thirty eight (63%) of the Remand Home participants had at least one lifetime psychiatric disorder compared with 14 (23%) among the comparison group (p disorder compared with 2 (3%) among the comparison group (p = 0.004). Disruptive behaviour disorders, posttraumatic stress disorder and substance use disorders were the most common psychiatric disorders among the Remand Home residents. Indices of family disruption and inconsistency in caregivers were the key predictors of psychiatric disorders. Study has established further that psychiatric disorders are common among children within the juvenile justice system and that there is a need for appropriate policy response. Some policy directions were highlighted.

  2. Services Use of Children and Adolescents before Admission to Psychiatric Inpatient Care.

    Science.gov (United States)

    Zechmeister-Koss, Ingrid; Winkler, Roman; Fritz, Corinna; Thun-Hohenstein, Leonhard; Tuechler, Heinz

    2016-06-01

    Although 20% of children and adolescents in Europe suffer from overt mental health problems, their illness-related service utilisation is often unknown. If at all, existing research has only addressed the health care sector while services requirements in mental health care go far beyond the health care system, including the social, the educational and the criminal justice system. This paper aims at describing the service contact patterns of children and adolescents within and outside the health care sector before they are admitted to a child and adolescent mental health hospital. Additionally, we evaluate the private out-of-pocket payments that occur for primary carers. A cohort of consecutive admissions to a child and adolescent hospital in Austria was prospectively analysed. We collected data on service use and out-of-pocket expenses before hospital admission from primary carers through face-to-face interviews using an adapted version of the European Child and Adolescent Mental Health Service Receipt Inventory (EU-CAMHSRI). Clinical data came from validated questionnaires (CBCL, YSR) and from the anamnestic documentation. Ninety percent from a cohort of 441 patients had some contact with services or took medication before they were admitted to hospital. Most often, services in the health care outpatient setting were used. Outside of the health care system, support in school, as well as counselling services, were used most frequently, whereas the persons hardly sought support in living or employment. Roughly 32,400 per 100 patients was spent privately, yet these out-of pocket expenses were very unevenly distributed. Service use and out-of-pocket spending increased with social status and were gender-specific. The more severe external behaviour symptoms were, the more non-health care services were used. Mentally ill children and adolescents use a broad range of services across sectors before admission to hospital. Service use is associated with specific symptoms of

  3. Measurement of dollar value of services in a capitated dental plan.

    Science.gov (United States)

    Schoen, M H; Atchison, K A

    1992-01-01

    A number of attempts have been made to develop measures of the cost of resources expended to produce specific services that are more equitable than fees. Two conceptually different relative value methods (RVU and RTCU) and UCR fee-for-service were used to measure the dollar value of care produced in three consecutive years under a network-type capitation dental plan. While each yielded a different total, the values were relatively close in the first year. However, they diverged in the second and third years even when an inflation factor was kept constant for all three. In addition, the dollar value of specific services varied markedly over the three methods. The relative merits of the different systems are discussed, as well as possible reasons for the divergence. It is concluded that the RTCU system is preferable, but that great care must be taken to keep any system current, regardless of specific derivation.

  4. Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use

    DEFF Research Database (Denmark)

    Heiervang, Einar; Stormark, Kjell M; Lundervold, Astri J

    2007-01-01

    OBJECTIVE: The Bergen Child Study is a longitudinal study of child mental health from the city of Bergen, Norway. We present methods and results from the first wave of the study, focusing on prevalence of disorders, associations with risk factors, and the use of services. METHOD: The target...... population included all 9,430 children attending grades 2 to 4 in Bergen schools during the academic year 2002/2003. The main screening instrument was the Strengths and Difficulties Questionnaire, whereas diagnoses were based on the Development and Well-Being Assessment. Information about child and family......%) were assessed with the Development and Well-Being Assessment in the second phase. The weighted prevalence for any DSM-IV psychiatric disorder was 7.0% (95% confidence interval 5.6%-8.5%). Disorders were associated with age, gender, learning difficulties, family type, and poverty. Although 75...

  5. Integration of oral health care and mental health services: Dental hygienists' readiness and capacity for secondary prevention of eating disorders.

    Science.gov (United States)

    DeBate, Rita DiGioacchino; Plichta, Stacey B; Tedesco, Lisa A; Kerschbaum, Wendy E

    2006-01-01

    Often the first to observe overt health effects of eating disorders, dentists and dental hygienists play a fundamental role in the secondary prevention of eating disorders. The purpose of this study was to explore readiness and capacity for integration of oral health and mental health services. Employing a randomized cross-sectional study based upon the Transtheoretical and Health Belief Models, data were collected from 378 dental hygienists. Results reveal that the majority do not currently engage in secondary prevention practices. Only 18% of respondents indicated referring patients exhibiting oral manifestations of eating disorders to treatment. Significantly increasing the likelihood of assessment, referral, and case management included modifying factors regarding greater perceived self-efficacy, and knowledge of oral cues of disordered eating, as well as the individual's perception pertaining to severity of eating disorders. Implications for bridging dental care to mental health services include increasing behavioral capacity among dental hygienists via consciousness raising and improved self-efficacy.

  6. Reasons for referral of very elderly patients to the community dental service in rural England and the implications for developing oral health care services.

    Science.gov (United States)

    Fenwick, J E; Batchelor, P A; Samarawickrama, D Y

    1998-01-01

    To analyse the medical conditions and dental treatment requirements. Retrospective analysis. Rural South West Surrey, England. 100 patients aged 75 or over who were referred for dental treatment to the Community Dental Services (CDS) because of various medical disabilities. Age, sex, medical history including drug intake, dental treatment provided, time taken for treatment. Two-thirds of the patients required domiciliary care; two-thirds had problems of mental confusion. In addition, 89% were dependent on carers. Treatment requirements indicate that the majority of dental care, although time consuming, were simple in nature and within the technical scope of a competent general dental practitioner (GDP). This study implies that the reasons for referral are other than lack of dental skills and may be due to perceived difficulties in managing patients. Further research is recommended to establish whether aspects of patient management are problematic so that resources, including appropriate training programmes, can be developed to enable a quality service to be provided. In the evolving health care system in the United Kingdom (UK) these issues will need to be considered when developing contracts at a local level.

  7. Eradicating Barriers to Mental Health Care Through Integrated Service Models: Contemporary Perspectives for Psychiatric-Mental Health Nurses.

    Science.gov (United States)

    Ellis, Horace; Alexander, Vinette

    2016-06-01

    There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in

  8. [Psychiatric Emergencies in the Preclinical Emergency Medicine Service in Ulm, Germany in 2000 and 2010, and Practical Consequences].

    Science.gov (United States)

    Schönfeldt-Lecuona, Carlos; Gahr, Maximilian; Schütz, Stefan; Lang, Dirk; Pajonk, Frank Gerald Bernhard; Connemann, Bernhard J; Muth, Claus-Martin; Freudenmann, Roland W

    2017-07-01

    Background  Psychiatric emergencies (PE) in preclinical emergency medical services are about 5 - 10 % of all emergencies and represent often a source of difficulties in handling for the non-psychiatric professional helpers that deal with them. Studies informing about quantitative and qualitative changes of PEs in preclinical emergency medicine in Germany are scarce. Methods  Therefore, we conducted a retrospective cross-sectional study of PE in a preclinical emergency medical service based on the protocols of the emergency ambulance of the Section for Emergency Medicine at the University Hospital Ulm comparing the years 2000 and 2010. Results  We observed a significant increase of PEs from 8.8 % in the year 2000 (n = 285, from a total of n = 3227) to 10.3 % in 2010 (n = 454, from a total of n = 4425). In both years intoxications were the most common PE [2000: n = 116 (44.4 %); 2010: n = 171 (37.7 %)], followed by suicide-related behavior [2000: n = 59 (22.6 %); 2010: n = 78 (17.2 %)] and acute anxiety disorders [2000: n = 37 (13 %); 2010: n = 105 (23.1 %)]. The mentioned three conditions accounted for about 80 % of all PE. Most frequently PE occurred at the weekend and with the highest density in the evening and at night (18 - 24 h) in both years. Patients with PE were predominantly men, but the rate of women causing PE increased between 2000 and 2010. Discussion/Conclusion  This study provides preliminary data on current trends in PEs in preclinical emergency medicine in Germany and has implications for improving the medical care provided. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Reported exposure to trauma among adult patients referred for psychological services at the Free State Psychiatric Complex, Bloemfontein

    Directory of Open Access Journals (Sweden)

    Laurisa van Zyl

    2017-10-01

    Objective: The study aimed to explore and describe the extent and nature of reported potentially traumatic events and associated variables in adult patients referred for psychological services at the Free State Psychiatric Complex (FSPC, Bloemfontein. Methods: In this cross-sectional study, demographic information, diagnostic morbidity and co-morbidity, and presence and type of reported trauma exposure reported by patients during the initial assessment were obtained from files of adult patients seen during a one-year period (2010 at the out-patient unit and the in-patient affective ward at the FSPC. Data were captured on data record forms by the researchers and analysed by means of descriptive statistics, univariate analysis and logistic regression (SAS version 9.1. Results: Of the 192 adults (71.9% White and 67.2% female referred for psychological services,75.5% were diagnosed with mood disorders, 17.2% with anxiety disorders, 22.4% with substance-related disorders and 20.9% with cluster B personality disorders or traits. A total of 145 (75.5% reported past trauma exposure. The most frequently reported types of trauma exposure were traumatic death/injury of a loved one (37.0%, physical assault (24.5%, witnessed/threatened violence (19.3%, and sexual assault (17.7%. Women were more likely to have been exposed to trauma than men (OR 4.02, 95% CI 1.87–8.62, in particular to traumatic death of a loved one (OR 3.13, physical assault (OR 4.08, or sexual assault (OR 5.43. Conclusions: The findings of this study contribute to current data regarding the prevalence of exposure to trauma and its possible association with mental illness. The importance of comprehensive trauma exposure screening in routine psychiatric interviewing practices is highlighted.

  10. Differences in pediatric dental services under general anesthesia for Medicaid and military dependent children.

    Science.gov (United States)

    Johnson, M B; Cappelli, D P; Bradshaw, B S; Mabry, J C

    2010-01-01

    This study's purpose was to compare pediatric dental services provided for Medicaid and military dependent children to determine if differences in dental treatment choices exist based on site and payment method. Subjects included 120 Medicaid patients at the University of Texas Health Science Center at San Antonio and 120 military dependents at Lackland Air Force Base, Texas. Demographic data and treatment information were abstracted for children younger than 6 years old receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using Wilcoxon rank sum, Kruskal-Wallis, and Fisher's exact tests. The Medicaid recipients were younger (40.2 vs 49.8 months, Pcrowns did not differ between sites. Medicaid children received more composite fillings (P<.001), fewer amalgam fillings (P<.001), fewer pulp therapies (P<.001), more extractions (P=.01), and fewer sealants (P<.001). Age and gender did not affect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs 8.6, P=.02). This study found no difference in the number of less conservative, albeit more costly, procedures performed with Medicaid children at a university compared to military dependents at a military base.

  11. Strategies for student services for lesbian, gay, bisexual, and transgender students in dental schools.

    Science.gov (United States)

    More, Frederick G; Whitehead, Albert W; Gonthier, Mark

    2004-06-01

    The purpose of this article is to explore issues that pertain to the needs of gay men, lesbians, and bisexual and transgender (GLBT) students as a subgroup in U.S. dental schools. The increasing visibility of GLBT persons in all aspects of life is one aspect of the changing face of the U.S. population. Increasingly, there is dialogue about issues related to GLBT persons, their nontraditional families, and their full engagement in society. Recent court decisions, changing policies in states and municipalities, and increasing acceptance in society promote inclusion. Likewise, this dialogue has extended into academic life. In medicine and nursing, GLBT issues include the needs of GLBT patients, the mentoring of faculty and administration, and acculturation of students in a dynamic college environment. Increasing the acceptance of GLBT persons and enhancing the value of diversity throughout the community and within the profession are challenges that must be met. In addition, fostering positive behaviors in a multicultural environment is a priority that is recognized in business and academe. In an effort to assess the present situation in U.S. dental schools, a survey was developed to gather data about support services provided for GLBT students. Based on the results of the survey, a series of recommendations are made to meet the needs of GLBT students, faculty, staff, and administrators in dental education institutions.

  12. NHS dental care and the issues of public service ethos, governance, accountability and probity.

    Science.gov (United States)

    Batchelor, Paul

    2009-06-01

    A decision by any government to intervene in dental care requires that accountability arrangements exist and that the public has faith in them. Such arrangements require a range of governance mechanisms that in turn create routes of accountability. If accountability is to have meaning an appropriate probity system is necessary. Existing probity arrangements in the NHS dental care system are far from ideal: the checks on claims are far less vigorous than under the previous contractual agreement. While the Dental Reference Service continues to refine its probity activities there are few, if any, assessments of the quality of diagnosis and treatment planning let alone the quality of the treatment provided, along with financial shortfalls. The nature of the contract introduced in April 2006 means that, even with compliance, its use as a quality assurance mechanism is substantially weaker. To address these shortfalls requires improvements in the governance arrangements a key element of which is clarity in accountability. Accountability provides an understanding of how a delivery system works, the pressures and incentives facing its actors and allows for better reform design and implementation. If a public dental service is to have excellent outcomes, be fair and equitable and offer value for money the present failings must be addressed. As has been identified in other public services: "...certain assumptions appear to be based on a belief that these standards were general throughout the public sector and would be maintained or adapted during periods of change. Little attention was given to what compromises the standards, how they are perceived and implemented across the public sector and who monitors or polices them, particularly in times of change." (Doig, 1995). The development of improved probity arrangements and a suitable contract through which the service delivered is specified would be a starting point. Perhaps then both the public and the profession can begin to

  13. Relationship between risk assessment and payment models in Swedish Public Dental Service

    DEFF Research Database (Denmark)

    Petersson, Gunnel Hänsel; Twetman, Svante

    2017-01-01

    assessment was carried out in 1295 young adults attending eight Public Dental Clinics in the Scania region and 75% could be re-examined after 3 years; 615 had selected the CP model and 310 the traditional FFS. Caries was scored according to WHO and data concerning preventive care was extracted from...... risk preferred the prepaid model while those in the higher risk categories selected fee-for-service. As more additional preventive care was delivered to patients in the subscribed care, oral health planners and decision makers should be aware of the fact that capitation payment models may enhance...

  14. The dynamics of toothache pain and dental services utilization: 24-month incidence.

    Science.gov (United States)

    Duncan, R Paul; Gilbert, Gregg H; Peek, Chuck W; Heft, Marc W

    2003-01-01

    The aims of this study were twofold: (1) to describe patterns of change in reported toothache pain, and (2) to examine the impact of toothache pain on dental care utilization and vice versa. Data from the Florida Dental Care Study (FDCS), a longitudinal study of oral health and dental service utilization conducted in north Florida, were used to measure self-reported toothache pain among dentate adults at baseline and four subsequent times during a 24-month period. Only persons 45 years of age or older with at least one remaining natural tooth at baseline were eligible. A total of 873 subjects participated, 764 of whom participated through 24 months. The analysis is focused on modeling transitions in the reported experience of toothache pain during intervals of six months. At the time of the baseline interview, 11.5 percent of subjects reported current toothache pain. During subsequent six-monthly interviews, from 13.4 percent to 21.6 percent of subjects reported having experienced toothache pain during the prior six-month interval. Among those with no toothache pain at baseline (n = 772), 31.2 percent experienced toothache pain at some time during the 24-month study period. The six-month incidence probability reflects the likelihood of developing toothache pain by estimating the conditional probability of reporting a toothache in a later interval given that this problem was not reported in the earlier one (for consecutive pairs of intervals). Overall, the six-month incidence probability for toothache pain in this study was. 11. Significantly higher 24-month incidence was observed for African-American subjects, those with less formal education, those in poorer financial circumstances, and problem-oriented dental attenders. In this diverse sample of adults, toothache pain occurs frequently and is quite variable overtime. Toothache occurs in conjunction with various forms of self-reported oral disease (e.g., abscess, cavities) or tissue damage (e.g., loose tooth

  15. Availability of dental treatment is associated with satisfaction derived from Primary Health Care Services accessed by elderly

    Directory of Open Access Journals (Sweden)

    Aline Blaya MARTINS

    Full Text Available Abstract Objective This research evaluated whether having dental treatment available in the primary health care centers of the Brazilian Unified Health System was associated with greater satisfaction with the services accessed. The offering of dental care within the health service that elders usually access may improve their satisfaction with the services as a whole. Material and method In this cross-sectional study, 401 elders living in the districts of Lomba do Pinheiro and Partenon in Porto Alegre, Brazil were interviewed. Elders were selected using a cluster sampling design process from census tract drawings. Result Poisson Regression revealed that age and dental treatment supply were associated with outcome, and age, number of teeth, and the presence of dental treatment were associated with a higher prevalence of satisfaction with health services. Conclusion These results provide new contributions for health system qualification because this study demonstrated the importance of having dental treatment available to improve the satisfaction of older people with the Primary Health Care (PHC services accessed.

  16. Challenges to Improve Inter-Professional Care and Service Collaboration for People Living With Psychiatric Disabilities in Ordinary Housing.

    Science.gov (United States)

    Andersson, Ann-Christine; Ainalem, Ingrid; Berg, Agneta; Janlöv, Ann-Christin

    2016-01-01

    The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back--evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

  17. Service referral for juvenile justice youths: associations with psychiatric disorder and recidivism

    NARCIS (Netherlands)

    Hoeve, M.; McReynolds, L.S.; Wasserman, G.A.

    2014-01-01

    Secondary multiple regression analyses related disorder profile, probation officers' mental health/substance use service referrals, and recidivism in 361 juvenile justice youths. Those with externalizing (disruptive behavior or substance use) disorder or substance offenses were most likely to

  18. The influence of economic incentives on treatment patterns in a third-party funded dental service.

    LENUS (Irish Health Repository)

    Woods, N

    2010-03-01

    OBJECTIVE: To investigate the response of dental practitioners to administration and remuneration adjustments to the Dental Treatment Services Scheme (DTSS) in the Republic of Ireland. DESIGN: Following the introduction of a series of administration and fee adjustments by a third party payments system in December 1999 the pattern of extractions and restorations are examined to determine whether the adjustments had influenced provider behaviour, in particular whether a substitution effect from extractions to restorations would result from a relative fee increase of 62% for amalgam fillings. DATA AND METHODS: Data on patient and provider characteristics from June 1996 to April 2005, collected by the Health Service Executive (HSE) National Shared Services Primary Care Reimbursement Service to facilitate remuneration to dentists providing services in the DTSS, was used in this analysis. A graphical analysis of the data revealed a structural break in the time-series and an apparent substitution to amalgam fillings following the introduction of the fee increases. To test the statistical significance of this break, the ratio of amalgams to restorations was regressed on the trend, growth and level dummy variables, using Ordinary Least Squares (OLS) regression. The diagnostics of the model were assessed using the Jarque-Bera normality test and the LM to test for serial correlation. RESULTS: The initial results showed no evidence of a structural break. However on further investigation, when a pulse dummy was included to account for the immediate impact of the fee adjustment the results suggest a unit root process with a structural break in December 1999. This implies that the amalgam fee increase of December 1999 influenced the behaviour patterns of providers. CONCLUSIONS: System changes can be used to change the emphasis from a scheme that was principally exodontia\\/emergency based to a scheme that is more conservative and based on restoration\\/prevention.

