Comprehensive analysis of aerobic and anaerobic bacteria found on dental bib clips.

Multiple-use dental bib clips are considered to present relatively low risks for transmitting infections and, thus, are thought to only require disinfection between patient visits. This study was designed to: 1) determine the presence and composition of bacterial contaminants on reusable rubber-faced metal bib clips after dental treatment at the hygiene clinic at Tufts University School of Dental Medicine and 2) evaluate the effectiveness of the disinfection for this clip type. Aerobic and anaerobic bacterial contaminant loads on the surfaces of the clips were investigated immediately after hygiene treatments were rendered and again after clips were disinfected. The species and strains of bacterial isolates were identified using 16S rDNA sequencing and Human Oral Microbe Identification Microarray analyses. The results demonstrated that although the use of disinfection proved to be significantly effective, some clips retained at least one bacterium on their surfaces after disinfection. Although the bacterial species present on disinfected clips were typical skin or environmental isolates, some were oral in origin. In the study's settings, bacterial presence on the clips did not indicate an infectious disease problem. The different bacterial loads on clips suggest that cross-contamination risks may not be the same for all clinics, and that this difference may be related to the type of treatments and services performed.

PubMed instruction for medical students: searching for a better way.

In 2007, Duke University Medical Center Library instituted an interactive, online PubMed tutorial and quiz for medical students to replace an in-person lecture. This article describes the events leading to this educational paradigm shift and how the tutorial was implemented. Important concerns in the switch to an online approach to PubMed training were student satisfaction and the extent to which searching skills would improve. To determine the effectiveness of the online model, two years of student quizzes and evaluations were examined. Results indicate that students benefit from and appreciate the interactive tutorial.

Comparison of administrative-only versus administrative plus chart review data for reporting HEDIS hybrid measures.

OBJECTIVE: Health plans, medical groups, and commercial vendors are using administrative data to measure clinical performance at the plan or physician level. We compared results of using administrative claims data alone versus administrative data combined with chart review for selected Healthcare Effectiveness Data and Information Set (HEDIS) measures. STUDY DESIGN: Cross-sectional comparison of health plan performance rates using different methods of data collection. METHODS: We analyzed data reported by 283 commercial managed care plans in 2004 and 2006 for 15 HEDIS hybrid measures. Hybrid specifications included the use of administrative data supplemented with medical record review and required plans to report performance rates based on administrative data only and for administrative data supplemented with chart review. We calculated differences in rates and changes in quartile rankings of health plans between the 2 reported rates. RESULTS: Performance rates using administrative data alone were substantially lower than rates using combined data (average difference of 20.4 percentage points). On average, more than half of the plans had different quartile rankings based on administrative-only rates versus combined data rates. Measures relying on laboratory claims or laboratory results had the largest discrepancies. CONCLUSIONS: Currently available health plan administrative data alone do not appear to provide sufficiently complete results for ranking health plans on HEDIS quality-of-care measures with hybrid specifications. The results suggest that reporting of clinical performance measures using administrative data alone should include prior testing and reporting on the completeness of data, relative rates, and changes in rankings compared with the use of combined administrative data and chart review.

The influence of social environment and social image on adolescent smoking.

This purpose of this article is to explore differences by gender and school grade in patterns of association among social influences and tobacco use. Data from the 1999 (N = 15,038) and 2000 (N = 35,828) National Youth Tobacco Survey (American Legacy Foundation, 1999, 2000), a nationally representative, repeated cross-sectional survey, were used in the analysis. The authors compared effects on adolescent smoking. Direct paths from social environment to current smoking increased from middle school to high school. Indirect paths with social image mediating this relationship revealed a smaller increase. The pattern was constant across subsamples. Social image of smokers mediated the influence of social environment on adolescent smoking. Social image had a greater effect on smoking among middle school boys and high school girls.