| | Medical Ethics: The Delinquent Patient | Medical Ethics: The Delinquent Patient
Medical Ethics: The Delinquent Patient
Patients are the lifeblood of a practice, considering that no practice can survive without patients. If you have a service that no patient is willing to pay for, you will never have a stable practice. Patients pay the bills and provide opportunities for your practice to grow.
However, sometimes patients are encountered in practice, who make the lives of the practitioner and staff miserable. Difficult patients can leave you and your staff angry, empty, and frustrated. The way difficult patients are handled will define the quality of the patient experience. Not knowing how to deal with difficult patients may lead to low staff morale, low patient volume and a damaged practice reputation.
At times, managing difficult patients can hinder your ability to get your work done. But if handling difficult patients is seen as an opportunity rather than trouble, you may find that you can strengthen your patient service skills while retaining their business.
Practicing medicine in your own private practice requires a fine balance between caring for patients and running a business. Harry Rosen
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| | Medical Ethics: Embelishment and Exaggeration in Practice | Medical Ethics: Embelishment and Exaggeration in Practice
Medical Ethics: Embelishment and Exaggeration in Practice
Overview
“I am so hungry I could eat a horse.” “This ice cream is out of this world.”
Exaggeration is common in everyday language, and phrases such as those stated above are well known. Embellishing stories about one's accomplishments or qualifications, whether by exaggeration or misstatement, is part of human nature, experts say, and almost everyone is guilty of it at one time or another. Left unchecked, however, exaggerations that seemed innocuous at first can result in serious, potentially career-ending consequences.
Thanks to the Internet, it is easier than ever to get caught in an exaggeration, experts and others note. But the temptation to embellish has also never been greater, as recession-weary workers feel pressured to justify their worth and a 24-hour news cycle demands that leaders have an immediate, sound-bite-ready answer for everything. If you are prone to exaggeration, however, this could mean that you habitually overstate the truth.
This article examines exaggeration in all its guises but with a particular reference to the risks and responsibilities of a health care provider.
Harry Rosen
| 3 | | R485.00 |  |
| | Medical Ethics: Ethical Challenges: Beyond Covid | Medical Ethics: Ethical Challenges: Beyond Covid
Medical Ethics: Ethical Challenges: Beyond Covid
Overview
“Ethical challenges will intensify as the pandemic wanes”.
The disruptions caused by COVID-19 have heightened the risk of unethical behaviour in different sectors, including in healthcare, where trust is our lifeblood. We’ve seen an outbreak of misinformation during the pandemic, ranging from fake cures, false claims, and harmful health advice. We’ve seen bad-acting opportunists take advantage to trade illegitimate or non-compliant products.
For the past two and a half years, the world has been duly tested by the challenges resulting primarily from the COVID-19 pandemic. In response, health care providers have shown tremendous resilience. However, as jurisdictions around the world progressed toward a more hopeful future, the ethical challenges health care providers face are far from over.
In fact, they might intensify.
As the pandemic fades, but taking cognisance of continued threats such as the ‘5th and 6th wave’ in South Africa, many entities as well as individuals will be eager to demonstrate their potential by posting quick wins and an accelerating recovery. Others will continue to navigate the intricacies of government support schemes, and, as those taper, some entities will find themselves on the brink of insolvency. Just as the economic impacts of this crisis unfolded in an uneven and unpredictable manner around the world, so too will recovery efforts. Health care providers must anticipate a continued period of heightened uncertainty and prioritize their ethical responsibilities all the more.
Harry Rosen
| 3 | | R425.00 |  |
| | Medical Ethics: The Rule of Law in Turbulent Times | Medical Ethics: The Rule of Law in Turbulent Times
Medical Ethics: The Rule of Law in Turbulent Times
Overview
Primarily, as a result of the advent of Covid, planet Earth has been thrown off its axis. South Africa is no exception, with the added aggravation and devastation due to looting, floods, etc. The consequences to practitioners, practice staff, families and patients have been immeasurable.