  19. "Conversation" group in the Psychiatric service for the diagnosis and treatment of Caltagirone (Italy

    Directory of Open Access Journals (Sweden)

    Raffaele Barone

    2014-09-01

    Full Text Available The clinical device, introduced in clinical psychiatric hospital of Caltagirone, wants to be a crisis intervention for the patient and the entire family system. The "conversation group" with the participation of family members and professionals who want to make contact with their patients. Knowing the discomfort that the users bring in hospital, enables the development, comparison with others and with their stories, comments and different perspectives. In the space of the group the patient can admit the possibility of expressing content and see all the thoughts and feelings more destructive, to find a meaning to their crisis, their discomfort, in order to start a process of recovery. Within this space processes are activated mutual aid, sharing and reflections that mobilize resources for individual and family awareness and the development of transformative movements. A resonance in terms transformative is perceived by the whole micro-community of the department, influencing the climate, the processes of socialization among patients and between patients and their personal health, combating loneliness admission and burnout of health personnel. Keywords:Multifamily group; Mutual aid; Sharing and reflection; Multiple transfert; narrative medicine 

  20. Practice characteristics and service provision rates of dental hygienists in Australia.

    Science.gov (United States)

    Amarasena, N; Teusner, D N; Brennan, D S; Satur, J

    2017-08-14

    Dental hygienists (DHs) have been practising in Australia since the early 1970s. This study describes the clinical activity of Australian DHs. A questionnaire was mailed to members of two professional associations representing DHs. Practitioner characteristics, employment characteristics and clinical activity on a self-reported typical practice day were collected. The proportion of each service item of all services provided was estimated. Associations between practice characteristics and service provision were assessed by log-binomial regression models. Adjusted response rate was 60.6%. Of the DHs included in analysis (n=341), 80% were employed in general practice, and nearly all (96%) worked in the private sector. About half (53.7%) of all service provided were preventive services, and one-fourth (23.9%) were diagnostic. Service provision varied by practice and practitioner characteristics, with the largest variations observed by practice type. Unadjusted analysis showed that general practice DHs provided a higher mean number of periodontal instrumentation and coronal polishing (0.92 vs 0.26), fluoride applications (0.64 vs 0.08), oral examinations (0.51 vs 0.22) and intraoral radiographs (0.33 vs 0.07) per patient visit and a lower mean number of impressions (0.05 vs 0.17) and orthodontic services (0.02 vs 0.59) than specialist practice DHs. In adjusted analysis, rates of periodontal services also significantly varied by practice type; other associations persisted. Service provision of DHs varied by practice type. Practice activity was dominated by provision of preventive services while provision of periodontal treatments, fissure sealants and oral examinations was relatively limited indicating areas in which DHs are possibly underutilized. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey.

    Science.gov (United States)

    Hansen, Anne Helen; Høye, Anne

    2015-10-22

    Overall, men are less likely than women to seek health care services for mental health problems, but differences between genders in higher age groups are equivocal. The aim of the current study was to investigate the association between gender and the use of psychiatric outpatient specialist services in Norway, both in a general population and in a subpopulation with self-reported anxiety and/or depression. Using questionnaires from 12,982 participants (30-87 years) in the cross-sectional sixth Tromsø Study (2007-8) we estimated proportions reporting anxiety/depression, and proportions using psychiatric outpatient specialist services in a year. By logistic regressions we studied the association between gender and the use of psychiatric outpatient specialist services. Analyses were adjusted for age, marital status, income, education, self-reported degree of anxiety/depression, and GP visits last year. Analyses were also performed for genders separately. Anxiety/depression was reported by 21.5 % of women and 12.3 % of men in the general population. Visits to psychiatric outpatient services during one year were reported by 4.6 % of women and 3.3 % of men. The general population's probability of a visit was significantly lower among men compared to women in ages 30-49 years (odds ratio [OR] 0.58, confidence interval [CI] 0.39-0.84, p-value [p] = 0.004), whereas men used services slightly more than women in ages 50 years and over (OR 1.36, CI 1.00-1.83, p = 0.047). Among those with anxiety/depression 13.5 % of women and 10.5 % of men visited psychiatric outpatient services in a year. We found no statistically significant gender differences in the use of services in this subgroup. Other factors associated with services use in women with anxiety/depression were higher education, more severe anxiety/depression, and GP visits the last year, whereas in men only a more severe anxiety/depression was associated with psychiatric outpatient visits. Overall, the use of

  2. Disorder-Specific Mental Health Service Use for Mood and Anxiety Disorders: Associations with Age, Sex, and Psychiatric Comorbidity

    Science.gov (United States)

    Mackenzie, Corey S.; Reynolds, Kristin; Cairney, John; Streiner, David L.; Sareen, Jitender

    2013-01-01

    Background The objectives of this study are to examine the prevalence of disorder-specific mental health service use for mood and anxiety disorders, and relationships between helpseeking and age, sex, and psychiatric comorbidity. Methods The authors used Wave 2 data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), which included 34,653 adults. Cross tabulations provided helpseeking prevalence rates for five anxiety disorders and three mood disorders by age and sex, as well as for individuals with and without comorbid anxiety and mood disorders. Logistic regression analyses explored the likelihood of helpseeking among younger and middle-aged adults in comparison to older adults. Results The prevalence of helpseeking was highest for panic disorder (45.3%) and dysthymia (44.5%) and lowest for specific phobias (7.8%). For each condition except panic disorder service use was most likely among middle-aged adults and especially unlikely among older individuals. Sex differences in treatment seeking favoring women showed only modest variability with age. Finally, the prevalence of helpseeking was generally lower among individuals without comorbid anxiety or mood disorders, and the hill-shaped influence of age on service use was attenuated in this pure group. Conclusions The results of this study highlight the highest prevalence of disorder-specific service use among middle-aged adults and women, and among individuals with panic disorder and dysthymia. For purposes of identifying groups who are in need of targeted efforts to increase service use, helpseeking was especially unlikely among people suffering from specific phobia, as well as among men and older adults. PMID:22065571

  3. The use of the BDA Case Mix Model to assess the need for referral of patients to specialist dental services.

    Science.gov (United States)

    AlKindi, N A; Nunn, J

    2016-04-22

    Access to health services is a right for every individual. However, there is evidence that people with disabilities face barriers in accessing dental health. One of the reasons associated with this is the unclear referral pathway existing in the Irish dental health service. The appropriate assignment of patients to relevant services is an important issue to ensure better access to healthcare. This is all the more pertinent because there are only a few trained dental practitioners to provide dental treatment for people with disabilities, as well as even fewer qualified specialists in special care dentistry. The aim of this part of the study was to assess the use of the BDA Case Mix Model to determine the need for referral of patients to specialist dental services, and to determine any association between patient complexity and the need for adjunct measures, such as sedation and general anaesthesia for the management of people with disabilities and complex needs. A retrospective analysis of dental records using the BDA Case Mix Model.Results The results showed that patients with different levels of complexities were being referred to the special care dentistry clinic at the Dublin Dental University Hospital. The results also showed that the need for supportive adjunct measures such as sedation and general anaesthesia was not necessarily the main reason for referring patients to specialist services. The assessment with the BDA Case Mix Model was comprehensive as it looked at many factors contributing to the cases' complexity. Not all categories in the Case Mix Model had significant association with the need for an adjunct.Conclusion The BDA Case Mix Model can be used to measure the need for supportive adjunct measures, such as sedation and general anaesthesia.

  4. Limited English proficiency as a barrier to mental health service use: a study of Latino and Asian immigrants with psychiatric disorders.

    Science.gov (United States)

    Kim, Giyeon; Aguado Loi, Claudia X; Chiriboga, David A; Jang, Yuri; Parmelee, Patricia; Allen, Rebecca S

    2011-01-01

    Language barriers pose problems in mental health care for foreign-born individuals in the United States. Immigrants with psychiatric disorders may be at particular risk but are currently understudied. The purpose of this study was to examine the effect of limited English proficiency (LEP) on mental health service use among immigrant adults with psychiatric disorders. Drawn from the National Latino and Asian American Study (NLAAS), Latino and Asian immigrant adults aged 18-86 with any instrument-determined mood, anxiety, and substance use disorder (n = 372) were included in the present analysis. Results from hierarchical logistic regression analyses showed that having health insurance, poor self-rated mental health, and more psychiatric disorders were independently associated with higher probability of mental health service use in the Latino group. After controlling for all background characteristics and mental health need factors, LEP significantly decreased odds of mental health service use among Latino immigrants. None of the factors including LEP predicted mental health service use among Asian immigrants, who were also the least likely to access such services. LEP was a barrier to mental health service use among Latino immigrants with psychiatric disorders. This study suggests that future approaches to interventions might be well advised to include not only enhancing the availability of bilingual service providers and interpretation services but also increasing awareness of such options for at least Latino immigrants. In addition, further investigation is needed to identify factors that can enhance access to mental health care services among Asians. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Consumer satisfaction with psychiatric services: The role of shared decision making and the therapeutic relationship.

    Science.gov (United States)

    Klingaman, Elizabeth A; Medoff, Deborah R; Park, Stephanie G; Brown, Clayton H; Fang, Lijuan; Dixon, Lisa B; Hack, Samantha M; Tapscott, Stephanie L; Walsh, Mary Brighid; Kreyenbuhl, Julie A

    2015-09-01

    Although dissatisfaction is a primary reason for disengagement from outpatient psychiatric care among consumers with serious mental illnesses, little is known about predictors of their satisfaction with medication management visits. The primary purpose of this study was to explore how dimensions of consumer preferences for shared decision making (i.e., preferences for obtaining knowledge about one's mental illness, being offered and asked one's opinion about treatment options, and involvement in treatment decisions) and the therapeutic relationship (i.e., positive collaboration and type of clinician input) were related to visit satisfaction. Participants were 228 Veterans with serious mental illnesses who completed a 19-item self-report questionnaire assessing satisfaction with visits to prescribers (524 assessments) immediately after visits. In this correlational design, a 3-level mixed model with the restricted maximum likelihood estimation procedure was used to examine shared decision-making preferences and therapeutic alliance as predictors of visit satisfaction. Preferences for involvement in treatment decisions was the unique component of shared decision making associated with satisfaction, such that the more consumers desired involvement, the less satisfied they were. Positive collaboration and prescriber input were associated with greater visit satisfaction. When consumers with serious mental illnesses express preferences to be involved in shared decision making, it may not be sufficient to only provide information and treatment options; prescribers should attend to consumers' interest in involvement in actual treatment decisions. Assessment and tailoring of treatment approaches to consumer preferences for shared decision making should occur within the context of a strong therapeutic relationship. (c) 2015 APA, all rights reserved).

  6. Medication Adherence, Work Performance and Self-Esteem among Psychiatric Patients Attending Psychosocial Rehabilitation Services at Bangalore, India.

    Science.gov (United States)

    Gandhi, Sailaxmi; Pavalur, Rajitha; Thanapal, Sivakumar; Parathasarathy, Nirmala B; Desai, Geetha; Bhola, Poornima; Philip, Mariamma; Chaturvedi, Santosh K

    2014-10-01

    Work benefits mental health in innumerable ways. Vocational rehabilitation can enhance self-esteem. Medication adherence can improve work performance and thereby the individuals' self-esteem. To test the hypothesis that there would be a significant correlation between medication adherence, work performance and self-esteem. A quantitative, descriptive correlational research design was adopted to invite patients attending psychiatric rehabilitation services to participate in the research. Data was collected from a convenience sample of 60 subjects using the 'Medication Adherence Rating scale', 'Griffiths work behaviour scale' and the 'Rosenberg's Self-esteem scale'. Analysis was done using spss18 with descriptive statistics, Pearsons correlation coefficient and multiple regression analysis. There were 36 males and 24 females who participated in this study. The subjects had good mean medication adherence of 8.4 ± 1.5 with median of 9.00, high mean self-esteem of 17.65 ± 2.97 with median of 18.0 and good mean work performance of 88.62 ± 22.56 with median of 93.0. Although weak and not significant, there was a positive correlation (r = 0.22, P = 0.103) between medication adherence and work performance; positive correlation between (r = 0.25, P = 0.067) medication adherence and self-esteem; positive correlation between (r = 0.136, P = 0.299) work performance and self-esteem. Multiple regression analysis showed no significant predictors for medication adherence, work performance and self-esteem among patients with psychiatric illness. Medication monitoring and strengthening of work habit can improve self-esteem thereby, strengthening hope of recovery from illness.

  7. An international, multidisciplinary, service-learning program: an option in the dental school curriculum.

    Science.gov (United States)

    Martinez-Mier, Esperanza A; Soto-Rojas, Armando E; Stelzner, Sarah M; Lorant, Diane E; Riner, Mary E; Yoder, Karen M

    2011-04-01

    Many health professions students who treat Spanish-speaking patients in the United States have little concept of their culture and health related traditions. The lack of understanding of these concepts may constitute major barriers to healthcare for these patients. International service-learning experiences allow students to work directly in communities from which patients immigrate and, as a result, students gain a better understanding of these barriers. This article describes the implementation of an international, multidisciplinary, service-learning program in a dental school in the United States. The Indiana University International Service-Learning program in Hidalgo, Mexico began in 1999 as an alternative spring break travel and clinical experience for medical students, focusing on the treatment of acute health problems. Travel-related preparatory sessions were offered, and no learning or service objectives had been developed. The program has evolved to include a multidisciplinary team of dental, medical, nursing, public health and social work students and faculty. The experience is now integrated into a curriculum based on the service-learning model that allows students to use their clinical skills in real-life situations and provides structured time for reflection. The program aims to enhance teaching and foster civic responsibility in explicit partnership with the community. Preparatory sessions have evolved into a multidisciplinary graduate level course with defined learning and service objectives. PROGRAM EVALUATION METHODS: In order to assess the program's operation as perceived by students and faculty and to evaluate student's perceptions of learning outcomes, evaluation tools were developed. These tools included student and faculty evaluation questionnaires, experiential learning journals, and a strengths, weaknesses, opportunities and threats analysis. Evaluation data show that after program participation, students perceived an increase in their

  8. Perceptions of psychosocial disability amongst psychiatric service users and caregivers in South Africa.

    Science.gov (United States)

    Brooke-Sumner, Carrie; Lund, Crick; Petersen, Inge

    2014-01-01

    In many parts of South Africa there is little support for people with psychosocial disability caused by schizophrenia, beyond provision of psychotropic medications. Appropriate community-based psychosocial rehabilitation interventions are a crucial element of mental health service development. This study aimed to use an explanatory model of illness framework to document experiences of illness, disability and recovery amongst service users with schizophrenia and their caregivers in a poorly resourced area in the North West Province. Data were used to provide recommendations for a contextually appropriate non-specialist facilitated group psychosocial rehabilitation intervention. Eighteen in-depth individual interviews were conducted: nine with schizophrenia service users and nine with caregivers. Interviews were conducted by two trained field researchers; both clinical psychologists fluent in the first language of participants. All interviews were recorded, translated and transcribed. Data were thematically analysed using NVivo 9. Participants linked the illness to witchcraft, poverty and stress. Family conflict was recognised in the course of the illness, causing stress and challenges for emotional well-being. Knowledge of diagnosis and biomedical treatment was minimal. Key factors recognised by service users as promoting recovery were the ability to work, and the support of traditional healers and religious structures. Based on the findings of this study, a group psychosocial rehabilitation intervention emerged as a recommendation, with the incorporation of psycho-education, adherence support, coping skills, and opportunities for income generation and productive activity. The importance of also enlisting the support of religious leaders and traditional healers in supporting recovery is emphasised.

  9. Perceptions of psychosocial disability amongst psychiatric service users and caregivers in South Africa

    Directory of Open Access Journals (Sweden)

    Carrie Brooke-Sumner

    2014-04-01

    Full Text Available Background: In many parts of South Africa there is little support for people with psychosocial disability caused by schizophrenia, beyond provision of psychotropic medications. Appropriate community-based psychosocial rehabilitation interventions are a crucial element of mental health service development.Objectives: This study aimed to use an explanatory model of illness framework to document experiences of illness, disability and recovery amongst service users with schizophrenia and their caregivers in a poorly resourced area in the North West Province. Data were used to provide recommendations for a contextually appropriate non-specialist facilitated group psychosocial rehabilitation intervention.Method: Eighteen in-depth individual interviews were conducted: nine with schizophrenia service users and nine with caregivers. Interviews were conducted by two trained field researchers; both clinical psychologists fluent in the first language of participants. All interviews were recorded, translated and transcribed. Data were thematically analysed using NVivo 9.Results: Participants linked the illness to witchcraft, poverty and stress. Family conflict was recognised in the course of the illness, causing stress and challenges for emotional well-being. Knowledge of diagnosis and biomedical treatment was minimal. Key factors recognised by service users as promoting recovery were the ability to work, and the support of traditional healers and religious structures.Conclusion: Based on the findings of this study, a group psychosocial rehabilitation intervention emerged as a recommendation, with the incorporation of psycho-education, adherence support, coping skills, and opportunities for income generation and productive activity. The importance of also enlisting the support of religious leaders and traditional healers in supporting recovery is emphasised.

  10. Chronic kidney disease and use of dental services in a United States public healthcare system: a retrospective cohort study.

    Science.gov (United States)

    Grubbs, Vanessa; Plantinga, Laura C; Tuot, Delphine S; Powe, Neil R

    2012-04-02

    As several studies have shown an association between periodontal disease and chronic kidney disease (CKD), regular dental care may be an important strategy for reducing the burden of CKD. Access to dental care may be limited in the US public health system. In this retrospective cohort study of 6,498 adult patients with (n = 2,235) and without (n = 4,263) CKD and at least 12 months of follow-up within the San Francisco Department of Public Health Community Health Network clinical databases, we examined the likelihood of having a dental visit within the observation period (2005-2010) using Cox proportional hazards models. To determine whether dental visits reflected a uniform approach to preventive service use in this setting, we similarly examined the likelihood of having an eye visit among those with diabetes, for whom regular retinopathy screening is recommended. We defined CKD status by average estimated glomerular filtration rate based on two or more creatinine measurements ≥ 3 months apart (no CKD, ≥ 60 ml/min/1.73 m2; CKD, dental visit. Those with CKD had a 25% lower likelihood of having a dental visit [HR = 0.75, 95% CI (0.64-0.88)] than those without CKD after adjustment for confounders. Among the subgroup of patients with diabetes, 11.8% vs. 17.2% of those with and without CKD had a dental visit, while 58.8% vs. 57.8% had an eye visit. Dental visits, but not eye visits, in a US public healthcare setting are extremely low, particularly among patients with CKD. Given the emerging association between oral health and CKD, addressing factors that impede dental access may be important for reducing the disparate burden of CKD in this population.

  11. COMMUNITY DENTAL HEALTH SURVEY TRAINING TO DENTAL HEALTH PERSONNEL

    OpenAIRE

    Sandra Fikawati; Ita Yulita

    2015-01-01

    Dentist and dental nurse as dental health personnel in community health center are spearheads in community dental health service. The effectiveness and efficacy of community dental health service needs updated adequate dental health knowledge and skill. One effort to assure the fulfillment of those needs is by providing community dental health survey training. This training aims at improving the skill and capability of dental health personnel to conduct dental health survey. The training cons...

