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Objective: To analyze the criteria for diagnosis and treatment decision-making in relation to dental caries in different participants (teachers of dentistry, dental students at dental schools, and dentists practicing at public oral health services) in the city of Medellin (Colombia). Material and Methods: A cross-sectional study was applied in the period September 2015-december 2016 by means of an international validated questionnaire in 340 participants (dental teachers: 69, dental students: 193, dentists: 78). The survey addressed several topics related to detection and restorative threshold, preferences of preparation type, restorative materials used and opinions about diagnosis and treatment for dental caries. A descriptive analysis was carried out and Chi square tests were applied to observe statistically significant differences between the study variables.Results: 340 participants were surveyed among teachers who teach cariology, health care dentists, and undergraduate final-year students. Most participants were women (70%). The age mean was higher for DDSs (46 ± 9 years). On average, practicing dentists and dental teachers had a work experience of 21 ± 9 years. In case of treatment decisions, the majority of the surveyed would use immediate operative restorative treatment for advanced carious lesions (inner one-third of the dentin for approximal and grade 5 for occlusal). In addition, respondents reported different cavities diagnosis for clinical occlusal cases and some significant statistically differences were found for restorative treatment decisions and type of materials according to the type of participant. Conclusion: Criteria for diagnosis and treatment of dental caries differed among the student, dentist and dental teachers with variety in diagnosis and treatment concepts. However, a conservative tendency for restorative treatment decisions was observed. Strategies for incorporating non-restorative and minimal measures in professional practice should be considered in curricula of universities.
Objetivo: Analizar los criterios para la toma de decisiones diagnósticas y terapéuticas en relación a la caries dental en diferentes participantes (docentes, estudiantes de odontología de las facultades de odontología y odontólogos de los servicios públicos de salud bucal) de la ciudad de Medellín (Colombia). Material y Métodos: Se aplicó un estudio transversal en el período septiembre 2015 - diciembre 2016 mediante cuestionario internacional validado en 340 participantes (profesores de odontología: 69, estudiantes de odontología: 193, odontólogos: 78). La encuesta abordó varios temas relacionados con la detección y el umbral de restauración, las preferencias del tipo de preparación, los materiales de restauración utilizados y las opiniones sobre el diagnóstico y el tratamiento de la caries dental. Se realizó un análisis descriptivo y se aplicaron pruebas de Chi cuadrado para observar diferencias estadísticamente significativas entre las variables de estudio. Resultados: Se encuestó a 340 participantes entre profesores que imparten clases de cariología, odontólogos y estudiantes de último año de pregrado. La mayoría de los participantes eran mujeres (70%). La edad media fue mayor para los odontólogos (46 ± 9 años). En promedio, los odontólogos y los profesores de odontología tenían una experiencia laboral de 21 ± 9 años. En caso de decisiones de tratamiento, la mayoría de los encuestados utilizaría tratamiento restaurador quirúrgico inmediato para lesiones cariosas avanzadas (tercio interno de la dentina para proximal y grado 5 para oclusal). Además, los encuestados informaron diferentes diagnósticos de caries para los casos clínicos oclusales y se encontraron algunas diferencias estadísticamente significativas para las decisiones de tratamiento restaurativo y el tipo de materiales según el tipo de participante. Conclusion: Los criterios para el diagnóstico y tratamiento de la caries dental fueron diferentes entre los estudiantes, odontólogos y profesores de odontología con variedad en los conceptos de diagnóstico y tratamiento. Sin embargo, se observó una tendencia conservadora para las decisiones de tratamiento restaurativo. Las estrategias para incorporar medidas mínimas y no restaurativas en la práctica profesional deben ser consideradas en los planes de estudio de las universidades.
