Objectives
The 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions ushered in a new paradigm for assessing and classifying periodontal diseases. This has ...significant implications for dental hygiene (DH) education programs' curricula. The purpose of this international survey was to assess: if and how accredited DH education programs were integrating the new staging and grading system into their curricula, and program directors' perceptions of the barriers and benefits to integration and teaching it.
Methods
This study was deemed exempt from IRB oversight. A total of 339 undergraduate DH program directors from the US, Canada and Australia that had similar accreditation standards were recruited for the survey. An electronic survey was developed and disseminated via QualtricsXM. Survey design included demographics and other questions to assess program directors' knowledge, understanding, integration of and barriers to implementing the new staging and grading system into their curricula.
Results
A total of 140 surveys were completed, for a response rate of 42%. Results showed that 91% of DH education programs had integrated the new staging and grading system into their curricula. DH didactic/theory courses (99%) and clinical courses (94%) were the curricular areas hosting the content. There was a statistically significant difference in the confidence of teaching the staging and grading system across institutional settings (p = 0.02). The three main benefits identified were the consideration of expected disease progression (3.25 ± 2.06), individual risk factors (3.45 ± 1.73) and personalized treatment (4.04 ± 2.20). The most frequently reported barrier was the lack of faculty support (26%).
Conclusion
DH educators have implemented the new staging and grading system into their clinical and didactic curricula. DH educators valued the individual, patient‐specific components of the new system. While educators were confident in integrating the new system, those at community and technical colleges were less confident in teaching the system.
Full text
Available for:
CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
The reductive dissolution of hematite (α-Fe2O3) was investigated in a flow-through system using AH2DS, a reduced form of anthraquinone-2,6-disulfonate (AQDS), which is often used as a model electron ...shuttling compound in studies of dissimilatory microbial reduction of iron oxides. Influent flow rate, pH, and Fe(II) and phosphate concentrations were varied to investigate the redox kinetics in a flow-through reactor. The hematite reduction rates decreased with increasing pH from 4.5 to 7.6 and decreased with decreasing flow rate. The rates also decreased with increasing influent concentration of Fe(II) or phosphate that formed surface complexes at the experimental pH. Mineral surface properties, Fe(II) complexation reactions, and AQDS sorption on hematite surfaces were independently investigated for interpreting hematite reduction kinetics. AH2DS sorption to hematite was inferred from the parallel measurements of AQDS and AH2DS sorption to α-Al2O3, a redox stable analog of α-Fe2O3. Decreasing Fe(II) and increasing AH2DS sorption by controlling flow rate, influent pH, and Fe(II) and phosphate concentrations increased the rates of reductive dissolution. The rates were also affected by the redox reaction free energy when reductive dissolution approached equilibrium. This study demonstrated the importance of the geochemical variables for the reductive dissolution kinetics of iron oxides.
Full text
Available for:
IJS, KILJ, NUK, PNG, UL, UM
In 2016, Medicare's Hospital-Acquired Condition Reduction Program (HAC-RP) will reduce hospital payments by $364 million. Although observers have questioned the validity of certain HAC-RP measures, ...less attention has been paid to the determination of low-performing hospitals (bottom quartile) and the assignment of penalties. This study investigated possible bias in the HAC-RP by simulating hospitals' likelihood of being in the worst-performing quartile for 8 patient safety measures, assuming identical expected complication rates across hospitals. Simulated likelihood of being a poor performer varied with hospital size. This relationship depended on the measure's complication rate. For 3 of 8 measures examined, the equal-quality simulation identified poor performers similarly to empirical data (c-statistic approximately 0.7 or higher) and explained most of the variation in empirical performance by size (Efron's R
> 0.85). The Centers for Medicare & Medicaid Services could address potential bias in the HAC-RP by stratifying by hospital size or using a broader "all-harm" measure.
Medicare recently announced its intention to withhold additional payments for "serious preventable events."
Beginning in 2009, Medicare will withhold its usual additional payments associated with ...hospitalizations that included one of several potentially preventable adverse events, such as certain hospital-acquired infections, pressure ulcers, and retained surgical objects. Several more events are being considered for the future. A new coding category, "present on admission" (POA), has been added to identify patients whose adverse events occurred before the index hospitalization.
A "not paying for errors" policy seems reasonable if evidence demonstrates that most of the adverse events can be prevented by widespread adoption of achievable practices, the events can be measured accurately, the events resulted in clinically significant patient harm, and POA determination is feasible. Many of these criteria are met for the events in Medicare's starter set; but there are concerns about each event.
Although the new Medicare policy will undoubtedly lead to instances of unfairness, gaming, and unforeseen consequences, it may be effective. This initial implementation should be considered a bold experiment, whose consequences are carefully monitored. Additional research will be needed to help identify preventable adverse events and evidence-based strategies to prevent them.
Studying Students: A Second Look presents the results of further ethnographic projects within the University of Rochester's River Campus Libraries. Topics range from how college students "learn the ...ropes" to their use of technology and how they study and write their research papers. The volume also discusses what professors expect of their students and the similarities and differences among faculty, student and librarian research practices. Filled with ideas for applying the findings, the book provides additional insight into the place and role of libraries in the academy.
PDF