  12. Psychiatric comorbidity and impact on health service utilization in a community sample of patients with epilepsy.

    Science.gov (United States)

    Lacey, Cameron J; Salzberg, Michael R; Roberts, Helene; Trauer, Tom; D'Souza, Wendyl J

    2009-08-01

    We aimed to determine the level of psychological distress in community-treated patients with epilepsy and to determine if this distress is associated with increased health service use. The Australian National prescription database was used to recruit patients with epilepsy onto the Tasmanian Epilepsy Register (TER). Psychological distress was measured using the K10 in the TER patients and compared to the Tasmanian population using the National Health Survey 2004-5. Of the 1,180 on the TER, 43 withdrew, 36 died, and 262 were excluded. Of 839 patients, 652 completed the K10 (78%). High-very high levels of psychological distress were observed in patients with epilepsy compared with the general population [odds ratio (OR) 2.14, 95% confidence interval (CI) 1.79-2.56]. Patients with high-very high psychological distress had increased attendance at general practitioners (p community-treated patients with epilepsy compared to the general population, and is associated with increased health service use.

  13. Required qualifications in the Swedish Public Dental Health Service as indicators of organizational ideology.

    Science.gov (United States)

    Franzén, C; Söderfeldt, B

    2001-12-01

    The manifestly required qualifications in job advertisements in the Journal of the Swedish Dental Association were analyzed as indicators of the organizational ideology in the Swedish Public Dental Health Service from the employers' viewpoint. All job advertisements that concerned dentists and managers on different hierarchical levels in general dentistry from January 1990 to December 1998 were included (n = 1152). The number of vacancies was 1856. The textual material was analyzed by content analysis, permitting quantitative descriptions of the text and analysis of the latent characteristics. Words and phrases were classified into categories on different levels of abstraction developed from the theoretical background and the purpose of the study. Altogether 5705 required qualifications were categorized. The inter-coder reliability of the first-level categorization resulted in 81% correspondence of the classification, and lambda = 0.90. Qualifications were more frequently required with higher hierarchical job positions, and personality characteristics were more frequent than technical competence and knowledge. Qualifications interpreted as related to economic goals occurred more frequently than those related to odontological goals. The qualification demands reflected the language of human resource management (HRM), emphasizing the 'soft' people-centered approach and was interpreted as an 'ideal' model of HRM. Dentists were regarded as a profitable organizational asset rather than participants in relations with patients. In conclusion, the results indicate an organizational ideology primarily of economic character.

  14. Clinical decision making by dentists working in the NHS General Dental Services since April 2006.

    Science.gov (United States)

    Davies, B J B; Macfarlane, F

    2010-11-27

    In April 2006 a new contract was introduced that governed how NHS General Dental Practitioners would be funded for the services they provide. This study looks at the impact that the contract has had in the three years since its introduction, evaluating its influence on the clinical care that patients receive and the clinical decisions that dentists are making. This qualitative service evaluation involved interviewing 12 dentists representative of a range of NHS dentists involved with the new NHS dental contract using a semi-structured approach. We found evidence that the new contract has led to dentists making different decisions in their daily practice and sometimes altering their treatment plans and referral patterns to ensure that their business is not disadvantaged. Access to care for some patients without a regular dentist can be compromised by the new contract as it can be financially challenging for a dentist to accept to care for a new patient who has an unknown and potentially large need for treatment. Cherry-picking of potentially more profitable patients may be common. The incentive is to watch borderline problems rather than to treat if a treatment band threshold has already been crossed and treatment may be delayed until a later course of treatment for the same reason. Dentists often feel that complex treatments (for example, endodontic treatments) are financially unviable. Some dentists are referring difficult cases that might previously have been treated 'in house', such as extractions, to another provider, as this enables offloading of costs while potentially retaining full fees. Younger and less experienced dentists may be further pressured.

  15. Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

    Science.gov (United States)

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

    2016-01-01

    Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

  16. Caries experience and use of dental services in rural and urban adults and older adults from central Chile.

    Science.gov (United States)

    Quinteros, Maria E; Cáceres, Dante D; Soto, Alex; Mariño, Rodrigo J; Giacaman, Rodrigo A

    2014-10-01

    To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. A sample of 453 adults, 35-44 years of age, and 438 older adults, 65-74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population - 41.7% of adults and 31.5% of older adults - received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P dental damage from caries. Although rurality and use of services do not seem to affect caries experience, they are associated with differences in fillings and missing teeth. © 2014 FDI World Dental Federation.

  17. Care home managers' views of dental services for older people living in nursing and residential homes in inner city London.

    Science.gov (United States)

    Belsi, A; Gonzalez-Maffe, J; Jones, K; Wright, D; Gallagher, J E

    2013-06-01

    To investigate care home managers' views on the provision of dental care (current and future; urgent, check-up and follow-up) for their residents, barriers to care and the impact of policy changes, by type of home (nursing vs residential), with a view to informing the planning and provision of care. A cross sectional postal questionnaire survey and follow-up semi-structured interviews. Care homes in South East London. PARTCIPANTS: All care home managers in three south east London boroughs. A 72% response rate (n=152) was achieved, 140 of which were designated as nursing and/or residential homes (92%). Almost all managers reported that the care homes had arrangements in place for residents to access some elements of dental care (99%, n=148). Reported barriers to care included residents' fear of treatment (53%), patients' limited mobility (45%) and waiting times for services (42%). Limited mobility (p=0.01) and transport issues (p=0.01) were more significant barriers for nursing homes, whereas fear (p=0.02) was more significant for residential homes. Access to a range of dental services and modes of service delivery were requested for the future; most notable were the demands for domiciliary services to be available to nursing homes and for residential homes to access local general dental practitioners to meet the needs of their residents. Managers report having arrangements in place for residents to access dental services; however, there was a clear view that future arrangements should be more appropriate to the needs and vulnerabilities of their residents.

  18. [Variables associated with the use of dental services among preschool population in Spain: a national health survey analysis].

    Science.gov (United States)

    Barriuso Lapresa, Laura; Sanz-Barbero, Belén

    2012-01-01

    oral health is integral to health from the eruption of the first tooth. To achieving, it is necessary an early establishment of healthy oral habits as regular dental checkups. In developed countries, caries is the most prevalent chronic pediatric disease and it may be increasing in preschool age. a) assessing prevalence of oral health services use among Spanish preschool population, b) quantifying and analyzing the existence of variability among autonomous community and c) identifying variables associated with such use. cross-sectional study about Spanish National health Survey (2006). 2,172 children aged between 2 and 5 years (both inclusive). have gone to dental services at least once during life. sociodemographic, self-referred dental health, habits and family socioeconomic status variables. Multivariate logistic regression analysis. 20.8% of Spanish preschoolers reported had attended dental services. Probability of use increased with age (OR: 1,88; IC:1,53-2,31), frequency of daily tooth brushing (three or more times per day vrs less than once: OR: 2,94; IC: 1,47-5,87) and presence of caries (OR: 2,60; IC: 1,22-5,51). There is a socioeconomic gradient about probability of use: it increased with family socioeconomic status measured by social class (low vrs high: OR: 0,41; IC: 0,19-0,86) and maternal educational level (OR: 1,62; IC: 1,13-2,32). There was not variability in the oral health services use attributable to the autonomous community. the use of dental health services among Spanish preschool population is lower than desirable. The promotion of its use should be intensified in children from disadvantaged families.

  19. A retrospective study of 92 avulsed primary teeth in 69 children assisted at a dental urgency service

    OpenAIRE

    Orlando Aguirre Guedes; Ana Helena Gonçalves de Alencar; Álvaro Henrique Borges; Lilian de Fátima Guedes de Amorim; Cyntia Rodrigues de Araújo Estrela; Carlos Estrela

    2013-01-01

    The purpose of this study was to evaluate the epidemiological aspects associated with avulsion of primary teeth. The sample consisted of 92 avulsed teeth of 69 patients seen at the dental urgency service of the Dental School of the Federal University of Goiás, Brazil, from 1998 to 2005. The data obtained from the records included children’s gender and age, causes of tooth avulsion, daily and monthly distribution, type and number of avulsed teeth and the treatment procedures. Frequency distrib...

  20. Toward the integration of comprehensive mental health services in HIV care: an assessment of psychiatric morbidity among HIV-positive individuals in sub-Saharan Africa.

    Science.gov (United States)

    Olagunju, Andrew T; Ogundipe, Olasimbo A; Erinfolami, Adebayo R; Akinbode, Abiola A; Adeyemi, Joseph D

    2013-01-01

    Existing evidence from research supports the desirability of integration of mental health services into HIV care in order to mitigate the grave consequences of unattended mental health morbidity among People Living with HIV/AIDS (PLWHA). This study aims to find out the burden and pattern of psychiatric disorders that is prevalent among HIV-positive individuals attending a Nigerian-based HIV clinic. The study participants, consisting of 295 HIV-positive adults were recruited using systematic random sampling method. The participants were subjected to questionnaire to elicit demographic profile and General Health Questionnaire (GHQ-28) to screen for probable psychiatric disorders. This was followed by Structured Clinical Interview for DSM-IV Non patient (SCID-NP) to diagnose the presence of psychiatric morbidity in any of the participant with a GHQ-28 score ≥5 and 10% of those with GHQ-28 score mental disorder detected as 44 (14.9%) met the DSM-IV Axis 1 diagnosis of major depressive disorders. Anxiety disorders, concurrent Nicotine with Alcohol dependence and cannabis abuse were elicited in 24 (8.1%), 4 (1.3%), and 2 (0.7%) participants, respectively. This study finds a higher burden of psychiatric disorders in PLWHA in comparison to what is obtainable in the general population based on previous research works in similar context. Thus further underscores the need for integration of comprehensive psychiatric services into HIV care. We advocate the support and commitment of key stakeholders in HIV care to the translation of this research-based evidence into practice among PLWHA.

  1. Utilization of services and referrals through dental outreach programs in rural areas of India. A two year study.

    Science.gov (United States)

    Asawa, Kailash; Bhanushali, Nikhil V; Tak, Mridula; Kumar, Dola Rama Venkata; Rahim, Muhammad Furqon Bin Abd; Alshahran, Obaid Abdullah; Divakar, Darshan Devang

    2015-01-01

    Oral health care services are often sparse and inconsistent in India therefore it is often difficult for poor people to get access to the oral health care services. The approach by dental institutions with the help of community outreach programs is a step ahead in overcoming this situation. The study was conducted to evaluate the number of patients, disease pattern and the services provided in the outreach programmes and also effectiveness of patient referral. A retrospective study was conducted and the data were obtained from records of outreach programs conducted, in last 2 years by Pacific Dental College and Hospital. The data were analysed using descriptive statistics for the computation of percentages Chi-square test was applied to know the association of effectiveness of referral with age and gender. Confidence level and level of significance was fixed at 95% and 5% respectively. A total of 22982 individuals in the age group of 4-80 years attended the outreach program. Dental caries (42.3%), periodontal diseases (63.2-69.0%) and dental fluorosis (33.7-35.0%) were commonly observed diseases. Effectiveness of referral was significantly high among the middle age adults and females (Pdental institutions with the help of community outreach programs can spread awareness and disseminate treatment and thereby enhancing access to care and eliminating access to care within the rural communities.

  2. Factors associated with no dental treatment in preschoolers with toothache: a cross-sectional study in outpatient public emergency services.

    Science.gov (United States)

    Machado, Geovanna C M; Daher, Anelise; Costa, Luciane R

    2014-08-08

    Many parents rely on emergency services to deal with their children's dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children's age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children's mean age was 4.1 (SD 1.0) years (range 1-5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of "sex", the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5-0.8), radiography request (OR 3.8; 95% CI 1.7-8.2), medication prescribed (OR 7.5; 95% CI 4.9-11.5) and patient referred to another service (OR 5.7; 3.0-10.9). Many children with toothache received no oral procedure for pain relief.

  3. The impact of the global budget system on dynamics of dental manpower and utilization of dental services.

    Science.gov (United States)

    Huang, Laura Yueh-Guey; Huang, Boyen

    2016-01-01

    This study aimed to investigate dentists' supply and practice patterns following the implementation of the global budget system in Taiwan. Data of reimbursement claims, municipal socioeconomic status and dental manpower were collected from the National Health Insurance administration, the Ministry of Internal Affair, and the Ministry of Health and Welfare, respectively. A multivariate linear regression method was used for data analysis. A municipality that reported a higher percentage of tertiary educated population (t = 3.718, P dental manpower in Taiwan. A relationship between HHI and dentists' move-out rate has been found. The relationship between municipal socioeconomic status and the density of dentists has also been confirmed. In addition, reduced utilization of amalgam restorations was accompanied by increased utilization of tooth-colored material restorations. Further investigations are indicated.

  4. [Perceived oral health and use of dental services during pregnancy: the MaterniDent study].

    Science.gov (United States)

    Vergnes, Jean-Noel; Pastor-Harper, Diana; Constantin, Delia; Bedos, Christophe; Kaminski, Monique; Nabet, Cathy; Sixou, Michel; Rouillon, F

    2013-01-01

    The main objective of the MaterniDent study was to determine the nature and frequency of dental problems experienced by pregnant women and their associated factors. The secondary objective was to determine the frequency of dental visits during pregnancy and to identify associated factors. The MaterniDent study was a multicenter cross-sectional study conducted among 904 postpartum women in three French maternity wards. Data were collected using self-administered questionnaires. Measured variables included socio-demographic, health and behavioral characteristics. 57% of women reported having experienced at least one dental problem during pregnancy, while 20% had experienced dental pain during pregnancy. Multiparity, vomiting, soda consumption and increased sugar consumption during pregnancy were significantly associated with dental pain (pdental visit (p dental problem during pregnancy, although they did not necessarily consult a dentist to treat the problem. Given the impact of oral diseases for both mother and child, prevention and professional dental care during pregnancy should be promoted.

  5. Are the dental health needs of adults with illegal drug dependence being met by current service provision in the United Kingdom?: a literature review.

    Science.gov (United States)

    Hewson, Victoria; Wray, Jane

    2012-10-01

    This literature review outlines the current issues and debates relating to the dental health of adults with drug dependence. The dental health of adults with illegal drug dependence (IDD) continues to be under debate throughout dental practice, and the most appropriate model of care suitable to meet the high complex needs of this client group remains uncertain. The study aims to review and critically analyze available research relating to the oral health effects of illegal drug misuse and the dental health needs and status of adults with drug dependence. Second, it aims to identify and critically evaluate current models of dental service/care delivery, including relevant best practice guidance and potential barriers to dental access for adults with IDD. The available literature pertaining to dental health and adults with drug dependence are systematically reviewed and critically analyzed and evaluated in order to execute a rigorous investigation. The oral effects along with general medical complications associated with IDD are increasingly being recognized. There are substantive negative effects of IDD on oral health, particularly for those with opioid dependence; therefore, these clients have high complex dental needs and low use of dental services. Adults with drug dependence comprise a group with special dental needs and therefore need greater access to dental care than most people due to their high level of need. A high awareness of the implications for oral health care for adults with drug dependence is essential. Dental professionals have a key role in supporting the rehabilitation of these patients from potentially severe or fatal addictions. There is a distinct lack of national policy and guidance relating specifically to adults with drug dependence, and therefore, problems persist. Key findings and recommendations are presented to enhance the development of dental services for adults with IDD.

  6. Guantanamo Bay, Cuba 1996: psychiatric services to Cuban migrants in the final days of Operation Sea Signal.

    Science.gov (United States)

    Grieger, T A; Adams, B

    1997-12-01

    Conditions during the final days of Operation Sea Signal in Guantanamo Bay, Cuba, presented a unique challenge for the U.S. Naval Hospital psychiatry/mental health team. The team was charged with evaluation and treatment of Cuban migrants and with determining suitability for immigration to the United States. Degradation of social support networks appeared to be a factor in the course of psychiatric symptoms. The cases of two Cuban migrant males presenting with psychiatric disorders in the final month of the operation illustrate the complexities of the operation's psychiatric mission. Our focus was on behavioral interventions and social supports rather than definitive pharmacologic management of the underlying psychiatric disorders. Suggestions for management of similar missions in the future are provided.

  7. Using the simplified case mix tool (sCMT) to identify cost in special care dental services to support commissioning.

    Science.gov (United States)

    Duane, B G; Freeman, R; Richards, D; Crosbie, S; Patel, P; White, S; Humphris, G

    2017-03-01

    To commission dental services for vulnerable (special care) patient groups effectively, consistently and fairly an evidence base is needed of the costs involved. The simplified Case Mixed Tool (sCMT) can assess treatment mode complexity for these patient groups. To determine if the sCMT can be used to identify costs of service provision. Patients (n=495) attending the Sussex Community NHS Trust Special Care Dental Service for care were assessed using the sCMT. sCMT score and costs (staffing, laboratory fees, etc.) besides patient age, whether a new patient and use of general anaesthetic/intravenous sedation. Statistical analysis (adjusted linear regression modelling) compared sCMT score and costs then sensitivity analyses of the costings to age, being a new patient and sedation use were undertaken. Regression tables were produced to present estimates of service costs. Costs increased with sCMT total scale and single item values in a predictable manner in all analyses except for 'cooperation'. Costs increased with the use of IV sedation; with each rising level of the sCMT, and with complexity in every sCMT category, except cooperation. Costs increased with increase in complexity of treatment mode as measured by sCMT scores. Measures such as the sCMT can provide predictions of the resource allocations required when commissioning special care dental services. Copyright© 2017 Dennis Barber Ltd.

  8. Caries risk assessment in young adults using Public Dental Service guidelines and the Cariogram-a comparative study

    DEFF Research Database (Denmark)

    Hänsel Petersson, Gunnel; Ericson, Ewa; Isberg, Per-Erik

    2012-01-01

    Abstract Objectives. To investigate the caries risk profiles in young adults and to compare the risk classification using the Public Dental Service (PDS) guidelines with a risk assessment program, the Cariogram. Materials and methods. All 19-year-old patients registered at eight public dental...... clinics were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects representing 10% of all 19 year-olds attending dental care at the PDS in Skåne, Sweden. A risk classification of each patient was made by the patient's regular team according...... to the PDS guidelines. A research team collected whole saliva samples and information from a questionnaire and a structured interview in order to calculate risk according to the Cariogram model. Results. The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk...

  9. Academic performance of students who underwent psychiatric treatment at the students' mental health service of a Brazilian university.

    Science.gov (United States)

    Campos, Cláudia Ribeiro Franulovic; Oliveira, Maria Lilian Coelho; Mello, Tânia Maron Vichi Freire de; Dantas, Clarissa de Rosalmeida

    2017-01-01

    University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students' mental health service (SAPPE) and to compare their academic performance with that of non-patient students. Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university. Files of 1,237 students attended by psychiatrists at SAPPE from 2004 to 2011 were reviewed. Their academic performance coefficient (APC) and status as of July 2015 were compared to those of a control group of 2,579 non-patient students matched by gender, course and year of enrolment. 37% of the patients had had psychiatric treatment and 4.5% had made suicide attempts before being attended at SAPPE. Depression (39.1%) and anxiety disorders/phobias (33.2%) were the most frequent diagnoses. Severe mental disorders such as psychotic disorders (3.7%) and bipolar disorder (1.9%) were less frequent. Compared with non-patients, the mean APC among the undergraduate patients was slightly lower (0.63; standard deviation, SD: 0.26; versus 0.64; SD: 0.28; P = 0.025), but their course completion rates were higher and course abandonment rates were lower. Regarding postgraduate students, patients and non-patients had similar completion rates, but patients had greater incidence of discharge for poor performance and lower dropout rates. Despite the inclusion of socially vulnerable people with severe mental disorders, the group of patients had similar academic performance, and in some aspects better, than, that of non-patients.

