Factors Modulating Fallow Period of Aerosol-Generating Dental Procedures in a Clinical Setting.

The COVID-19 pandemic has resulted in amended regulations and guidelines governing the practice of dentistry and dental hygiene to ensure the protection of both patients and clinicians from transmission of the SARS-CoV-2 virus. These guidelines include changes in personal protective equipment and, under some guidelines, the institution of a fallow period after any aerosol-generating procedure (AGP). This study aimed to investigate the effect of both ventilation and 4-handed dentistry in clinical practice with patients undergoing supportive periodontal therapy (SPT) by air polishing, ultrasonic and hand instrumentation in a closed operatory. We studied 34 patients during SPT using either 2- or 4-handed dentistry in an operatory with either 0 or 20 additional air changes/h (ACH). Under clinical conditions, 20 additional ACH are adequate to eliminate aerosols produced during an SPT and before the cessation of the AGP. The presence of an assistant had no significant effect on the time needed for aerosol particles to return to baseline values following the AGP. This study supports the efficacy of 20 additional ACH during the process of AGP, but does not support the need for an extended fallow period or 4-handed dentistry to provide additional high-volume evacuation throughout the procedure.

Evaluating Florida's Medicaid provider services network demonstration.

RESEARCH OBJECTIVE: To evaluate the design, development, and implementation of Florida's Medicaid provider service network (PSN) demonstration, and the implications of that demonstration for subsequent Medicaid Reform in Florida. DATA SOURCES, DATA COLLECTION: Organizational analyses were based on archival and enrollment data obtained from Florida's Medicaid program and the South Florida Community Care Network, as well as key informant interviews. Closely related fiscal analyses utilized Medicaid claims data from March 1999 through October 2001 extracted from the Florida Medicaid Management Information System. STUDY DESIGN: The organizational analyses reported here were based on a structured case study research design. PRINCIPAL FINDINGS: Almost every aspect of the development of the new organizational form (PSN) took longer and was more difficult than anticipated. Prior organizational experience with insurance functions proved to be an asset. While fiscal analyses indicated that the program saved the state of Florida a significant amount of money, tracking the precise origin of the savings proved to be challenging. CONCLUSIONS: By most standards, the PSN program was observed to meet its stated objectives. Based in part on this conclusion, the state chose to extend the use of PSNs within its 2006 Medicaid Reform initiative.

Florida nurse practitioners' attitudes and practices regarding oral cancer prevention and early detection.

PURPOSE: To examine Florida nurse practitioners' (NPs') attitudes and practices regarding oral cancer prevention and early detection. DATA SOURCE: A statewide mail survey was conducted among Florida NPs who provided primary care. The questionnaire was adapted from an existing survey instrument used to measure NPs' knowledge, attitudes, and practices about oral cancer prevention and early detection. A total of 448 Florida NPs (33% response rate) completed the survey. CONCLUSIONS: Florida NPs reportedly were not well prepared for oral cancer prevention and early detection. Although most NPs realized the importance of annual oral cancer screening for high-risk populations and held positive attitudes toward the benefit of early detection, only 39.3% of respondents thought his or her knowledge about oral cancer was current and more than half had never provided oral cancer examinations. IMPLICATIONS FOR PRACTICE: Florida has among the nation's highest oral cancer rates, but persons at highest risk are among those least likely to see a dentist. Therefore, a multidisciplinary approach involving all relevant healthcare providers, including NPs, may be more effective than relying only on dentists' efforts in improving survival rates for oral cancer. Strategies are needed to increase the involvement of Florida's NPs in oral cancer detection.

Variations in health insurance coverage for rural and urban nonelderly adult residents of Florida, Indiana, and Kansas.

CONTEXT: Evidence exists for differences in health insurance coverage among states, but less is known about variations across different kinds of communities within states. PURPOSE: This article assesses the role of residential setting (metropolitan county, rural adjacent, and rural nonadjacent) in health insurance coverage for adult residents, under age 65, using data from large-scale surveys collected in 3 diverse states (Florida, Indiana, and Kansas). METHODS: Descriptive statistics are provided, and logistic regression models are used to examine the relationship between uninsurance status and residential settings while controlling for personal characteristics. Adjusted uninsurance rates by residential settings are presented for each state. FINDINGS: Residential settings are significantly associated with uninsurance status in 2 of the 3 states we examined. We find that adult Floridians of rural adjacent counties are more likely to be uninsured than those in urban counties, but, for Indiana residents, uninsurance status is comparable between urban and rural adjacent residents. Rural nonadjacent Indiana residents are more likely to be uninsured compared to those in urban counties. The insurance status of adult Kansans does not vary across residential settings. CONCLUSION: Residential settings are significantly associated with being uninsured, but the significance of this link between residential locations and uninsurance status varies from state to state.

Enrollee satisfaction with three Florida Medicaid managed care programs.

A study was undertaken to compare adult enrollees' satisfaction with three Medicaid Programs operating in South Florida: (1) the provider service network (PSN), (2) MediPass, and (3) Medicaid HMOs. The Consumer Assessment of Health Plans Study 2.0 Medicaid Adult instrument was used to collect information on four global ratings and five composite ratings. MediPass enrollees were satisfied with their overall health care, whereas PSN enrollees gave only average scores for their doctors, specialists, overall health care, provider communication, and staff helpfulness. The HMO enrollees were satisfied with their specialists, health plan, access to care, promptness of care, staff helpfulness, and member/customer service. Improvements in satisfaction would require different interventions in each of the programs.