The perspectives, barriers, and willingness of Utah dentists to engage in human papillomavirus (HPV) vaccine practices.

Including dental health providers in human papillomavirus (HPV) vaccination could reduce rising rates in HPV-associated oropharyngeal cancer (HPV-OPC). This study assessed Utah dentists' perspectives on providing HPV vaccination education and services in the dental setting. A cross-sectional, 70-item self-administered survey was conducted among a convenience sample of N = 203 practicing Utah dentists. Statistical analyses included Chi Square tests of independence, scaled scores and Cronbach's alpha coefficients. Majority of Utah dentists surveyed perceived that discussing the link between HPV and OPC and recommending the HPV vaccine is within their scope of practice, but not administration of the HPV vaccine. Dentists with >10 minutes of patient education per week were less likely to be concerned about the cultural, social norms or religious ideology of discussing HPV with their patients (p = .024). Rural dentists were more concerned about the safety and liability of the HPV vaccine (p = .011). Good internal consistency was observed survey items regarding barriers and willing to engage in HPV vaccination practices. Dental providers were interested in HPV training and patient education brochures as strategies, but less interested in administering the HPV vaccine. Dental associations support dentists' engagement in HPV education and HPV-OPC prevention. This is the first study in Utah to examine dentists' perspectives on HPV vaccination. Findings have implications for program planning, intervention development, and future research.

Chronic osteomyelitis of the hand caused by Salmonella typhimurium. A case report.

Salmonella osteomyelitis of the hand unassociated with hemoglobinopathy developed in a 39-year-old woman. After 11 debridement and curettage operations on the affected finger, she was successfully treated with excision of the diseased bone and reconstruction with a silicone prosthesis and extensor indicis transfer. This patient, examined 19 years after the onset of symptoms, illustrates that Salmonella osteomyelitis may persist for an exceedingly long period when limited curettage is the only method of treatment.

The economic costs and benefits of adding medical manpower to rural and urban communities: a human capital perspective.

For health planners to be able to use scarce resources efficiently and effectively to improve health, it is necessary for them to have reliable information on the productivity of the major categories of health producing expenditures. The present study utilizes a human capital perspective to evaluate the economic costs and benefits of medical manpower to communities in the West South Central United States. The results of the study suggest that beyond problems of maldistribution of physicians and nurses, the larger problem from an economic effectiveness perspective may be significant excesses of medical manpower, although some rural communities could justify, economically, adding physicians and/or nurses to reduce lost human capital. The findings indicate a need to further rationalize the allocation of health care resources as well as the need to consider means other than increased spending on curative medicine (e.g., health promotion and health education) as a strategy for efficiently meeting the objective of improving public health.