  10. Academic performance of students who underwent psychiatric treatment at the students’ mental health service of a Brazilian university

    Directory of Open Access Journals (Sweden)

    Cláudia Ribeiro Franulovic Campos

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students’ mental health service (SAPPE and to compare their academic performance with that of non-patient students. DESIGN AND SETTING: Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university. METHODS: Files of 1,237 students attended by psychiatrists at SAPPE from 2004 to 2011 were reviewed. Their academic performance coefficient (APC and status as of July 2015 were compared to those of a control group of 2,579 non-patient students matched by gender, course and year of enrolment. RESULTS: 37% of the patients had had psychiatric treatment and 4.5% had made suicide attempts before being attended at SAPPE. Depression (39.1% and anxiety disorders/phobias (33.2% were the most frequent diagnoses. Severe mental disorders such as psychotic disorders (3.7% and bipolar disorder (1.9% were less frequent. Compared with non-patients, the mean APC among the undergraduate patients was slightly lower (0.63; standard deviation, SD: 0.26; versus 0.64; SD: 0.28; P = 0.025, but their course completion rates were higher and course abandonment rates were lower. Regarding postgraduate students, patients and non-patients had similar completion rates, but patients had greater incidence of discharge for poor performance and lower dropout rates. CONCLUSION: Despite the inclusion of socially vulnerable people with severe mental disorders, the group of patients had similar academic performance, and in some aspects better, than, that of non-patients.

  11. Oral and dental health issues in people with mental disorders.

    Science.gov (United States)

    Torales, Julio; Barrios, Iván; González, Israel

    2017-09-21

    Patients with mental disorders are subject to a greater number of risk factors for oral and dental disease than the general population. This is mostly caused by the side effects of the medications that they receive, lack of self-care, difficulty to access health services, a negative attitude towards healthcare providers, and patients’ lack of cooperation in dental treatments. The most common psychiatric disorders in our population are depression, anxiety disorders, schizophrenia, bipolar disorder, and dementia. In disorders such as anxiety and depression, the main issue is the loss of interest in self-care, which results in a poor hygiene. The most frequent oral and dental diseases in these patients are dental cavities and periodontal disease. The purpose of this brief review is to provide up-to-date information about the management of oral and dental diseases of patients with mental disorders.

  12. A study of a culturally focused psychiatric consultation service for Asian American and Latino American primary care patients with depression

    Directory of Open Access Journals (Sweden)

    Fava Maurizio

    2011-10-01

    Full Text Available Abstract Background Ethnic minorities with depression are more likely to seek mental health care through primary care providers (PCPs than mental health specialists. However, both provider and patient-specific challenges exist. PCP-specific challenges include unfamiliarity with depressive symptom profiles in diverse patient populations, limited time to address mental health, and limited referral options for mental health care. Patient-specific challenges include stigma around mental health issues and reluctance to seek mental health treatment. To address these issues, we implemented a multi-component intervention for Asian American and Latino American primary care patients with depression at Massachusetts General Hospital (MGH. Methods/Design We propose a randomized controlled trial to evaluate a culturally appropriate intervention to improve the diagnosis and treatment of depression in our target population. Our goals are to facilitate a primary care providers' ability to provide appropriate, culturally informed care of depression, and b patients' knowledge of and resources for receiving treatment for depression. Our two-year long intervention targets Asian American and Latino American adult (18 years of age or older primary care patients at MGH screening positive for symptoms of depression. All eligible patients in the intervention arm of the study who screen positive will be offered a culturally focused psychiatric (CFP consultation. Patients will meet with a study clinician and receive toolkits that include psychoeducational booklets, worksheets and community resources. Within two weeks of the initial consultation, patients will attend a follow-up visit with the CFP clinicians. Primary outcomes will determine the feasibility and cost associated with implementation of the service, and evaluate patient and provider satisfaction with the CFP service. Exploratory aims will describe the study population at screening, recruitment, and enrollment

  13. Impact of universal health coverage on urban-rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan

    National Research Council Canada - National Science Library

    Chiang, Chih-Lin; Chen, Pei-Chun; Huang, Ling-Ya; Kuo, Po-Hsiu; Tung, Yu-Chi; Liu, Chen-Chung; Chen, Wei J

    2016-01-01

    To examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urban-rural residence following the implementation...

  14. Improving Access to Dental Hygiene Services in the European Regional Dental Command Concurrent With Implementation of the U.S. Army Dental Care Reengineering Initiative.

    Science.gov (United States)

    1998-05-15

    that includes restorative, oral surgery, periodontal and endodontic procedures. 5. Elective treatment that includes prosthetic, periodontal, and...when Cooper (1974) introduced process management techniques for dental practices—the only exceptions being the introduction of ultrasonic sealers and...to begin the appointment early. This policy was incorporated into the clinic modeling. The data extracted from the sign-in rosters and the centralized

  15. Does Medicaid improve utilization of medical and dental services and health outcomes for Medicaid-eligible children in the United States?

    Science.gov (United States)

    Fisher, Monica A; Mascarenhas, Ana K

    2007-08-01

    Data are lacking to support the contention that Medicaid services improve utilization of healthcare services and result in better health. To compare sociodemographic, utilization of healthcare services and health status characteristics among Medicaid-eligible children. The third National Health and Nutrition Examination Survey included 2821 children 2-16 years of age eligible for Medicaid. The main outcome measures are annual physician visit, annual dentist visit, general health status, oral health status, asthma (second most common childhood disease), dental caries (most common childhood disease), asthma treatment needs, and dental treatment needs. We quantified the association of these outcome measures with Medicaid insurance status and sociodemographic status using multiple logistic regression modeling, taking into account the complex survey design and sample weights. Among Medicaid-eligible children, 27% were uninsured. Among uninsured Medicaid-eligible children, 62% had an annual physician visit, 32% had an annual dentist visit, 10% needed asthma treatment, and 57% needed dental treatment. Among insured Medicaid-eligible children, 81% had an annual physician visit, 39% had an annual dentist visit, 13% needed asthma treatment, and 42% needed dental treatment. After simultaneously taking into account other characteristics, uninsured Medicaid-eligible children were more likely to not have an annual physician visit (OR(NoMDvisit) = 2.21; 1.26-3.90), and to need dental treatment (OR(DentalNeed) = 1.57; 1.13-2.18). This USA population-based study found disparities exist within Medicaid's services between utilization of dental and medical services. Medicaid insurance improved utilization of medical services, but did not improve the utilization of dental services. This suggests that Medicaid insurance does not improve access to dental services for poor children.

  16. Physical, mental and cognitive disabilities in relation to utilization of dental care services by nursing home residents.

    Science.gov (United States)

    Almomani, Fidaa M; Bani-Issa, Wegdan

    2017-05-01

    The main purpose of this study was to investigate factors affecting dental care utilization among nursing home residents in Jordan. A total of 221 subjects with a mean age of 62.4 years (121 males and 100 females) taken from among nursing home residents across Jordan were recruited and composed a convenience sample for this study. The Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB), Disability of Arm, Shoulder, and Hand test (DASH) were administered and oral health status was assessed for all subjects and examined as expected correlates of dental care utilization among nursing home residents. The response rate was about 88%. One-third of residents suffered from total edentulism and most of the remaining dentate residents exhibited periodontal disease (90%). Of the dentate sample, 90% of residents had bleeding upon probing, 85% were diagnosed with tooth mobility, 88% had presence of dental calculus, and 30% were diagnosed with root caries. Of the denture wearers, 59.1 % reported having soreness with their dentures and 32% of denture wearers reported having poor quality dentures. MMSE score, suffering from tooth sensitivity and having diabetes mellitus were identified to be indicators for utilization of dental care services among the study population. Regular oral care, assessments, and rehabilitation services are considered to be limited for nursing home residents in Jordan. Based upon these findings, future interventions should address oral health among nursing home residents in Jordan. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

  17. [Epidemiological study of psychiatric disorders under a social security system (Institute of Social Security and Services for Government Workers)].

    Science.gov (United States)

    Lara Tapia, H; Ramírez de Lara, L

    1975-01-01

    The present study, fourth in the national literature about general psychiatric epidemiology, refers the experience of a social security system through the study of a sample obtained in a year of work of an important neurologic and psychiatric clinic of this system, studying relevant characteristics of 1 054 subjects in a total 7 102 acute and chronic psychiatric patients, showing a prevalence of 180 per 100 000 habitants. We found 36 different psychiatric disorders, most of them psychoneurotic in ambulatory patients and psychotic forms in hospitalized. The last ones made the 0.022% of the total sample. The biggest frecuency is made by young adults with moderate predominance of females than males. The sample is formed near the 10% by patients of 26 states of Mexican Republic. The period of major frecuency are the months of vacations of government workers, most of them of Public Education Secretary (Secretaría de Educación Pública). We comment some epidemiological articles of Mexican medical literature concerning psychiatric disorders and some socioeconomic and cultural characteristics of mental pathology in our country.

  18. Gaps in smiles and services: a cross-sectional study of dental caries in refugee-background children.

    Science.gov (United States)

    Quach, Alicia; Laemmle-Ruff, Ingrid L; Polizzi, Tatiana; Paxton, Georgia A

    2015-01-22

    Refugees are reported to experience high rates of dental disease, although there are limited data on refugee children. The aim of this study was to report on oral health in refugee-background children in Australia, and to assess their follow-up at dental services. Cross-sectional study of opportunistic oral health screening and subsequent dental service use in refugee-background children attending a refugee health clinic in Victoria, Australia, between November 2006-November 2010. 350 patients (0-18 years, mean age 8 years 7 months) had oral health screening; 241 (68.9%) were born overseas, (176 Africa, 65 other countries) and 109 (31.1%) were born in Australia to African-background families. Parents were concerned about oral health in 65/341 (19.1%) children, with specific concern about caries in only 9/341 (2.6%). On assessment, 155/336 (46.1%) had visible caries and 178/345 (51.6%) had caries experience (dmft/DMFT > 0). Where parents were concerned about caries, they were likely to be present (positive predictive value = 100%), however absence of parent concern about caries was not reassuring (negative predictive value = 56.1%).Compared to Australian-born children of African background; African-born children were more likely to be referred for further dental care (adjusted PR 1.33, 95% CI [1.02-1.73]), although there was no statistically significant difference in caries prevalence. African-born children were less likely to have caries compared to other overseas-born children (adjusted PR 0.73, 95% CI [0.58 - 0.93]). Overall 187/344 (54.4%) children were referred for further dental care; 91/124 (73.4%) attended any dental appointment. Attendance rates were 90% with a phone reminder system for appointments, attendance reduced when this system lapsed. Oral health is an important public health issue in refugee-background children, despite low levels of parent concern and very few parent reported caries. Routine direct oral health assessment is important

  19. Improving feedback from outpatient medical appointments attended by escorted psychiatric patients in the North London Forensic Service.

    Science.gov (United States)

    McCurdy, Kathleen; Croxford, Anna

    2015-01-01

    It is well established that patients with mental illness are known to have a high level of morbidity and mortality compared to the general population. This is particularly prominent in long-stay psychiatric patients, such as those in secure settings. The Royal College of Psychiatrists recommends that psychiatrists should promote the physical health of their patients and liaise with other specialties. However, there is evidence that communication between psychiatry and other specialties is poor. A survey was carried out at the North London Forensic Service in June 2014. This looked at the views of clinical staff about the frequency and quality of feedback obtained when inpatients attend outpatient hospital appointments at local general hospitals. This survey highlighted the general perception among staff that feedback is poor, with 68.43% of respondents saying that they were "very unsatisfied" or "unsatisfied" with the level and quality of feedback. Clinical staff felt that many patients who attended hospital outpatient appointments, even when escorted by staff, returned with little or no feedback. This was confirmed by a baseline audit across 3 wards showing that details of the appointment (date, time, hospital, and specialty) were only documented in 54.5% of cases and the content of the appointment documented in even fewer cases. A form was designed by junior doctors that provided a simple framework of 6 questions to be answered at the outpatient clinic about the problem, diagnosis, and further actions needed. This was introduced and its impact assessed with a 3-month and 6-month audit of electronic notes, as well as a follow-up survey after 6 months. The audit showed significant improvement in the quality of feedback about the appointment at both the 3-month and 6-month point. The follow-up survey showed that 70% of respondents were aware of the form and 100% of those who were aware of the form had used it at least once and found it helpful. The general

  20. Effect of Free Dental Services on Individuals with Sickle Cell Disease.

    Science.gov (United States)

    Whiteman, Lauren N; Haywood, Carlton; Lanzkron, Sophie; Strouse, John J; Batchelor, Adrian H; Schwartz, Anthony; Stewart, Rosalyn W

    2016-09-01

    Poor oral health can have a negative impact on overall health. This is especially concerning for individuals with sickle cell disease (SCD), an inherited blood disorder that affects hemoglobin and can lead to an increased risk of infection and hyperalgesia. Because the majority of individuals with SCD have Medicaid insurance and no dental coverage, we provided free basic dental care to individuals with SCD to determine whether it decreased overall healthcare utilization. Through a contract with a private dental office, we provided free basic dental care (eg, cleanings, fillings, x-rays) to individuals with SCD. We reviewed medical records for the 12 months before and after their initial dental visit to determine whether there were any changes in acute care visits (defined as a visit to the emergency department, sickle cell infusion center, or visits to both in the same day), hospitalizations, and total days hospitalized. We conducted a negative binomial regression to determine any differences in the pre-post periods. In our multivariable analysis, there was a statistically significant decrease in hospital admissions. In addition, there was a significant decrease in total days hospitalized if dental work was completed, but an increase in days hospitalized in men. Providing dental care to individuals with SCD who did not have dental insurance did not greatly alter acute care visits. A larger sample size may be necessary to observe an effect.

  1. The management of dental caries in primary teeth - involving service providers and users in the design of a trial.

    Science.gov (United States)

    Marshman, Zoe; Innes, Nicola; Deery, Chris; Hall, Melanie; Speed, Chris; Douglas, Gail; Clarkson, Jan; Rodd, Helen

    2012-08-22

    There is a lack of evidence for the effective management of dental caries in children's primary teeth. The trial entitled 'Filling Children's Teeth: Indicated Or Not?' (FiCTION) was designed to examine the clinical and cost effectiveness, in primary dental care, of three different approaches to the management of caries in primary teeth. However, before the FiCTION main trial commenced, a pilot trial was designed. Service provider (dentists and other members of the team including dental nurses and practice managers) and participant (child participants and their parents) involvement was incorporated into the pilot trial. The aim of this study is to describe service providers' and users' perspectives on the pilot trial to identify improvements to the conduct and design of the FiCTION main trial. Qualitative interviews (individual and group) were held with dentists, dental team members, children and parents involved in the FiCTION pilot trial. Individual interviews were held with four dentists and a group interview was held with 17 dental team members. Face-to-face interviews were held with four parents and children (four- to eight-years old) representing the three arms of the trial and five telephone interviews were conducted with parents. All interviews were transcribed verbatim. Framework analysis was used. Overall, service providers, children and parents found the pilot trial to be well conducted and an interesting experience. Service providers highlighted the challenges of adhering to research protocols, especially managing the documentation and undertaking new clinical techniques. They indicated that the time and financial commitments were greater than they had anticipated. Particular difficulties were found recruiting suitable patients within the timeframe. For parents recruitment was apparently more related to trusting their dentist than the content of information packs. While some of the older children understood what a study was, others did not understand or

  2. The management of dental caries in primary teeth - involving service providers and users in the design of a trial

    Directory of Open Access Journals (Sweden)

    Marshman Zoe

    2012-08-01

    Full Text Available Abstract Background There is a lack of evidence for the effective management of dental caries in children’s primary teeth. The trial entitled ‘Filling Children’s Teeth: Indicated Or Not?’ (FiCTION was designed to examine the clinical and cost effectiveness, in primary dental care, of three different approaches to the management of caries in primary teeth. However, before the FiCTION main trial commenced, a pilot trial was designed. Service provider (dentists and other members of the team including dental nurses and practice managers and participant (child participants and their parents involvement was incorporated into the pilot trial. The aim of this study is to describe service providers’ and users’ perspectives on the pilot trial to identify improvements to the conduct and design of the FiCTION main trial. Methods Qualitative interviews (individual and group were held with dentists, dental team members, children and parents involved in the FiCTION pilot trial. Individual interviews were held with four dentists and a group interview was held with 17 dental team members. Face-to-face interviews were held with four parents and children (four- to eight-years old representing the three arms of the trial and five telephone interviews were conducted with parents. All interviews were transcribed verbatim. Framework analysis was used. Results Overall, service providers, children and parents found the pilot trial to be well conducted and an interesting experience. Service providers highlighted the challenges of adhering to research protocols, especially managing the documentation and undertaking new clinical techniques. They indicated that the time and financial commitments were greater than they had anticipated. Particular difficulties were found recruiting suitable patients within the timeframe. For parents recruitment was apparently more related to trusting their dentist than the content of information packs. While some of the older

  3. A Research Note on Transitions in Out-of-Pocket Spending on Dental Services.

    Science.gov (United States)

    Manski, Richard J; Moeller, John F; Chen, Haiyan; Hyde, Jody Schimmel; Pepper, John V; St Clair, Patricia A

    2015-08-01

    We analyze correlates of the direction and magnitude of changes in out-of-pocket (OOP) payments for dental care by older Americans over a recent 4-year period. We analyzed data from the 2006 and 2008 waves of the Health and Retirement Study. We estimated multinomial logistic models of the direction and linear regression models of the amounts of OOP changes over survey periods. Financial-based factors were more strongly associated with the direction and magnitude of changing self-payments for dental care than were health factors. Findings suggested that dental coverage, income, and wealth and changes in these financial factors were more strongly correlated with the persistence of and changes in OOP payments for dental care over time than were health status and changes in health status. The sensitivity to dental coverage changes should be considered as insurance and retirement policy reforms are deliberated. © The Author(s) 2014.

  4. A Research Note on Transitions in Out of Pocket Spending on Dental Services

    Science.gov (United States)

    Manski, Richard J.; Moeller, John F.; Chen, Haiyan; Hyde, Jody Schimmel; Pepper, John V.; St. Clair, Patricia A.

    2014-01-01

    Objective We analyze correlates of the direction and magnitude of changes in out of pocket (OOP) payments for dental care by older Americans over a recent 4-year period. Methods We analyzed data from the 2006 and 2008 waves of the Health and Retirement Study (HRS). We estimated multinomial logistic models of the direction and linear regression models of the amounts of OOP changes over survey periods. Results Financial-based factors were more strongly associated with the direction and magnitude of changing self- payments for dental care than were health factors. Discussion Findings suggested that dental coverage, income, and wealth and changes in these financial factors were more strongly correlated with the persistence of and changes in OOP payments for dental care over time than were health status and changes in health status. The sensitivity to dental coverage changes should be considered as insurance and retirement policy reforms are deliberated. PMID:25651590

  5. Stakeholder views on a recovery-oriented psychiatric rehabilitation art therapy program in a rural Australian mental health service: a qualitative description.

