Negative perceptions of dental stimuli and their effects on dental fear.

PURPOSE: About 40% of modern western society are apprehensive about dental visits, 20% are highly fearful, and 5% avoid oral health care completely. This study examined how negative perceptions of dental stimuli contribute to dental fear. METHODS: One-hundred-and-seven people recruited from a dental school clinic and a private practice, participated in the study. Each participant completed measures of general dental anxiety (DAS-R) and negative perception of specific dental stimuli (DFAS). Upon completion of the scales, data were coded and analyzed using Statistical Package for Social Sciences. RESULTS: Data analyses revealed a significant correlation between negative perceptions of common dental stimuli and dental fear (p < .05). Getting an injection, having dental radiographs taken, use of scalers and curets, and the sight of the needle were identified as the dental stimuli evoking the highest negative perceptions by the sample. CONCLUSION: Because exposure to certain stimuli triggers dental fear, it is important to identify anxious oral health care patients, and oral health care providers must be sensitive to their fear. Providing a positive experience will help to lower negative perceptions of oral health care. If particular stimuli produce anxiety and fear, then ways to limit exposure to them is necessary.

Teaching health-care providers coping: results of a two-year study.

This study examined coping strategies and occupational burnout in a sample of 118 health-care providers. Subjects who participated in a 6-week program designed to improve coping reported significant short-term decreases in emotional exhaustion and lack of personal accomplishment, two dimensions of burnout. Subjects who received 1-hr coping "refresher" sessions at 5, 11, and 17 months showed consistent decreases in burnout throughout the 2-year period. However, those who did not receive the refresher sessions following the 6-week course showed only temporary improvement. Results indicate that health-care providers can be taught to employ adaptive coping strategies that improve levels of burnout, but long-term changes are achieved only through long-term coping training.

Disease chronicity and quality of care in hospital readmissions.

The study described in this article examined disease chronicity and quality of care and their relationship to hospital readmissions during a 3-month period. Results showed that readmissions due to disease chronicity were significantly more prevalent than for other categories. Illnesses, including pulmonary disease, heart failure, and cancer, ranked as leading causes for readmission, whereas readmissions due to quality of care or complications most often resulted from a previous admission for surgery. This study's findings demonstrate that using readmission rates alone as indicators of poor care can be misleading.

Influences of hypothyroidism on the taste detection performance of rats: a signal detection analysis.

The influences of hypothyroidism on behavioral measures of the taste function in male and female Long-Evans rats were determined. Experimental rats' preferences for and ability to detect NaCl, HCl, sucrose, and quinine sulfate were examined before, during, and after 9 weeks of maintenance on 0.1% propylthiouracil (PTU), an agent that produces marked hypothyroidism, with similar determinations made for control animals. Despite significant decreases in PTU-treated rats' serum triiodothyronine (T3) and thyroxin (T4), there were no changes in sensitivity or responsivity to the target tastants. However, altered preferences for NaCl, HCl, and quinine sulfate were observed for PTU-treated rats; elevated consumption of HCl and quinine sulfate was present at the end of the study when serum T3 and T4 had returned to near-baseline levels. The data confirm observations that PTU-induced hypothyroidism alters rats' taste preference behavior.

Methyl xanthine, adenosine, and human taste responsivity.

The influences of three methyl xanthines (MX) on human taste responsivity, caffeine, theophylline, and theobromine, were examined using blind control procedures. Taste responsivity in the same subjects was determined using the matching procedure described by Schiffman (Study 1) and the whole-mouth procedure described by Sheperd (Study 2). In each study, the duration of MX pretreatment necessary to enhance taste responsivity was examined. No potentiation of overall- and taste-quality specific intensity ratings was observed for any tastant, independent of test procedure, type, and concentration of MX pretreatment, or length of MX pretreatment. Taste intensity ratings, especially for NaCl, were higher following pretreatment with water than methyl xanthine or adenosine combined with caffeine. Adenosine, added at several concentrations to caffeine pretreatments, influenced neither taste responsivity nor taste intensity ratings.

Quality-specific differences in rat taste detection performance as a function of stimulus volume.

Taste detection performance for representatives of the four taste qualities as a function of stimulus volume (5 x 10(-4) to 1 x 1(-1) ml) was examined in rats using high-precision gustometry, computer-controlled operant procedures, nonparametric signal detection measures of sensitivity and responsivity, and blind control procedures. The overall sensitivity index was positively related to stimulus volume (rs = .60), with optimal detection performance attained with a 5 x 10(-3) ml stimulus volume for salty tastants and a 1 x 10(-2) ml stimulus volume for the other taste qualities. The overall responsivity index was inversely related to stimulus volume (rs = -.47), especially for sour and bitter tastants. These results are consistent with prior observations and demonstrate that operant methods using small tastant samples produce sensitive estimates of the rat's taste detection performance and response bias.

A report on a state-wide community mental health center outcome study.

The Washington State Mental Health Outcome Study was intended (a) to collect descriptive data on the status of a cross-sectional sample of the client caseload in state mental health centers, and descriptive data on the change between admission and 90-day follow-up of a sample of new admissions to the centers, and (b) to test the feasibility of state-wide mental health outcome studies. Results show highly significant changes between pre- and post-treatment interviews, although since there is no control group the changes cannot be attributed to the treatment programs. The data have been used by state level mental health administrators in presentations to the legislature and to community groups. The Washington strategy is compared with two other approaches to state-wide mental health outcome.