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Humans , Male , Female , Dental Caries/diagnosis , Dental Caries/therapy , Clinical Decision-Making , Students, Dental , Cross-Sectional Studies , Surveys and Questionnaires , Dental Care , Practice Guidelines as Topic , Colombia , DentistsABSTRACT
PURPOSE: We used a questionnaire to explore perceptions and clinical practice patterns of Korean pediatric ophthalmologists in terms of amblyopia.METHODS: From September to November 2018, we conducted a web-based questionnaire survey of 99 specialists of the Korean Association for Pediatric Ophthalmology and Strabismus who operated ophthalmology clinics in Korea. We received 56 responses (56.57%) and retrospectively analyzed the data.RESULTS: The average specialist age was 44.0 ± 9.7 years. The mean age of treated amblyopia patients was 3 to 5 years (69.6%); the most common amblyopia was refractive anisometropic amblyopia (75.0%). On average, treatment commenced at 4 years of age (53.6%); child and parent co-operation most significantly influenced treatment success (46.4%). The preferred test was cycloplegic refraction (96.4%) and the preferred treatment occlusion therapy (100%) with glasses correction (98.2%). Occlusion therapy was most commonly performed for 2 hours/day (69.6%); the minimum age for eyeglasses prescription was 2.10 ± 1.18 years. Only three respondents (5.36%) prescribed contact lenses and only one (1.79%) performed refractive surgery.CONCLUSIONS: In Korea, amblyopia treatment is based on occlusion therapy and glasses correction. However, the time of treatment commencement, the duration of occlusion therapy, and the glasses used for correction varied. It is necessary to develop guidelines for amblyopia treatment; these should reflect current medical conditions.
Subject(s)
Child , Humans , Amblyopia , Contact Lenses , Eyeglasses , Glass , Korea , Ophthalmology , Parents , Practice Patterns, Physicians' , Prescriptions , Refractive Surgical Procedures , Retrospective Studies , Specialization , Strabismus , Surveys and QuestionnairesABSTRACT
BACKGROUND: Limited data exist on real-world treatment patterns for diabetic macular edema (DME) in Korea. In this study, we investigated DME treatment patterns from 2009 to 2014 and the impact of baseline treatment on healthcare resource utilization and visual acuity (VA) outcomes. METHODS: A retrospective cohort chart review of DME patients treated at 11 hospital ophthalmology clinics between January 1, 2012 and December 31, 2013 was conducted. We collected data on demographics, healthcare resource utilization (clinic visits, treatment visits, and visits for ocular investigations), distribution of DME treatments, and VA. RESULTS: Overall, 522 DME patients (men, 55.2%; mean age, 59 years; mean HbA1c [n = 209], 8.4%) with 842 DME eyes were evaluated. For all treatments, healthcare resource utilization was significantly higher during the first 6 months versus months 7–12, year 2, or year 3 (P ≤ 0.001), but was highest for patients whose first treatment was an anti-vascular endothelial growth factor (VEGF) treatment (visits/quarter; anti-VEGF, 1.9; corticosteroids, 1.7; laser, 1.4). Use of macular laser therapy decreased (44% to 8%), whereas use of anti-VEGF injections increased (44% to 69%) during the study period. However, VA improvement was not commensurate with healthcare resource utilization of anti-VEGF treatment (mean VA gain, 2.7 letters). CONCLUSION: A trend toward increasing use of intravitreal anti-VEGF injections for DME treatment was observed in Korea. However, the frequency of dosing and monitoring was lower in clinical practice versus major clinical trials, which may have led to the less-than-favorable improvements in visual outcomes.
Subject(s)
Humans , Adrenal Cortex Hormones , Cohort Studies , Delivery of Health Care , Demography , Endothelial Growth Factors , Intravitreal Injections , Korea , Laser Therapy , Macular Edema , Ophthalmology , Practice Patterns, Physicians' , Retrospective Studies , Visual AcuityABSTRACT
Objective To investigate the current situation of clinical practice mode of intensive care unit specialist nurses in Chongqing city, and to provide reference for the construction of standardized clinical practice mode of intensive care unit specialist nurses. Methods A self-designed questionnaire was used to investigate and analyze the 509 students who participated in the training of intensive care unit nurses in Chongqing city. Results Clinical practice time was 2 months, the practice base could meet the clinical practice needs of clinical nurses, clinical practice and assessment methods were varied, but the time arrangement was not reasonable (6.67%, 29/435), the practice content lacked the pertinence (5.52%, 24/435), the teaching method was not reasonable (2.76%, 12/435), the teacher capital was not qualified (1.38%, 6/435) and so on. Conclusions The clinical practice base and teaching staff needs to be improved, and the clinical practice pattern of intensive care unit specialist nurses is good, but the ability to recognize it is not in place. Should be guided by the needs of nurses, under the supervision of the health department, construction of training bases, training in line with the requirements of clinical teachers, strengthen the ability of students to understand, to help study the clinical application of knowledge and skills.