    Science.gov (United States)

    De Vecchi, Nadia; Kenny, Amanda; Kidd, Susan

    2015-01-01

    Recovery-oriented care is a guiding principle for mental health services in Australia, and internationally. Recovery-oriented psychiatric rehabilitation supports people experiencing mental illness to pursue a meaningful life. In Australia, people with unremitting mental illness and psychosocial disability are often detained for months or years in secure extended care facilities. Psychiatric services have struggled to provide rehabilitation options for residents of these facilities. Researchers have argued that art participation can support recovery in inpatient populations. This study addressed the research question: Is there a role for the creative arts in the delivery of recovery-oriented psychiatric rehabilitation for people with enduring mental illness and significant psychosocial disability detained in a secure extended care unit? The study had two major aims: to explore the experiences of consumers detained in a rural Australian secure extended care unit of an art therapy project, and to examine the views of nurse managers and an art therapist on recovery-oriented rehabilitation programs with regard to the art therapy project. A qualitative descriptive design guided the study, and a thematic network approach guided data analysis. Ethics approval was granted from the local ethics committee (AU/1/9E5D07). Data were collected from three stakeholders groups. Five consumers participated in a focus group; six managers and the art therapist from the project participated in individual interviews. The findings indicate that consumer participants benefitted from art participation and wanted more access to rehabilitation-focussed programs. Consumer participants identified that art making provided a forum for sharing, self-expression, and relationships that built confidence, absent in the regular rehabilitation program. Nurse manager and the art therapist participants agreed that art participation was a recovery-oriented rehabilitation tool, however, systemic barriers

  6. Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model.

    Science.gov (United States)

    Ganavadiya, R; Chandrashekar, Br; Goel, P; Hongal, Sg; Jain, M

    2014-05-01

    India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

  7. Child Indicators: Dental Health.

    Science.gov (United States)

    Lewit, Eugene M.; Kerrebrock, Nancy

    1998-01-01

    Reviews measures of dental health in children and the evidence on child dental health. Although children's dental health has improved over the past two decades, many poor children do not receive necessary dental health services, and reasons for this failure are summarized. (SLD)

  8. Factors Associated with No Dental Treatment in Preschoolers with Toothache: A Cross-Sectional Study in Outpatient Public Emergency Services

    Directory of Open Access Journals (Sweden)

    Geovanna C. M. Machado

    2014-08-01

    Full Text Available Many parents rely on emergency services to deal with their children’s dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children’s age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children’s mean age was 4.1 (SD 1.0 years (range 1–5 years and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of “sex”, the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5–0.8, radiography request (OR 3.8; 95% CI 1.7–8.2, medication prescribed (OR 7.5; 95% CI 4.9–11.5 and patient referred to another service (OR 5.7; 3.0–10.9. Many children with toothache received no oral procedure for pain relief.

  9. Developing a model to assess community-level risk of oral diseases for planning public dental services in Australia.

    Science.gov (United States)

    de Silva, Andrea M; Gkolia, Panagiota; Carpenter, Lauren; Cole, Deborah

    2016-03-31

    Poor oral health is a chronic condition that can be extremely costly to manage. In Australia, publicly funded dental services are provided to community members deemed to be eligible-those who are socio-economically disadvantaged or determined to be at higher risk of dental disease. Historically public dental services have nominally been allocated based on the size of the eligible population in a geographic area. This approach has been largely inadequate for reducing disparities in dental disease, primarily because the approach is treatment-focused, and oral health is influenced by a variety of interacting factors. This paper describes the developmental process of a multi-dimensional community-level risk assessment model, to profile a community's risk of poor oral health. A search of the evidence base was conducted to identify robust frameworks for conceptualisation of risk factors and associated performance indicators. Government and other agency websites were also searched to identify publicly available data assets with items relevant to oral diseases. Data quality and analysis considerations were assessed for the use of mixed data sources. Several frameworks and associated indicator sets (twelve national and eight state-wide data collections with relevant indicators) were identified. Determination of the system inputs for the Model were primarily informed by the World Health Organisation's (WHO) operational model for an Integrated Oral Health-Chronic Disease Prevention System, and Australia's National Oral Health Plan 2004-2013. Data quality and access informed the final selection of indicators. Despite limitations in the quality and regularity of data collections, there are numerous data sources available that provide the required data inputs for community-level risk assessment for oral health. Assessing risk in this way will enhance our ability to deliver appropriate public oral health care services and address the uneven distribution of oral disease across the

  10. Oral-health-related background factors and dental service utilisation among Sudanese children with and without a congenital heart defects.

    Science.gov (United States)

    Ali, H M; Mustafa, M; Nasir, E F; Lie, S A; Hasabalrasol, S; Elshazali, O H; Ali, R W; Skeie, M S

    2016-11-15

    Sudanese children with congenital heart defects (CHDs) were found to have poorer oral health than those without CHDs. The aims of this study were to: describe the patterns of oral-health-related background factors in children with and without CHD and explore any differences, and to evaluate the effects of background factors on caries and gingivitis prevalence and dental services utilisation. In this analytical cross-sectional study, caregivers of children aged 3-12 years with (CHD cases n = 111) and without CHDs (Controls n = 182), underwent face-to-face interviews using a structured questionnaire. The questionnaire items covered several oral health background factors (independent variables) including: child's health status, oral hygiene practices, dental services utilization, mother's level of education, and caregiver's perception and awareness of their child's oral health. The relationship between these factors and occurrence of 'caries' and 'gingivitis' as well as 'child's dental services utilisation' (dependent variables) were explored using multiple adjusted and hierarchal logistic regression analyses. Compared with controls, CHD cases had lower frequencies of brushing and use of fluoridated toothpaste, and their caregivers were less knowledgeable about caries. Among CHD cases, the variables (brushing and fluoridated toothpaste use) had significant impacts on caries prevalence (odd ratio (OR) =5.6, 95% confidence interval (CI): 1.4-22.8 and OR = 0.3, 95% CI: 0.1-0.8 for infrequent compared to frequent ones, respectively) as well as the mother's level of education (OR = 2.6, 95% CI: 1.0-6.4). When differences in background factors were controlled for, the adjusted ORs for caries and gingivitis prevalence in CHD cases compared with controls were 1.8, (95% CI: 1.1-3.2) and 5.3 (95% CI: 2.9-9.4), respectively. Among CHD cases, the child's age (8-12 years: OR = 11.9, 95% CI: 1.9-71.6), and the mother's level of education (lower education: OR

  11. Changing pattern of clinical profile of first-contact patients attending outpatient services at a general hospital psychiatric unit in India over the last 50 years

    Directory of Open Access Journals (Sweden)

    Mamta Sood

    2017-01-01

    Full Text Available Introduction: Over the last five decades, general hospital psychiatric units (GHPUs have become important mental health service setups in India. The present study reports on the changing clinical profile of the patients attending the GHPUs over the last five decades. Methodology: A total of 500 subjects, attending a GHPU were recruited prospectively for the study. The subjects were assessed using a semistructured proforma. A comparison was made with similar studies conducted in GHPU settings over the last five decades. Results: In the present study, neurotic, stress-related and somatoform disorders formed the commonest diagnostic group (33% followed by psychotic disorders (17% and mood disorders (15%. The diagnostic distribution is broadly similar to the studies done at different times in the last 5 decades, though there were lesser number of patients with mental retardation and organic brain syndrome. About 15% of the subjects did not have a psychiatric diagnosis. Conclusion: GHPUs in India attend to a broad range of patients with psychiatric disorders.

  12. The importance of relationships in mental health care: A qualitative study of service users' experiences of psychiatric hospital admission in the UK

    Directory of Open Access Journals (Sweden)

    Slade Mike

    2008-04-01

    Full Text Available Abstract Background While a number of studies have looked at life on service users' experiences of life on psychiatric wards, no research exists that have approached these experiences from the user perspective since the introduction of community care. Methods This user-led study uses a participatory approach to develop an understanding of the processes and themes which define the user experience of hospitalisation. Nineteen service users who had all had inpatient stays in psychiatric hospitals in London were interviewed in the community. Results Relationships formed the core of service users' experiences. Three further codes, treatment, freedom and environment defined the role of hospital and its physical aspects. Themes of communication, safety, trust, coercion, and cultural competency contributed to the concept of relationships. Conclusion Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff. Barriers to positive relationships included ineffective and negative communication, a lack of trust, a lack of safety in terms of staff as ineffective in preventing violence, and as perpetrators themselves, and the use of coercion by staff. This unique perspective both acts as a source of triangulation with previous studies and highlights the importance of the therapeutic relationship in providing a safe and therapeutic milieu for the treatment of people with acute mental health problems.

  13. Planning predicts dental service attendance and the effect is moderated by dental anxiety and educational status: findings from a one-year prospective study.

    Science.gov (United States)

    Pakpour, Amir H; Gellert, Paul; Asefzadeh, Saeed; Sniehotta, Falko F

    2014-07-01

    The aim of this study was to investigate whether planning a dental appointment is a predictor of actual dental visits over a one-year period when controlling for past attendance, demographic factors, and dental health beliefs. In addition, the planning-attendance association was explored to determine whether dental anxiety and educational status moderated this relationship. A total of N = 1,422 adults with a mean age of M = 44.4 (SD = 11.0) years and resident in Iran participated in a prospective study over a one-year period. The primary outcome was self-reported dental appointment attendance at one-year follow-up, which was validated using clinical records. Action planning, coping planning, health beliefs, age, dental insurance, income, dental health status, dental anxiety, and years of education were assessed at baseline by self-report questionnaire. Data were analysed using multivariate logistic regression. Action planning and coping planning were significantly associated with dental appointment attendance at one-year follow-up. Planning a dental appointment was more predictive of dental appointment attendance for people with higher levels of education and lower dental anxiety. The findings of this study suggest that implementation of the behaviour change technique planning into routine dental practice may have the potential to increase dental appointment attendance rates. © 2014 The International Association of Applied Psychology.

  14. Evaluation of patients' satisfaction from dental care services: TUMS, school of dentistry, 1385-86

    Directory of Open Access Journals (Sweden)

    Seidi D

    2011-02-01

    Full Text Available "nBackground and Aims: Association between patient satisfaction and success of the treatment determines the quality of health care. Measuring the level of satisfaction is an important factor for improving the quality of services provided by a system, so it is necessary to determine the expectations of patients. The aim of this study was to evaluate the patient satisfaction from services provided by the dental faculty of Tehran University of Medical Sciences."nMaterials and Methods: In this descriptive and cross-sectional study, 385 patients were randomly selected from different departments of dental faculty including prosthodontics, endodontics, periodontics, operative dentistry, radiology and oral medicine. A two-part questionnaire including demographic characteristics of patients and satisfaction from reception process, infection control, student and personnel behavior, and the outcome of treatment was filled out by patients. Data were analyzed using SPSS software."nResults: The most dissatisfying factor was the time wasted in paying the cost and the most satisfying factor was student behavior. General satisfaction form the process was evaluated (complete satisfaction 51.9%, partial satisfaction 38.4% and dissatisfaction 9.6%, and 62.9% of patients were completely agree with introducing dental faculty to others."nConclusion: The most satisfying item was student behavior which indicates that this factor is of great importance in increasing the quality of treatment. The deficiencies determined by patient can provide reliable data for determination and regulation of health care policies.

  15. Trends in levels of self-reported psychological distress among individuals who seek psychiatric services over eight years: a comparison between age groups in three population surveys in Stockholm County.

    Science.gov (United States)

    Kosidou, Kyriaki; Lundin, Andreas; Lewis, Glyn; Fredlund, Peeter; Dal, Henrik; Dalman, Christina

    2017-10-11

    Psychiatric service use has increased in Sweden and in other developed countries, particularly among young people. Possible explanations include lower threshold for help-seeking among young people, but evidence is scarce. We analysed the 2002, 2006 and 2010 Stockholm public health surveys for changes in the mean level of psychological distress among adult users of psychiatric in- and outpatient services in four age groups: 18-24, 25-44, 45-64 and ≥65 years. Psychological distress was measured via the 12-item General Health Questionnaire (GHQ-12), using the Likert scoring method 0-1-2-3. In- and out-patient psychiatric service use within 6 months from the surveys was obtained from registers. The mean level of distress among young adults 18-24 years who utilize psychiatric services decreased between 2002 (mean GHQ-12 score, 95% confidence interval 20.5, 18.1-23.0) and 2010 (16.2, 14.6-17.7), while it remained fairly stable in older age groups. Results were similar in sex-stratified analyses, although the decrease was statistically significant only among young women 18-24 years. At the end of the follow-up, the level of distress among patients was similar for all age-groups. There were no differences between age groups in the level of distress when seeking care at the end of the follow-up period, supporting that there is no age-specific over- or under-consumption of psychiatric care in later years. However, the lowered threshold for help-seeking among young adults over time might have contributed to increases in psychiatric service use in the young age group. Public health policy and service delivery planning should consider the needs of the widening group of young users of psychiatric services.

  16. Assessment of the University of Michigan's dental hygiene partnership with the Huron Valley Boys & Girls Club: a study of students' and staffs' perceptions and service learning outcomes.

    Science.gov (United States)

    Christensen Brydges, Sarah; Gwozdek, Anne E

    2011-01-01

    The Boys & Girls Club of America (BGCA) requires a health curriculum be taught. With the assistance of the University of Michigan (UM) Dental Hygiene program, these requirements have been addressed at the Huron Valley Boys & Girls Club (HVBGC) through dental hygiene students presenting oral health education to club members throughout the year. This study assessed the outcomes and benefits of the service learning initiative between the UM Dental Hygiene Program and the HVBGC from both the students' and staffs' perceptions. Three surveys were distributed: one to the HVBGC staff, one to UM's Dental Hygiene class of 2012 (with no service learning experience at the HVBGC) and one to UM Dental Hygiene classes of 2010 and 2011 (most of whom had experience at the HVBGC). Qualitative and quantitative data were collected and evaluated. The respondents from the class of 2012 were less knowledgeable about the BGCA and access to care issues. The members of the classes of 2010 and 2011, 79% of whom had HVBGC experience, identified they had benefitted from this service learning experience. The HVBGC staff survey indicated a high level of satisfaction with the student presentations and felt their curricular requirements were being met. Future topics of safety, orthodontics and gardening/nutrition were identified. This study indicates the service learning initiative has been beneficial for both the UM Dental Hygiene students and the HVBGC. Future studies should use a longitudinal design to obtain baseline and post-service learning data.

  17. Shared decision-making for psychiatric medication: A mixed-methods evaluation of a UK training programme for service users and clinicians.

    Science.gov (United States)

    Ramon, Shulamit; Morant, Nicola; Stead, Ute; Perry, Ben

    2017-12-01

    Shared decision making (SDM) is recognised as a promising strategy to enhance good collaboration between clinicians and service users, yet it is not practised regularly in mental health. Develop and evaluate a novel training programme to enhance SDM in psychiatric medication management for service users, psychiatrists and care co-ordinators. The training programme design was informed by existing literature and local stakeholders consultations. Parallel group-based training programmes on SDM process were delivered to community mental health service users and providers. Evaluation consisted of quantitative measures at baseline and 12-month follow-up, post-programme participant feedback and qualitative interviews. Training was provided to 47 service users, 35 care-coordinators and 12 psychiatrists. Participant feedback was generally positive. Statistically significant changes in service users' decisional conflict and perceptions of practitioners' interactional style in promoting SDM occurred at the follow-up. Qualitative data suggested positive impacts on service users' and care co-ordinators confidence to explore medication experience, and group-based training was valued. The programme was generally acceptable to service users and practitioners. This indicates the value of conducting a larger study and exploring application for non-medical decisions.

  18. Shared decision-making for psychiatric medication: A mixed-methods evaluation of a UK training programme for service users and clinicians

    Science.gov (United States)

    Ramon, Shulamit; Morant, Nicola; Stead, Ute; Perry, Ben

    2017-01-01

    Background: Shared decision making (SDM) is recognised as a promising strategy to enhance good collaboration between clinicians and service users, yet it is not practised regularly in mental health. Aims: Develop and evaluate a novel training programme to enhance SDM in psychiatric medication management for service users, psychiatrists and care co-ordinators. Methods: The training programme design was informed by existing literature and local stakeholders consultations. Parallel group-based training programmes on SDM process were delivered to community mental health service users and providers. Evaluation consisted of quantitative measures at baseline and 12-month follow-up, post-programme participant feedback and qualitative interviews. Results: Training was provided to 47 service users, 35 care-coordinators and 12 psychiatrists. Participant feedback was generally positive. Statistically significant changes in service users’ decisional conflict and perceptions of practitioners’ interactional style in promoting SDM occurred at the follow-up. Qualitative data suggested positive impacts on service users’ and care co-ordinators confidence to explore medication experience, and group-based training was valued. Conclusions: The programme was generally acceptable to service users and practitioners. This indicates the value of conducting a larger study and exploring application for non-medical decisions. PMID:29067837

  19. NHS Dentistry: Options for Change in context--a personal overview of a landmark document and what it could mean for the future of dental services.

    Science.gov (United States)

    Pitts, N B

    2003-12-06

    The aims of this paper are to provide an impartial overview of the proposals and agenda for the future brought together in the NHS Dentistry: Options for Change document in the context of previous dental service delivery in primary care, and to start to explore what Options for Change could mean for the future of NHS dental services. Options has been described as perhaps the most radical and ground breaking opportunity for NHS dentistry to finally move forward after prolonged periods of stagnation and disharmony. The Options agenda has the potential to bring in a new style of NHS practice for dentistry, providing a way to finally get off the current 'treadmill' and to develop new NHS dental services where prevention is a priority and providing high quality dental treatment, tailored to the long term needs of the 21st century patient, is the driving aim. However, the difficulties on all sides of leaving behind decades of disputes and overcoming real access, workforce and funding issues must not be underestimated or dismissed. The report was prepared by a working group comprising representatives from the profession, of patient groups and various sections of the Department of Health in England which was brought together by the then Chief Dental Officer. The key themes and priorities for action identified in Options include: local commissioning and funding, methods of remuneration for general dental practitioners, prevention and an oral health assessment for patients, clinical pathways, information and communication technology, practice structure, development of the dental team and the patient experience. The document also contains comprehensive reports of the three Options for Change task groups making recommendations for: 1) a new deal for patients - national standards, 2) systems of delivery of dental care and 3) education, training and development of the dental team. Ways forward for delivering improved, modern, effective, preventive, patient-centred dental care

  20. Total saliva pH in patients with periodontal disease of UNMSM Dental Faculty Periodontal Service.

    OpenAIRE

    García Linares, Sixto; Departamento Médico-Quirúrgico. Facultad Odontología. UNMSM. Lima - Perú.; Bravo Castañola, Francis; Segunda Especialidad en Periodoncia. Facultad Odontología. UNMSM. Lima - Perú.; Ayala Luis, Jocelyn; Alumna Odontología pregrado. Facultad Odontología. UNMSM. Lima - Perú.; Bardales Cuzquén, Guadalupe; Alumna Odontología pregrado. Facultad Odontología. UNMSM. Lima - Perú.

    2014-01-01

    The present study evaluates the relationship between salivary pH and periodontal disease. Sixty patients (30 gingivitis patients and 30 periodontitis patients) who went to UNMSM Dental School were evaluated. Also, we took a control group that included 20 dental students with healthy periodontum. We evaluated periodontal status and salivary samples were taken before and after phase I treatment. It was found a difference between control group that presented an average pH of 6.9 and gingivitis a...

  1. Trends and predictors of primary dental care health services for adults in Israel.

    Science.gov (United States)

    Zlotnick, C; Baron-Epel, O; Zusman, S Paul; Keinan-Boker, L

    2014-12-01

    Guided by the Andersen-Aday Behavioral Model of Health Care Utilization, this study compared primary dental care use trends between 2000 and 2010, and differences in primary dental care use between Israel's two largest ethnic groups, Jews and Arabs. Two waves (years 2000 and 2010) of existing cross-sectional data collected from a nationwide sample on the population's health knowledge, attitudes and practice were used. This study uses the sample of Israeli-Jews (n = 2806) from 2000; and the nationally representative sample of Israeli-Jews (n = 2539) and Israeli-Arabs (n = 1723) from 2010. Primary dental care use increased between 2000 and 2010 in Israel. Israelis who had at least a high school diploma, average or higher income, no dental pain and reported flossing their teeth were more likely to use primary dental care, but this was true of fewer Israeli-Arabs than Israeli-Jews. Other variables, associated with use of primary dental care but differing by ethnic group, were: being older than 65 years, being a native-born Israeli, employment, and health risk factors such as smoking and obesity. As with other western societies and as indicated by the model's three factors (i.e., predisposing, enabling and reinforcing/need), disparities in primary dental care use were found based on income (i.e., enabling); immigrants and ethnic minority status (i.e., predisposing), and health risk such as smoking (i.e., reinforcing/need). It is evident that health promotion activities are needed to target specific population subgroups to reduce disparities in primary dental care utilisation.

  2. Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: a systematic review.

    Science.gov (United States)

    Bauer, Amy M; Alegría, Margarita

    2010-08-01

    This literature review examined the effects of patients' limited English proficiency and use of professional and ad hoc interpreters on the quality of psychiatric care. PubMed, PsycINFO, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were systematically searched for English-language publications from inception of each database to April 2009. Reference lists were reviewed, and expert sources were consulted. Among the 321 articles identified, 26 met inclusion criteria: peer-reviewed articles reporting primary data on clinical care for psychiatric disorders among patients with limited proficiency in English or in the provider's language. Evaluation in a patient's nonprimary language can lead to incomplete or distorted mental status assessment. Although both untrained and trained interpreters may make errors, untrained interpreters' errors may have greater clinical impact, compromising diagnostic accuracy and clinicians' detection of disordered thought or delusional content. Use of professional interpreters may improve disclosure in patient-provider communications, referral to specialty care, and patient satisfaction. Little systematic research has addressed the impact of language proficiency or interpreter use on the quality of psychiatric care in contemporary U.S. settings. Findings are insufficient to inform evidence-based guidelines for improving quality of care among patients with limited English proficiency. Clinicians should be aware of the ways in which quality of care can be compromised when they evaluate patients in a nonprimary language or use an interpreter. Given U.S. demographic trends, future research should help guide practice and policy by addressing deficits in the evidence base.

  3. The Impact of Patient Language Proficiency and Interpreter Service Use on the Quality of Psychiatric Care: A Systematic Review

    Science.gov (United States)

    Bauer, Amy M.; Alegría, Margarita

    2010-01-01

    Objective To determine the effects of limited English proficiency and use of interpreters on the quality of psychiatric care. Methods A systematic literature search for English-language publications was conducted in PubMed, PsycInfo, and CINAHL and by review of the reference lists of included articles and expert sources. Of 321 citations, 26 peer-reviewed articles met inclusion criteria by reporting primary data on the clinical care for psychiatric disorders among patients with limited proficiency in English or in the providers’ language. Results Little systematic research has addressed the impact of language proficiency or interpreter use on the quality of psychiatric care in contemporary US settings. Therefore, the literature to date is insufficient to inform evidence-based guidelines for improving quality of care among patients with limited English proficiency. Nonetheless, evaluation in a patient’s non-primary language can lead to incomplete or distorted mental status assessment whereas assessments conducted via untrained interpreters may contain interpreting errors. Consequences of interpreter errors include clinicians’ failure to identify disordered thought or delusional content. Use of professional interpreters may improve disclosure and attenuate some difficulties. Diagnostic agreement, collaborative treatment planning, and referral for specialty care may be compromised. Conclusions Clinicians should become aware of the types of quality problems that may occur when evaluating patients in a non-primary language or via an interpreter. Given demographic trends in the US, future research should aim to address the deficit in the evidence base to guide clinical practice and policy. PMID:20675834

  4. Assessment of the management factors that influence the development of preventive care in the New South Wales public dental service

    Directory of Open Access Journals (Sweden)

    Masoe AV

    2015-03-01

    Full Text Available Angela V Masoe,1 Anthony S Blinkhorn,2 Jane Taylor,1 Fiona A Blinkhorn1 1Faculty of Health and Medicine, School of Health Sciences, Oral Health, University of Newcastle, Ourimbah, 2Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia Background: Oral diseases, particularly dental caries, remain one of the most common chronic health problems for adolescents, and are a major public health concern. Public dental services in New South Wales, Australia offer free clinical care and preventive advice to all adolescents under 18 years of age, particularly those from disadvantaged backgrounds. This care is provided by dental therapists and oral health therapists (therapists. It is incumbent upon clinical directors (CDs and health service managers (HSMs to ensure that the appropriate clinical preventive care is offered by clinicians to all their patients. The aims of this study were to 1 explore CDs’ and HSMs’ perceptions of the factors that could support the delivery of preventive care to adolescents, and to 2 record the strategies they have utilized to help therapists provide preventive care to adolescents. Subjects and methods: In-depth, semistructured interviews were undertaken with 19 CDs and HSMs from across NSW local health districts. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. Results: The 19 CDs and HSMs reported that fiscal accountability and meeting performance targets impacted on the levels and types of preventive care provided by therapists. Participants suggested that professional clinical structures for continuous quality improvement should be implemented and monitored, and that an adequate workforce mix and more resources for preventive dental care activities would enhance therapists’ ability to provide appropriate levels of preventive care. CDs and HSMs stated that capitalizing on the strengths of visiting pediatric

  5. Perception of Treatment Needs and Use of Dental Services for Children and Adolescents with Sickle Cell Disease.

    Science.gov (United States)

    Luna, Ana; Gomes, Monalisa; Granville-Garcia, Ana; Menezes, Valdenice

    2018-01-01

    To evaluate the perception of treatment needs and the use of dental services for children/adolescents with sickle cell disease. A cross-sectional study was conducted with 250 children/adolescents with sickle cell disease at a reference center in the city of Recife, Brazil. Data on the use of dental services were collected using a 13-item questionnaire administered to parents/guardians. The examiner in charge of determining l caries and periodontal status had previously undergone a training and calibration exercise. Descriptive statistics and Poisson regression analysis were also performed (α = 5%). A total of 47.2% of the children/adolescents with sickle cell disease were diagnosed with caries and 14.0% were diagnosed with some periodontal problems. The following variables were statistically significantly associated with the perceptions of parents/guardians regarding the treatment needs of their children: caries (PR = 1.24; 95%CI: 1.09-1.42), periodontal problems (PR = 1.10; 95%CI 1.01-1.20) and history of toothache in the previous six months (PR = 1.17; 95%CI 1.06-1.29). Only a lower level of mothers' schooling (PR = 1.64; 95%CI 1.06-2.53) was statistically significantly associated with the mean number of caries among the children/adolescents with sickle cell disease. Mean dmft/DMFT indices were higher among children/adolescents who sought dental care. Based on our results, a predomination of curative treatment was found, as seeking out dental treatment was more frequent among children/adolescents with a greater number of caries.

  6. Mental health service utilization for psychiatric disorders among Latinos living in the United States: the role of ethnic subgroup, ethnic identity, and language/social preferences.

    Science.gov (United States)

    Keyes, K M; Martins, S S; Hatzenbuehler, M L; Blanco, C; Bates, L M; Hasin, Deborah S

    2012-03-01

    To examine aspects of Latino experience in the US as predicting service utilization for mood, anxiety, and substance disorders. Latino participants 18 and older in the NESARC (N = 6,359), a US national face to face survey. Outcomes were lifetime service utilization for DSM-IV lifetime mood/anxiety or substance disorders, diagnosed via structured interview (AUDADIS-IV). Main predictors were ethnic subgroup, ethnic identity, linguistic/social preferences, nativity/years in the US, and age at immigration. Higher levels of Latino ethnic identity and Spanish language/Latino social preferences predicted lower service utilization for mood disorders [ethnic identity OR = 0.52, language/social OR = 0.44] and anxiety disorders [ethnic identity OR = 0.67, language/social OR = 0.47], controlling for ethnic subgroup, disorder severity, time spent in the US, and economic and practical barriers Service utilization for alcohol/drug disorders was low across all Latino subgroups, without variation by examined predictors. Ethnic/cultural factors are strong determinants of service utilization for mood/anxiety, but not substance use disorders among Latinos in the US strategies to increase service utilization among Latinos with psychiatric disorders should be disorder specific, and recognize the role of ethnicity and identity as important components of a help-seeking model.

  7. Examining the effects of a novel training program and use of psychiatric service dogs for military-related PTSD and associated symptoms.

    Science.gov (United States)

    Kloep, Megan L; Hunter, Richard H; Kertz, Sarah J

    2017-01-01

    This study explored an intensive 3-week training program and use of psychiatric service dogs for military-related posttraumatic stress disorder (PTSD) and associated symptoms. The sample included 2 separate cohorts of military veterans (n = 7 and n = 5) with prior diagnoses of PTSD. Participants completed self-report measures assessing PTSD, depression, perception of social support, anger, and overall quality of life 1 month prior to the training (baseline), at arrival to the training site, and 6-month follow-up. Results indicated that, for this sample, there was a statistically significant decrease in PTSD and depression symptoms from pre- to posttreatment, as well as 6-month follow-up. For most participants decreases were both clinically significant and reliable changes. Further, participants reported significant reductions in anger and improvement in perceived social support and quality of life. Limitations of the study include a lack of control group, a limitation of most naturalistic studies, as well as small sample size. Despite this, the findings indicate that utilizing psychiatric service dogs, coupled with an intensive trauma resilience training program for veterans with ongoing symptoms, is feasible as a complementary treatment for PTSD that could yield beneficial results in terms of symptom amelioration and improvement to overall quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. [Changes of the psychogeriatric inpatient care at the University Psychiatric Hospitals in Basel following the constitution of an outpatient care service for the elderly].

    Science.gov (United States)

    Eren, Gökhan; Hiss, Barbara; Maeck, Lienhard; Stoppe, Gabriela

    2014-05-01

    10-year follow-up of the psychogeriatric inpatient care at the University Psychiatric Hospitals Basel following the establishment of an outpatient care service for the elderly (ADA). Standardized chart review of a random sample of psychogeriatric cases (≥ 65 y) of the years 1997 and 2007 (n = 100 each) in terms of socio-demographic, diagnostic, therapeutic und administrative data. The number of patients with contact to both inpatient and outpatient services prior to admission increased. There was no change regarding the amount of unvoluntary admissions. As expected more complex cases were treated. The case management showed changes towards greater guideline conformity. The 10-year follow-up shows a better outpatient treatment and the provision of inpatient facilities for complex multimorbid and emergency patients. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Patients' satisfaction with dental care provided by public dental ...

    African Journals Online (AJOL)

    Background: In Tanzania, patient satisfaction with dental services has received only minor attention. Objective: To assess patients' satisfaction with public dental health services in Dar es Salaam. Design: A cross-sectional study. Setting: Five public dental clinics randomly selected from a list of all the nine public dental ...

  10. Dental Encounter System (DES)

    Data.gov (United States)

    Department of Veterans Affairs — Dental Encounter System (DES) is an automated health care application designed to capture critical data about the operations of VA Dental Services. Information on...

  11. Evaluation of an academic service-learning course on special needs patients for dental hygiene students: a qualitative study.

    Science.gov (United States)

    Keselyak, Nancy T; Simmer-Beck, Melanie; Bray, Kimberly Krust; Gadbury-Amyot, Cynthia C

    2007-03-01

    The purpose of this study was to evaluate the outcomes of a service-learning course on special needs patients for dental hygiene students by considering student reflections, community site coordinators' feedback, and faculty reflections in a qualitative analysis. Twenty-three female dental hygiene students beginning their fourth semester in the program provided preventive oral health services at eight community sites serving six diverse groups of people having special health care needs. Students reflected on the experience via commentaries written in self-reflection journals. The investigators applied the constant comparative method to analyze and unitize the data, ultimately reaching consensus on three category topics: awareness, higher order thinking, and professionalism. End of course project assessments provided additional data that was used to triangulate with data from the reflective journals. Telephone interviews with the site coordinators and personal interviews with the course faculty provided data from multiple perspectives. The outcomes of this study suggest that service-learning pedagogy can facilitate a deeper understanding of the subject matter and provide an opportunity for students to use critical thinking strategies in addition to becoming aware of complex social and professional issues related to the oral health care of individuals with special needs.

  12. [Independent dental patient consultation service--experiences of the information center for the Rhine-Neckar district].

    Science.gov (United States)

    Niekusch, U; Wagner, C; Klett, M

    2006-01-01

    Patients should be the focus of health care - or so resounds the frequently heard cry of politicians, consumer protection groups and patient representatives. It cannot be denied that the increased co-determination of the insured and of patients in the health service is a sign of the times. Demanding ever increasing health insurance premiums and exacting higher additional contributions from patients on the one hand without increasing their say and their rights on the other hand meets with little sympathy. Spouting like a mantra about "personal responsibility", the "voice of the patient" or the "sovereignty of the consumer" in talk-shows or studio debates is not sufficient. Words must be followed up by actions in order to give patients the necessary skills to enable them to make autonomous decisions. One step in this direction is the model of an independent dental consumer and patient advisory service in the Rhine-Neckar district health authority presented here and sponsored by the central associations of the health insurance companies in the scope of the funding provided under section sign 65 b SGB V [Social Security Code]. Since 2001 over 4000 people seeking advice have received information about dental treatment, planned therapies or legal issues. More than half of those seeking advice are between 40 and 70 years old and the number of women outweighs the number of men. The majority of patients want an independent second opinion, demonstrating the limits of call centres or Internet advice services. The anonymity of the consultation is an important factor for those seeking advice. The successful integration of the advisory service is evident, not only from the high number of consultations, but also from the fact that the majority of those seeking advice have been referred to the service by their respective health insurance company. For various reasons it can be assumed that there will be an increasing demand for qualified dental advice. It is therefore incumbent on

  13. Socio-economic Status, Needs, and Utilization of Dental Services among Rural Adults in a Primary Health Center Area in Southern India.

    Science.gov (United States)

    Bommireddy, Vikram Simha; Pachava, Srinivas; Ravoori, Srinivas; Sanikommu, Suresh; Talluri, Devaki; Vinnakota, Narayana Rao

    2014-01-01

    The oral disease burden in India is showing a steady increase in the recent years. Utilization of dental care being the major factor affecting the oral health status of the population is used as an important tool in oral health policy decision-making and is measured in terms of the number of dental visits per annum. A cross-sectional house to house questionnaire survey was conducted in three rural clusters which were randomly selected from a total of eight clusters served by a primary health center. Simple random sampling was used to select 100 houses from each cluster. Screening was done to examine the existing oral diseases. A total of 385 completed questionnaires were collected from 300 houses. Of 385 study subjects, 183 have experienced previous dental problems. Major dental problem experienced by the study subjects was toothache (68.85%) and the treatment underwent was extraction (50.27%). Most preferred treatment centers by the study subjects were private dental hospital (68.25%) and reason identified was accessibility which constituted (45.24%) of all the reasons given. Negative attitude toward dental care is one of the important barriers; 50.8% of the non-utilizers felt dental treatment is not much important. Person's attitude, lack of awareness, and affordability remain the barriers for utilization of dental services. Effective methods have to be exercised to breach such barriers.

  14. Methamphetamine use and dental problems among adults enrolled in a program to increase access to oral health services for people living with HIV/AIDS.

    Science.gov (United States)

    Walter, Angela W; Bachman, Sara S; Reznik, David A; Cabral, Howard; Umez-Eronini, Amarachi; Nath, Avantika; Flournoy, Minnjuan W; Young, Nancy S

    2012-05-01

    We examined the association between methamphetamine (meth) use and dental problems in a large sample of HIV-positive adults. We gathered data from 2,178 interviews across 14 sites of the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance Innovations in Oral Health Care Initiative from May 2007 to August 2010. We used multivariate generalized estimating equations to test the association between meth use and dental problems, adjusting for potential confounders. Past and current meth use was significantly associated with more dental problems. The study also found that poor self-reported mental health status, fewer years since testing positive for HIV, a history of forgoing dental care, less frequent teeth brushing, poor self-reported oral health status, oral pain, grinding or clenching teeth, some alcohol use, more years of education, and self-reported men-who-have-sex-with-men HIV risk exposure (compared with other exposure routes) were significantly associated with dental problems. Individuals who are HIV-positive with a history of meth use experience access barriers to oral health care and more dental problems. Our study demonstrated that it is possible to recruit this population into dental care. Findings suggest that predisposing, enabling, and need factors can serve as demographic, clinical, and behavioral markers for recruiting people living with HIV/AIDS into oral health programs that can mitigate dental problems.

  15. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement.

    Science.gov (United States)

    Moyer, Virginia A

    2014-06-01

    Update of the 2004 US Preventive Services Task Force (USPSTF) recommendation on prevention of dental caries in preschool-aged children. The USPSTF reviewed the evidence on prevention of dental caries by primary care clinicians in children 5 years and younger, focusing on screening for caries, assessment of risk for future caries, and the effectiveness of various interventions that have possible benefits in preventing caries. This recommendation applies to children age 5 years and younger. The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride. (B recommendation) The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by primary care clinicians in children from birth to age 5 years. (I Statement). Copyright © 2014 by the American Academy of Pediatrics.

  16. Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children

    Directory of Open Access Journals (Sweden)

    Márcia Helena Baldani

    2017-11-01

    Full Text Available Abstract: This cross-sectional study aimed to assess the association between the quality of primary health care (PHC and the use of dental services by preschoolers served by the Family Health Strategy (FHS, controlling for socio-demographic determinants and perceived need. The sample encompassed 438 children aged 3-5 years, enrolled in 19 FHS facilities in Ponta Grossa, Paraná State, Brazil. Individual level variables were collected by interviewing parents or caregivers at home. They answered a questionnaire on socioeconomic conditions, oral hygiene habits and use of dental services. Parental perception of child’s oral health related quality of life, as perceived need, was assessed by the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS. Normative need was assessed by oral examinations, according to guidelines standardized by the World Health Organization. The contextual level factor was defined as the extent of implementation of PHC in the facilities. Managers responded to PCATool-Brazil, a validated questionnaire which measures the extent of PHC. Dentists answered to a version of PCATool, which was adapted and pretested for dental services. Multilevel analysis, based on Andersen’s behavioral model, fitted the adjustment of “having ever consulted a dentist” to contextual and individual covariates. We observed high prevalence of dental caries. Almost half of the sample had had dental appointments in life. Social gradients were observed for the use of dental services. Although it was not able to eliminate the impact of adverse social conditions, higher levels of PHC attributes in dental services favored the effective use of such services by low-income children.

  17. Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children.

    Science.gov (United States)

    Baldani, Márcia Helena; Rocha, Juliana Schaia; Fadel, Cristina Berger; Nascimento, Antonio Carlos; Antunes, José Leopoldo Ferreira; Moysés, Samuel Jorge

    2017-11-21

    This cross-sectional study aimed to assess the association between the quality of primary health care (PHC) and the use of dental services by preschoolers served by the Family Health Strategy (FHS), controlling for socio-demographic determinants and perceived need. The sample encompassed 438 children aged 3-5 years, enrolled in 19 FHS facilities in Ponta Grossa, Paraná State, Brazil. Individual level variables were collected by interviewing parents or caregivers at home. They answered a questionnaire on socioeconomic conditions, oral hygiene habits and use of dental services. Parental perception of child's oral health related quality of life, as perceived need, was assessed by the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS). Normative need was assessed by oral examinations, according to guidelines standardized by the World Health Organization. The contextual level factor was defined as the extent of implementation of PHC in the facilities. Managers responded to PCATool-Brazil, a validated questionnaire which measures the extent of PHC. Dentists answered to a version of PCATool, which was adapted and pretested for dental services. Multilevel analysis, based on Andersen's behavioral model, fitted the adjustment of "having ever consulted a dentist" to contextual and individual covariates. We observed high prevalence of dental caries. Almost half of the sample had had dental appointments in life. Social gradients were observed for the use of dental services. Although it was not able to eliminate the impact of adverse social conditions, higher levels of PHC attributes in dental services favored the effective use of such services by low-income children.