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Objective Constructing a scientific and practical clinical practice patterns for intensive care nursing masters with professional degree.Methods Based on the competence based education,a clinical practice patterns for intensive care nursing master with professional degree was developed by literature review,questionnaire survey,unstructured interview and Delphi technique.Results 16 experts from 10 third-level and first-class hospitals and 1 Nursing College were consulted,the retrieving rates of questionnaire were 93.75％,100.00％,respectively.The authoritative coefficients were 0.94 and the coordination coefficients were 0.257.The index system consisted of 6 first dimensions,47 second-dimensions and 112 items.Conclusions The positivity and authority of experts in this study were in high degree,the concentration and harmonization of experts' opinions were relatively high.The results had high reliability and feasibility.It can be used to provide objective and quantitative reference for intensive care nursing master with professional degree.
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Objective To investigate the status of clinical practice of master of nursing specialist (MNS) and provide references for completing the clinical practice patterns of master of nursing specialist in intensive care units.Methods Totally 56 clinical nursing postgraduate students were investigated from 10 nursing colleges by questionnaire survey.Results 46.43％ students were not satisfied with effect of clinical practice;69.64％ students though there was little difference between postgraduate and undergraduate students in clinical teaching method; 82.14％ students considered clinical teachers couldn't meet their leaming needs; the main reasons affecting the effect of clinical practice included inadequate teaching method (73.21％),impertinent teaching contents (69.64％) and unreasonable time arrangement (51.79％);55.36％ students wanted to be nursing educators; 50.00％ students wanted to be nursing specialist.Conclusions The effect of clinical practice of clinical nursing postgraduate students did not achieve the target.Clinical teaching couldn't meet the learning needs.Students are lack of recognition to capability and quality of master of nursing specialist.We should highlight the special characteristics of intensive care nursing,regulate the clinical teaching method and strengthen the publicity of master of nursing specialist to optimize structure of nursing talent.
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PURPOSE: The objective of this study was to evaluate the change in the practice patterns for managing hereditary breast and ovarian cancer (HBOC) among Korean physicians after the Korean Hereditary Breast Cancer (KOHBRA) study. METHODS: The first survey was performed from July to August 2007, at the initiation of the KOHBRA study, and the follow-up survey was conducted from July to December 2009. Members of the Korean Breast Cancer Society were invited to participate in the study by e-mail. The 2009 survey was conducted with a self-administered questionnaire concerning HBOC management and was identical to the previous questionnaire. RESULTS: According to the 2009 survey, most physicians (60.0%) tended to draw a pedigree (48.0% in 2007 survey). The rate of genetic test recommendations for patients at risk for HBOC was higher in the 2009 survey (84.0%) than that in the 2007 survey (64.0%). Physicians tended to select a BRCA genetic testing candidate more appropriately than in the previous survey (42.4% answered right in 2007 survey; 74.4% in 2009 survey). Fifteen of 25 participants (60.0%) provided genetic counseling before their patients underwent a genetic test, which was higher than that (40.0%) in the 2007 survey. According to the 2009 survey, half of the genetic counseling was being conducted by KOHBRA study research nurses; whereas most of the genetic counseling was conducted by physicians in 2007. CONCLUSION: The KOHBRA study has played an important role in the appropriate selection of candidates for genetic testing. However, more effort should be placed on improving the pre-test genetic counseling rate.