  18. Relationship between risk assessment and payment models in Swedish Public Dental Service

    DEFF Research Database (Denmark)

    Petersson, Gunnel Hänsel; Twetman, Svante

    2017-01-01

    assessment was carried out in 1295 young adults attending eight Public Dental Clinics in the Scania region and 75% could be re-examined after 3 years; 615 had selected the CP model and 310 the traditional FFS. Caries was scored according to WHO and data concerning preventive care was extracted from...... the dental records. RESULTS: More patients in the low risk category preferred the CP model (74% vs. 26%) while >80% with high risk selected FFS. The baseline caries level was significantly higher in the FFS group as well as the 3-year caries increment (1.6 vs. 0.8 DFS: p ... preventive care delivered to each patient was generally lower in the FFS model; it was most frequent among patients with "some" risk in the CP model (83.8%) while the lowest delivery rates were found among low risk patients in the FFS system (32.4%). CONCLUSIONS: Young adults in public dental care with low...

  19. The INCENTIVE protocol: an evaluation of the organisation and delivery of NHS dental healthcare to patients-innovation in the commissioning of primary dental care service delivery and organisation in the UK.

    Science.gov (United States)

    Pavitt, Sue H; Baxter, Paul D; Brunton, Paul A; Douglas, Gail; Edlin, Richard; Gibson, Barry J; Godson, Jenny; Hall, Melanie; Porritt, Jenny; Robinson, Peter G; Vinall, Karen; Hulme, Claire

    2014-09-17

    In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards 'blended contracts' that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England. The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life. The study has been approved by NRES Committee London, Bromley. The results of this study will be disseminated at national and international conferences and in international journals

  20. Predicting Rural Practice and Service to Indigent Patients: Survey of Dental Students Before and After Rural Community Rotations.

    Science.gov (United States)

    Shannon, C Ken; Price, Shelia S; Jackson, Jodie

    2016-10-01

    Community-based clinical rotations in rural areas expose dental students to diverse patient populations, practice models, and career opportunities as well as rural culture. The aims of this study at West Virginia University were to determine the best predictors of rural practice, assess the predictive validity of students' intention to practice in a rural area before and after their rural rotations, and evaluate the relationship between students' intention to practice in a rural area and intention to provide care for indigent patients. Online survey data were submitted pre- and post-rural clinical rotation by 432 of 489 dental students over the study period 2001-12, yielding an 88% response rate. In 2013, practice addresses from the West Virginia Board of Dentistry were added to the student database. The results showed that significant predictors of rural practice site were intended rural practice choice, rural hometown, and projected greater practice accessibility for indigent patients. The likelihood of students' predicting they would choose a rural practice increased after completion of their rural rotations. After the rotations, students predicted providing greater accessibility to indigent patients; these changes occurred for those who changed their predictions to rural practice choice after the rotations and those who subsequently entered rural practice. The dental students with a rural background or a greater service orientation were also more likely to expect to enter a rural practice and actually to do so after graduation. These findings suggest that dental school curricula that include rural rotations may increase students' sensitivity to issues of indigent patients and increase students' likelihood of rural practice choice.

  1. Motivations of persons with psychiatric disabilities to work in mental health peer services: a qualitative study using self-determination theory.

    Science.gov (United States)

    Moran, Galia Sharon; Russinova, Zlatka; Yim, Jung Yeon; Sprague, Catherine

    2014-03-01

    Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers-a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental

  2. A retrospective chart review of the clinical and psychosocial profile of psychotic adolescents with co-morbid substance use disorders presenting to acute adolescent psychiatric services at Tygerberg Hospital

    Directory of Open Access Journals (Sweden)

    Anusha Lachman

    2012-05-01

    Full Text Available Background. A large number of adolescents meet criteria for ‘dual diagnosis’ (a psychiatric disorder plus co-morbid substance use disorder (SUD, which prolongs treatment response and complicates intervention strategies. The current service model in Cape Town divides the care of such patients into psychiatric treatment and a separate substance use intervention. Child and adolescent mental health services face the challenge of high rates of readmission of adolescents into psychiatric facilities before utilisation of community-based substance abuse services. Objective. There is a scarcity of available treatment guidelines for dual-diagnosis adolescents, and a lack of systematically documented epidemiological and clinical data in South African adolescent populations. Method. A retrospective chart review of adolescent psychiatric admissions to the Tygerberg Adolescent Psychiatric Unit during 2010 was conducted. Relevant epidemiological, clinical and demographic data for those presenting with a dual diagnosis (specifically psychotic disorders and SUD was recorded. Results. Results suggest a high prevalence of SUD among adolescents presenting with a first-episode psychosis. Statistically significant correlations with lower levels of education were found in those with ongoing substance abuse (specifically cannabis and methamphetamine, and a significant relationship between choice of debut drug and ongoing drug use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages, risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described. Conclusions. This cohort had an enhanced risk as a result of genetic vulnerability and environmental availability of substances, and the findings emphasise the differences in presentation, choice of drugs of abuse and psychosocial difficulties of adolescents with a dual

  3. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    LENUS (Irish Health Repository)

    Tickle, Martin

    2011-10-10

    Abstract Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. Methods\\/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will

  4. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    Science.gov (United States)

    2011-01-01

    Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. Methods/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained

  5. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    Directory of Open Access Journals (Sweden)

    Noble Solveig

    2011-10-01

    Full Text Available Abstract Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education with dental health education alone in young children. Methods/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years, fluoride toothpaste (1,450 ppm F (supplied twice per year, a toothbrush (supplied twice a year or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit. 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs

  6. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services.

    Science.gov (United States)

    Tickle, Martin; Milsom, Keith M; Donaldson, Michael; Killough, Seamus; O'Neill, Ciaran; Crealey, Grainne; Sutton, Matthew; Noble, Solveig; Greer, Margaret; Worthington, Helen V

    2011-10-10

    Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group.The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental

  7. A register-based study of variations in services received among dental care attenders

    DEFF Research Database (Denmark)

    Rosing, Kasper; Hede, Børge; Christensen, Lisa Bøge

    2016-01-01

    , root fillings and composite fillings were analyzed in relation to socioeconomic status, irregular/regular dental attendance, inhabitant/dentist ratio and to DMFT at age 15 (DMFT15) and change in DMFT (ΔDMFT) from age 15 to age 25 and age 40, respectively. Poisson regression and negative binomial...

  8. Transitioning of special needs paediatric patients to adult special needs dental services.

    Science.gov (United States)

    Borromeo, G L; Bramante, G; Betar, D; Bhikha, C; Cai, Y Y; Cajili, C

    2014-09-01

    Special needs dentistry is in its infancy compared to other dental specialties. Continuity of care through transition from paediatric to adult dental care providers is unknown. This study seeks to determine the nature of transition practices adopted by paediatric and special needs (SN) specialists practising throughout Australia. A survey was sent to all paediatric and SN specialist dentists in Australia to determine the nature of current transition practices for paediatric SN patients in Australia. Two subsequent mail-outs were sent to non-responders. Forty-nine specialist dentists registered across Australia completed the survey, of which 35 (71%) were paediatric dentists and 14 (29%) were SN dentists. Both paediatric and SN dentists treated patients over the age of 18. Of the total paediatric dentists who had transition discussions with their paediatric patients and their families, the majority (over 80%) discussed treatment options available as part of future oral care management. Paediatric dentists identified level of independence and financial situations as the most significant barrier for transition. Key factors exist that should be discussed with SN patients and their parents and/or guardians in order to enhance the prospect of sustained dental care into adulthood. © 2014 Australian Dental Association.

  9. Anxiety and fear of dental treatment among users of public health services.

    Science.gov (United States)

    do Nascimento, Daniella Lira; da Silva Araújo, Ana Cláudia; Gusmão, Estela Santos; Cimões, Renata

    2011-01-01

    The aim of the present investigation was to determine the degree of anxiety and fear in patients treated at the dental school clinics of the Universidade Federal de Pernambuco (Brazil) regarding the different types of treatment offered. The sample was made up of 400 patients from both genders over 18 years of age treated between July and October 2007. Data collection was carried out through the administration of validated questionnaires by a calibrated researcher. The Modified Dental Anxiety Scale (MDAS) and Gatchel's Scale were used to evaluate the degree of anxiety and fear among the patients. There was a 23.0% prevalence of dental anxiety; 9.5% were very anxious, 13.5% were anxious and 77.0% were not anxious. Women were more anxious than men (20.7% and 11.3%, respectively, P = 0.995). The age group that exhibited the highest prevalence of anxiety was 30 to 39 years (29.3%). Regarding fear, 13.5% felt extreme fear; 30.5% felt moderate fear and 56% felt no fear. Schooling was the only significant socioeconomic factor for both anxiety and fear. In the association between fear and anxiety, 38.9% of the patients with extreme fear were classified as very anxious. The majority of individuals were classified as non-anxious and without fear regarding dental procedures.

  10. 42 CFR Appendix G to Part 75 - Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography

    Science.gov (United States)

    2010-10-01

    ... Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section... individual State licensure processes, all of which include assessment of competence in dental radiography. In...

  11. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry.

    Science.gov (United States)

    Khalifeh, Hind; Hunt, Isabelle M; Appleby, Louis; Howard, Louise M

    2016-03-01

    Suicide in pregnant and postnatal women is an important cause of maternal death, but evidence to guide suicide prevention in this group is scarce. We aimed to compare the trend, nature, and correlates of suicide in perinatal and non-perinatal women in contact with psychiatric services. We used 1997-2012 data from the UK National Confidential Inquiry into Suicides and Homicides by People with Mental Illness, which includes all suicides by people (age ≥10 years) who had been in contact with psychiatric services in the previous year. The study sample comprised all women who died by suicide in pregnancy or the first postnatal year (perinatal suicides), and all women in the same age range who died by suicide outside this period (non-perinatal suicides). We compared suicides among perinatal and non-perinatal women with logistic regression of multiply imputed data. The study sample included 4785 women aged 16-50 years who died by suicide, of whom 98 (2%) died in the perinatal period. Of the 1485 women aged 20-35 years, 74 (4%) women died in the perinatal period. Over the course of the study, we recorded a modest downward trend in the mean number of women dying by suicide in the non-perinatal period (-2·07 per year [SD 0·96]; p=0·026), but not the perinatal period (-0·07 per year [0·37]; p=0·58). Compared with non-perinatal women, women who died by suicide in the perinatal period were more likely to have a diagnosis of depression (adjusted odds ratio [OR] 2·19 [95% CI 1·43-3·34]; psuicide within versus outside the perinatal period were also more likely to be younger (crude OR -6·39 [95% CI -8·15 to -4·62]; pillness duration (2·93 [1·88-4·56]; psuicides in the perinatal period were more likely to occur in those with a depression diagnosis and no active treatment at the time of death. Assertive follow-up and treatment of perinatal women in contact with psychiatric services are needed to address suicide risk in this group. Healthcare Quality Improvement

  12. [Scientific bases of the organization of psychiatric care: development of a conceptual framework of modern mental health services].

    Science.gov (United States)

    Yastrebov, V S; Mitikhin, V G; Solokhina, T A; Mitikhina, I A

    Analysis and development of conceptual models of mental health organization allowing to determine the perspective directions of its further development. The work was based on the collection of scientific publications on the problems of psychiatric care organization as well as the results of own research carried out by the authors over the last 25 years. System analysis was used for the development and analysis of the major conceptual models of mental health care. The system analysis of the major conceptual models of mental health care - from the matrix model to models of the DSM-5 and RDoC, was carried out. Priorities and main AIM: of the research were specified. It has been shown that the Analytic Hierarchy Process should be used, along with traditional methods, to solve the addressed problems.

  13. Does psychopathology at admission predict the length of inpatient stay in psychiatry? Implications for financing psychiatric services

    Directory of Open Access Journals (Sweden)

    Herwig Uwe

    2011-07-01

    Full Text Available Abstract Background The debate on appropriate financing systems in inpatient psychiatry is ongoing. In this context, it is important to control resource use in terms of length of stay (LOS, which is the most costly factor in inpatient care and the one that can be influenced most easily. Previous studies have shown that psychiatric diagnoses provide only limited justification for explaining variation in LOS, and it has been suggested that measures such as psychopathology might be more appropriate to predict resource use. Therefore, we investigated the relationship between LOS and psychopathological syndromes or symptoms at admission as well as other characteristics such as sociodemographic and clinical variables. Methods We considered routine medical data of patients admitted to the Psychiatric University Hospital Zurich in the years 2008 and 2009. Complete data on psychopathology at hospital admission were available in 3,220 inpatient episodes. A subsample of 2,939 inpatient episodes was considered in final statistical models, including psychopathology as well as complete datasets of further measures (e.g. sociodemographic, clinical, treatment-related and psychosocial variables. We used multivariate linear as well as logistic regression analysis with forward selection procedure to determine the predictors of LOS. Results All but two syndrome scores (mania, hostility were positively related to the length of stay. Final statistical models showed that syndromes or symptoms explained about 5% of the variation in length of stay. The inclusion of syndromes or symptoms as well as basic treatment variables and other factors led to an explained variation of up to 25%. Conclusions Psychopathological syndromes and symptoms at admission and further characteristics only explained a small proportion of the length of inpatient stay. Thus, according to our sample, psychopathology might not be suitable as a primary indicator for estimating LOS and contingent

  14. Self-reported oral health and use of dental services among asylum seekers and immigrants in Finland-a pilot study.

    Science.gov (United States)

    Mattila, Anni; Ghaderi, Peyvand; Tervonen, Laura; Niskanen, Leena; Pesonen, Paula; Anttonen, Vuokko; Laitala, Marja-Liisa

    2016-12-01

    The number of asylum seekers and immigrants arriving in European countries is growing explosively. The aim of this pilot study was to investigate self-reported oral health, oral health habits, dental fear and use of dental health care services among asylum seekers and immigrants in Finland. The interview study carried out in 2012 comprised 38 participants (18 males and 20 females) from 15 different countries, nine of whom were asylum seekers and 29 immigrants. The youngest participant was 17 and the oldest 53 years old. Each interview took approximately 30 min. The participants reported high need for dental treatment. Compared with the immigrants, the asylum seekers reported significantly more frequently dental pain and other symptoms and were less satisfied both in getting a dental appointment and in the quality of treatment they had received. All the asylum seekers and almost half of the immigrants found it difficult to get an appointment. The immigrants were more aware of good oral health habits than the asylum seekers. The asylum seekers suffered from dental fear more often than the immigrants. Despite the small number of participants, our interview-based study indicates that asylum seekers and immigrants have need for acute and basic dental treatment and health education. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  15. Inequalities in access and utilization of dental services: a cross-sectional study in an area covered by the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Márcia Helena Baldani

    2011-01-01

    Full Text Available This cross-sectional study aimed to investigate the presence of inequalities in the access and use of dental services for people living in the coverage area of the Family Health Strategy (FHS in Ponta Grossa, Paraná State, Brazil, and to assess individual determinants related to them. The sample consisted of 747 individuals who answered a pre-tested questionnaire. Data analysis was performed by chi-square test and Poisson regression analysis, obtaining explanatory models for recent use and, by limiting the analysis to those who sought dental care, for effective access. Results showed that 41% of the sample had recent dental visits. The lowest visit rates were observed among preschoolers and elderly people. The subjects who most identified the FHS as a regular source of dental care were children. Besides age, better socioeconomic conditions and the presence of a regular source of dental care were positively associated to recent dental visits. We identified inequalities in use and access to dental care, reinforcing the need to promote incentives to improve access for underserved populations.

  16. Childhood Sexual Abuse, Adult Psychiatric Morbidity, and Criminal Outcomes in Women Assessed by Medium Secure Forensic Service

    Science.gov (United States)

    Dolan, Mairead; Whitworth, Helen

    2013-01-01

    There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non-childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of…

  17. Study protocol for a cluster randomised controlled trial to assess the effectiveness of user-driven intervention to prevent aggressive events in psychiatric services.

    Science.gov (United States)

    Välimäki, Maritta; Yang, Min; Normand, Sharon-Lise; Lorig, Kate R; Anttila, Minna; Lantta, Tella; Pekurinen, Virve; Adams, Clive E

    2017-04-04

    People admitted to psychiatric hospitals with a diagnosis of schizophrenia may display behavioural problems. These may require management approaches such as use of coercive practices, which impact the well-being of staff members, visiting families and friends, peers, as well as patients themselves. Studies have proposed that not only patients' conditions, but also treatment environment and ward culture may affect patients' behaviour. Seclusion and restraint could possibly be prevented with staff education about user-centred, more humane approaches. Staff education could also increase collaboration between patients, family members and staff, which may further positively affect treatment culture and lower the need for using coercive treatment methods. This is a single-blind, two-arm cluster randomised controlled trial involving 28 psychiatric hospital wards across Finland. Units will be randomised to receive either a staff educational programme delivered by the team of researchers, or standard care. The primary outcome is the incidence of use of patient seclusion rooms, assessed from the local/national health registers. Secondary outcomes include use of other coercive methods (limb restraint, forced injection, and physical restraint), service use, treatment satisfaction, general functioning among patients, and team climate and employee turn-over (nursing staff). The study, designed in close collaboration with staff members, patients and their relatives, will provide evidence for a co-operative and user-centred educational intervention aiming to decrease the prevalence of coercive methods and service use in the units, increase the functional status of patients and improve team climate in the units. We have identified no similar trials. ClinicalTrials.gov NCT02724748 . Registered on 25th of April 2016.

  18. Positioning health care services: yellow pages advertising and dental practice performance.

    Science.gov (United States)

    McAlexander, J H; Becker, B W; Kaldenberg, D O

    1993-01-01

    The authors empirically explored the relationship between positioning strategies and financial performance in dental practices. They analyzed data collected from a random sample mail survey of Oregon dentists in conjunction with data obtained in a content analysis of yellow pages advertising. The authors' analysis of usable responses from 264 general dentists in private practice reveals that they use a variety of positioning strategies and that the selection of a positioning strategy correlates significantly with financial performance.

  19. Psychiatric Genomics

    DEFF Research Database (Denmark)

    Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M

    2018-01-01

    into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can...... then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691...

  20. Preventive Dental Service Utilization for Medicaid-Enrolled Children in New Hampshire: A Comparison of Care Provided by Pediatric Dentists and General Dentists

    Science.gov (United States)

    Chi, Donald; Milgrom, Peter

    2013-01-01

    In this study, we compared preventive dental utilization through visits to a pediatric dentist (PD) vs. visits to a general dentist (GD) among Medicaid-enrolled children in New Hampshire (n=12,964). Dental claims were analyzed using conditional logistic regression models. After adjusting for covariates, children seen by a PD were 51% more likely to have received fluoride treatment, 26% more likely to have had at least two dental examinations, and 19% more likely to have received a sealant than children seen by a GD. Overall, our results suggest that children seen by a PD were more likely to have received preventive services than those seen by a GD. Because Medicaid-enrolled children are at increased risk for poor oral health, policies should be enacted to ensure that high-risk children receive appropriate and regular prevention-oriented dental care. PMID:19395842

  1. A student operated, faculty mentored dental clinic service experience at the University of Texas Health Science Center at San Antonio for the underserved refugee community: an interprofessional approach.

    Science.gov (United States)

    Farokhi, Moshtagh R; Glass, Birgit Junfin; Gureckis, Kevin M

    2014-01-01

    in holistic and accessible health care for the refugees in San Antonio. Patients receive complimentary comprehensive care while students benefit from development of cultural competence reinforcement of humanitarian values. It is difficult to conclude which group is the biggest beneficiary of attending SARHC. As the dental students reflected, "We started attending the clinic as a service learning project. We then became their advocates, treated them at our dental school, and became knowledgeable about our community's dental clinics while offering tailored referrals."

  2. Correlates in the Endorsement of Psychotic Symptoms and Services Use: Findings from the Collaborative Psychiatric Epidemiology Surveys.

    Science.gov (United States)

    Barragán, Armando; Yamada, Ann-Marie; Lee, Karen Kyeunghae; Barrio, Concepción

    2016-08-01

    Endorsement of psychotic symptoms serves as an indicator of significant health issues and interpersonal distress. Seeking services is the ultimate recourse for many individuals, yet few studies have assessed the help-seeking process in a nationally representative sample. This study, guided by Lewis-Fernández et al.'s (J Nerv Ment Dis 197(5):337-347, 2009) analyses, examined the association of lifetime endorsement of psychotic symptoms with demographic, clinical and support system variables and types of services received. Based on nationally weighted epidemiological data, 11.6 % of adults reported one or more psychotic symptoms. Psychotic symptoms were associated with poor physical and mental health, specifically depressive, anxiety, and substance use disorders. Respondents were more likely to receive services from both informal and mental health providers and were more likely to be hospitalized than those not endorsing psychotic symptoms. Study findings inform community efforts to develop comprehensive services for individuals experiencing psychotic symptoms.

  3. Dental Fear among Medical and Dental Undergraduates

    Directory of Open Access Journals (Sweden)

    H. Hakim

    2014-01-01

    Full Text Available Objective. To assess the prevalence and level of dental fear among health related undergraduates and to identify factors causing such fear using Kleinknecht’s Dental Fear Survey (DFS questionnaire. Methods. Kleinknecht’s DFS questionnaire was used to assess dental fear and anxiety among the entire enrollment of the medical and dental undergraduates’ of the University of Malaya. Results. Overall response rate was 82.2%. Dental students reported higher prevalence of dental fear (96.0% versus 90.4%. However, most of the fear encountered among dental students was in the low fear category as compared to their medical counterpart (69.2 versus 51.2%. Significantly more medical students cancelled dental appointment due to fear compared to dental students (P=0.004. “Heart beats faster” and “muscle being tensed” were the top two physiological responses experienced by the respondents. “Drill” and “anesthetic needle” were the most fear provoking objects among respondents of both faculties. Conclusion. Dental fear and anxiety are a common problem encountered among medical and dental undergraduates who represent future health care professionals. Also, high level of dental fear and anxiety leads to the avoidance of the dental services.

  4. Dental fear among medical and dental undergraduates.

    Science.gov (United States)

    Hakim, H; Razak, I A

    2014-01-01

    To assess the prevalence and level of dental fear among health related undergraduates and to identify factors causing such fear using Kleinknecht's Dental Fear Survey (DFS) questionnaire. Kleinknecht's DFS questionnaire was used to assess dental fear and anxiety among the entire enrollment of the medical and dental undergraduates' of the University of Malaya. Overall response rate was 82.2%. Dental students reported higher prevalence of dental fear (96.0% versus 90.4%). However, most of the fear encountered among dental students was in the low fear category as compared to their medical counterpart (69.2 versus 51.2%). Significantly more medical students cancelled dental appointment due to fear compared to dental students (P = 0.004). "Heart beats faster" and "muscle being tensed" were the top two physiological responses experienced by the respondents. "Drill" and "anesthetic needle" were the most fear provoking objects among respondents of both faculties. Dental fear and anxiety are a common problem encountered among medical and dental undergraduates who represent future health care professionals. Also, high level of dental fear and anxiety leads to the avoidance of the dental services.

  5. Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use

    DEFF Research Database (Denmark)

    Heiervang, Einar; Stormark, Kjell M; Lundervold, Astri J

    2007-01-01

    OBJECTIVE: The Bergen Child Study is a longitudinal study of child mental health from the city of Bergen, Norway. We present methods and results from the first wave of the study, focusing on prevalence of disorders, associations with risk factors, and the use of services. METHOD: The target popul...... assessed with the Development and Well-Being Assessment. Children with emotional disorders have limited access to specialist services....

  6. Equity inthe use of dental services provided by the Brazilian Unified Health System (SUS) among the elderly: a population-based study.

    Science.gov (United States)

    Oliveira, Renata Francine Rodrigues de; Souza, João Gabriel Silva; Haikal, Desireé Sant'Ana; Ferreira, Efigênia Ferreira E; Martins, Andréa Maria Eleutério de Barros Lima

    2016-11-01

    The scope of this study is to establish the profile of elderly users of dental services provided by the Brazilian Unified Health System(SUS) and associated factors from the standpoint of equity. It involves an analytical cross-sectional study with hierarchical modeling conducted on the basis of a complex probabilistic sample of groups of the elderly (65-74 years of age) living in a densely populated Brazilian city. Independent variables were included relating to: socio-demographic characteristics, access to information on health, behaviors/health-care system and health outcomes. Descriptive, bivariate and multiple hierarchical analysis was performed. Of the 480 elderly persons included, 138 (31.2%) used dental services from the SUS. Use of these services was greater as per capita income and level of schooling decreased. It was lower among those who had not conducted exams of their own mouths (oral self-examinations) and higher among those individuals who used dental services for non-routine procedures. In addition, people whose relationship had been affected by oral health issues and a negative perception of their appearance used the SUS more frequently. The conclusion drawn is that the use of dental services of the SUS was most prevalent among the elderly living in precarious conditions.

  7. Investigation of Barriers of Access to Children’s Oral and Dental Health Services from the Point of View of Mothers Referring to Health Centers of Qom City, 2016 (Iran

    Directory of Open Access Journals (Sweden)

    Yasamin Berakyan

    2017-07-01

    Full Text Available Background and Objectives: Adequate access to oral and dental health services in childhood can reduce long-term complications in the following years of life. The objective of this study was to determine the barriers of access to children’s oral and dental health services from the point of view of mothers referring to health centers in Qom city. Methods: In this cross-sectional study, the statistical population included 325 mothers referred to health centers. Data were collected using a questionnaire consisted of items, including age, educational level, job, and barriers of access to oral health services. Data were analyzed using descriptive statistical indicators and logistic regression test. Results: In this study, lack of insurance coverage for dentistry costs (59.7% had the highest frequency in barriers of access to dental health services, followed by child's fear of dentistry (53.2% and high costs of dental services (49.8%. There was no significant relationship between mother's job and barriers of access to dental health services, but the chance of barriers of access to dental health services increased 1.60 times with father’s employment in government jobs. Also, the results showed that the chance of barriers of access to dental health services increased 3.60 times with residence in Pardisan region, on the other hand, the chance of access to the services, was improved up to 52% with residence in Tohid region. Conclusion: Expansion of insurance coverage of oral and dental health services and increase of public centers providing dental services can be eliminate the major part of barriers of access to these services. In addition, the proportional distribution of these services in different regions of the city can be effective in easy and low-cost access.

  8. Analysis of 261 avulsed permanent teeth of patients treated in a dental urgency service

    OpenAIRE

    Orlando Aguirre Guedes; Álvaro Henrique Borges; Matheus Coelho Bandeca; Cyntia Rodrigues de Araújo Estrela; Ana Helena Gonçalves de Alencar; Carlos Estrela

    2015-01-01

    Objective: The aim of this study was to evaluate the epidemiological aspects and clinical factors associated with avulsion of permanent teeth. Materials and Methods: The sample consisted of 261 avulsed teeth of 170 patients seen in the Dental School of the Federal University of Goiαs, Brazil, from 2000 to 2008. Result: The highest incidence was found among boys (71.18%) aged 6-15 years (61.18%). The main etiologic factors were falls (51.76%) and traffic accidents (29.41%). Most cases occurred...

  9. The Effect of Clinical Psychiatric Training on Medical Students' Belief ...

    African Journals Online (AJOL)

    femi oloka

    Background to the study: Medical student's attitude towards people with mental illness (PWMI) is very important for the future care of psychiatric patients. .... Nigeria. The College provides training for medical and dental ..... friendship with. PWMI.

  10. What do patients think about dental services in Quebec? Analysis of a dentist rating website.

    Science.gov (United States)

    Macdonald, Mary Ellen; Beaudin, Anne; Pineda, Carolina

    2015-01-01

    Disparity exists between the public view of the "ideal" dentist and patient experiences of dental practice: dentists are expected to be altruistic and patient-centred, yet patient surveys suggest that the profession is overly motivated by profit. To determine how the public views dental care in Quebec. A random sample of comments about Quebec dentists made in 2011 was extracted from the public website RateMDs.com. Dentist characteristics and patient comments were analyzed using descriptive statistics and qualitative deductive and inductive thematic analysis. Eighty-six entries from a random sample of 47 of a possible 750 dentists were extracted and analyzed. Most dentists were men (66%) and worked in Montreal (51%). Patient comments were mainly positive (83%). Themes included overall impressions, communication and care, clinical competence, professionalism and office environment. Positive comments focused on patient-centred communication, in which the patient felt respected and involved in treatment planning; competence, seen as comprehensive, efficient and long-lasting treatment; and professionalism, which included ethical behaviour such as knowing professional limits. Negative comments focused on reticent communication styles that did not encourage patient input; incompetence, which included poor pain management and unnecessary treatment; and unprofessional conduct, such as lack of transparency in pricing. In contrast with the negative image of dentists reported from patient surveys, comments on one public website were primarily positive. Our findings reinforce the importance of patient-centred education and communication training for students and continuing education.

  11. Barriers and facilitators that influence the delivery of prevention guidance in health service dental practice: a questionnaire study of practising dentists in Southwest England.

    Science.gov (United States)

    Witton, R V; Moles, D R

    2013-06-01

    Objective: To investigate the barriers and facilitators influencing the delivery of prevention in accordance with a national guideline (Delivering Better Oral Health, Department of Health England) in health service dental practice. Self-completion questionnaire. Health service general dental practices. Questionnaires were sent via two mailings to all 508 dentists registered to work in health service general dental practice in Devon, South West England. In total 266 questionnaires were returned (52% response rate). Examples of barriers and facilitators were evident at various organisational levels of dentistry. These were principally the healthcare system, practice (dental office) arrangements and professional factors. Respondents gave positive responses to questions concerning the flexibility (53%) and benefit of the guideline (63%) and they tended to indicate that they didn't perceive problems in changing their old routines (58%). Opinion was divided among respondents on whether they felt patients followed their advice (49%). There was overall agreement that delivering prevention in practice is problematic if there are insufficient staff (68%), facilities (53%) and time (60%). Encouragingly most respondents felt adequately trained to deliver the evidence based prevention guidance (59%). This study has identified some barriers and facilitators to the delivery of prevention guidance in this group of health service dentists with no single factor viewed consistently as more important than any others. A further qualitative study is planned to investigate in more depth the reasons underpinning the responses given in this study.

  12. Outcome of zirconia partial fixed dental prostheses made by predoctoral dental students: A clinical retrospective study after 3 to 7 years of clinical service.

    Science.gov (United States)

    Pihlaja, Juha; Näpänkangas, Ritva; Raustia, Aune

    2016-07-01

    Zirconia has an established role in fixed prosthodontics, especially for single crowns. Whether it is durable enough for fixed dental prostheses (FDPs) in the long term is yet unclear. The purpose of this retrospective study was to evaluate the outcome of FDPs made by predoctoral students after 3 to 7 years of clinical service. A total of 102 patients received 120 zirconia FDPs (range, 3-12 units; mean, 4.5 units) between 2007 and 2010. Materials used were Zirkonzahn Zirconia (Zirkonzahn), NobelProcera Zirconia (Nobel Biocare), and Prettau Zirconia (Zirkonzahn). Veneering porcelain was hand-layered on Zirkonzahn Zirconia (GC Initial Zr; GC Europe) and Nobel Procera Zirconia (VITA VM 9; VITA Zahnfabrik). Prettau Zirconia was monolithic and had no veneering porcelain. Success and survival rates were calculated using Kaplan-Meier survival analysis. Ethics approval was obtained from the Ethical Committee of the Northern Ostrobothnia Hospital District (100/2013). The 76 participants examined (75%) had received 88 zirconia FDPs. The mean follow-up period was 4.9 years (range, 3-7 years). The most common complication was chipping of the veneering porcelain in 13 of 88 FDPs (14.7%). The success rate of the zirconia-based partial FDPs after 4.9 years was 89%, and the survival rate was 100%. The success rate of the zirconia-based partial FDPs after 4.9 years was 89%, and the survival rate was 100%. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  13. The impact of a continuing education oral health program on providing services for young children by dentists, dental hygienists and dental assistants

    National Research Council Canada - National Science Library

    Shulman, Elliot R; Howard, Wesley G; Sharps, Gina; Wearden, Stanley

    2011-01-01

    ...) at 4 sites across West Virginia. Participants completed a pre- and post-test on topics including the timing of the first dental exam, fluorides, xylitol, Alternative Restorative Technique (ART...

  14. Tobacco use cessation services provided by dentists and dental hygienists in Manitoba: part 1. Influence of practitioner demographics and psychosocial factors.

    Science.gov (United States)

    Brothwell, Douglas J; Gelskey, Shirley C

    2008-12-01

    Despite high rates of tobacco use, overwhelming evidence of detrimental effects on oral health, smokers" desire to stop using tobacco and the availability of efficacious brief intervention counselling (BIC) strategies, the delivery of cessation services by dental practitioners is, at best, inconsistent. The purpose of this part of our study was to assess BIC practice patterns among dentists and dental hygienists in Manitoba and to determine whether demographic or psychosocial factors influence BIC delivery. A pre-piloted survey was mailed to all licensed dentists (547) and registered dental hygienists (566) in the province. In all, 514 oral health practitioners responded for a 46.2% response rate. Most oral health practitioners in Manitoba are not providing consistent BIC; however, 54.9% (279/508) of survey respondents advise smokers to quit. Women clinicians are more likely to ask, assess and assist patients and tend to advise against smoking more frequently than men; younger practitioners are more likely to ask and assess readiness to quit smoking than older practitioners; dental hygienists are more likely to provide assistance to quit than dentists. Assisting is the service least frequently provided by practitioners. The barriers to providing BIC are different for male and female practitioners and for dentists and dental hygienists; practitioners with more psychosocial barriers provide BIC less frequently than those reporting fewer barriers. Only 36.9% (188/510) of practitioners report feeling adequately prepared to assist smokers to quit.

  15. Academic performance of students who underwent psychiatric treatment at the students’ mental health service of a Brazilian university

    OpenAIRE

    Campos, Cláudia Ribeiro Franulovic; Oliveira, Maria Lilian Coelho de; Mello,Tânia Maron Vichi Freire de; Dantas, Clarissa de Rosalmeida

    2017-01-01

    ABSTRACT CONTEXT AND OBJECTIVE: University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students’ mental health service (SAPPE) and to compare their academic performance with that of non-patient students. DESIGN AND SETTING: Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university....

  16. The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder. Part 5: How Essential Are Gender-Specific Forensic Psychiatric Services?

    Science.gov (United States)

    Nicholls, Tonia L; Crocker, Anne G; Seto, Michael C; Wilson, Catherine M; Charette, Yanick; Côté, Gilles

    2015-01-01

    Objective: To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men’s and women’s treatment and management needs are different. Method: Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men. Results: There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men. Conclusions: Not criminally responsible on account of mental disorder–accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services. PMID:25886689

  17. Eight-year incidence of psychiatric disorders and service use from adolescence to early adulthood: longitudinal follow-up of the Mexican Adolescent Mental Health Survey.

    Science.gov (United States)

    Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Albor, Yesica; Casanova, Leticia; Orozco, Ricardo; Curiel, Teresa; Fleiz, Clara; Medina-Mora, María Elena

    2016-02-01

    Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.

  18. An examination of the temporal and geographical patterns of psychiatric emergency service use by multiple visit patients as a means for their early detection

    Directory of Open Access Journals (Sweden)

    Chaput Yves JA

    2007-10-01

    Full Text Available Abstract Background: Frequent users of the psychiatric emergency service (PES place a heavy burden upon the mental health care delivery system. The aim of this study was to identify distinct temporal or geographical patterns of PES use by these patients as potential markers for their early detection. Methods: Diagnostic profiles were obtained for patients making an intermediate (4 to 10 or a high (11 or more number of visits to a general hospital PES in Montreal (Canada between 1985 and 2004. Between-group comparisons were made with regards to several parameters. These included the time intervals between consecutive visits, visit clustering (single, repeating, and the time interval to the first cluster and visits made to three other services where data was similarly acquired from 2002 to 2004. Results: The two multiple visit groups differed with regards to diagnostic profiles and actual time between consecutive visits (significantly shorter in patients with 11 or more visits. Patients with 11 or more visits were more likely to have a single cluster (3 or more visits/3 months or repeating clusters (4 visits/3 months in their patterns of use. Personality disorders were more prevalent in patients with single clusters as they were, along with schizophrenia, in those with repeating clusters. In addition, clusters were found to occur sufficiently early so as to be potentially useful as markers for early detection. Ten percent of those with 11 or more visits and 16% of those with an intermediate number of visits frequented at least one other PES. A small number of patients, primarily those with substance abuse, made over 50% of their visits to other services. Conclusion: Temporal and geographical patterns of use differed significantly between the multiple visit groups. These patterns, combined with distinct diagnostic profiles, could potentially lead to the more rapid identification and treatment of specific sub-groups of multiple visit patients.

  19. Psychiatric comorbidities in patients with Atypical Odontalgia.

    Science.gov (United States)

    Miura, Anna; Tu, Trang T H; Shinohara, Yukiko; Mikuzuki, Lou; Kawasaki, Kaoru; Sugawara, Shiori; Suga, Takayuki; Watanabe, Takeshi; Watanabe, Motoko; Umezaki, Yojiro; Yoshikawa, Tatsuya; Motomura, Haruhiko; Takenoshita, Miho; Maeda, Hidefumi; Toyofuku, Akira

    2018-01-01

    Atypical Odontalgia (AO) is a condition characterized by tooth pain with no apparent cause. Although psychiatric comorbidity seems to be very common, it has rarely been studied. To clarify the influence of psychiatric comorbidity on the clinical features in patients with AO, we retrospectively evaluated their examination records. Clinical features and psychiatric diagnoses of 383 patients with AO were investigated by reviewing patients' medical records and referral letters. Psychiatric diagnoses were categorized according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We also analyzed visual analogue scale (VAS), self-rating depression scale (SDS), and the short-form McGill pain questionnaire (SF-MPQ) scores. Of the 383 patients with AO, 177 (46.2%) had comorbid psychiatric disorders. The most common were depressive disorders (15.4%) and anxiety disorders (10.1%). Serious psychotic disorders such as bipolar disorder (3.0%) and schizophrenia (1.8%) were rare. Dental trigger of AO was reported in 217 (56.7%) patients. There were no s