Within this turmoil, there have been an avalanche of diverse factors and forces introduced into the healthcare arena, that, in way or another, impact or have the potential to impact on practices. These factors are discussed in this study.
Harry Rosen
| 3 | | R485.00 |  |
| | Medical Ethics: Ethical Pitfalls in Practice | Medical Ethics: Ethical Pitfalls in Practice
Medical Ethics: Ethical Pitfalls in Practice
Overview
We live in a world where we face challenges daily. In technical terms, Ethical Pitfalls relate to that field of research, within the ambit of behavioural ethics , which focuses on how people behave when they're confronted with dilemmas and respond in ways that contradict their values, without even knowing they're doing it. In essence, the conduct of practitioners or staff may knowingly or unknowingly transgress existing ethical boundaries.
In practical terms, when an activity in a practice environment conflicts with moral human principles and affects individuals involved working within the practice, it becomes an ethical issue. While regulator-enforced rules can hold employees and employers accountable for lawbreaking conduct, they can't entirely prevent individuals from acting unethically. Thus, it is the responsibility of the practice owner to address ethical concerns and establish clear guidelines. This coursed discusses this ethical issue.
Harry Rosen
| 3 | | R465.00 |  |
| | Medical Ethics - Ethics in Practice | Medical Ethics - Ethics in Practice
Medical Ethics - Ethics in Practice
Overview Ethical issues in a practice environment can be a difficult challenge to navigate for any practice owner. Though there are laws and statutes that exist to hold workers and employers accountable, these alone do not entirely deter employees from behaving unethically. Avoiding ethical issues in the practice always starts with top management. Providing clearly written policies and processes that ensure those policies are both acknowledged and adhered to, can ensure transparency and ethical practices are applied. To effectively detect and, most importantly, deter ethical issues in practice from surfacing in your organization, there are several everyday efforts you can take. Be sure to communicate and enforce a robust code of ethics when making decisions and ask the same of your employees. Remain aware of the discrimination laws that exist in your region. Stay informed on the rules that impact your industry, and ensure your organization is acting in compliance with those regulations. Collaborate with accountants, maintaining transparency and honesty in your financial reports. Be present in your company, making sure your organization and employees alike are always doing the right and ethical thing.
Authors Harry Rosen
| 3 | | R460.00 |  |
| | Medical Ethics: Professional Practice: A Moral Enterprise | Medical Ethics: Professional Practice: A Moral Enterprise
Medical Ethics: Professional Practice: A Moral Enterprise
Overview Practice as a health care professional is based upon a relationship of mutual trust between patients and health care practitioners. From the perspective of the Health Professions Council of South Africa (HPCSA), to be a good health care practitioner, requires a life-long commitment to sound professional and ethical practices and an overriding dedication to the interests of one’s fellow human beings and society. In essence, the practice of health care professions is considered a moral enterprise. In this spirit the HPCSA presents ethical guidelines to guide and direct the practice of health care practitioners, primarily to protect the public. These guidelines form an integral part of the standards of professional conduct against which a complaint of professional misconduct is evaluated. Conducting business ethically is critical to a company’s success in the marketplace. Customers, suppliers and employees will not support a company that is involved in fraudulent, dishonest or unethical practices. Setting high standards of integrity in business relations and promoting their adherence by employees will enable the company to merit the confidence and support of its customers and the public at large.
Author Harry Rosen
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| | Medical Ethics: Ethical frameworks for complex medical decision making in older patients: A narrative review | Medical Ethics: Ethical frameworks for complex medical decision making in older patients: A narrative review
Medical Ethics: Ethical frameworks for complex medical decision making in older patients: A narrative review
Overview With an ageing population, physicians are more and more faced with complex medical and moral situations. Medical professional guidelines are often of limited use in these cases. To assist the decision-making process, several ethical frameworks have been proposed. Ethical frameworks are analytical tools that are designed to assist physicians and other involved healthcare workers in complex moral decision-making situations. Most frameworks are step-by-step plans that can be followed chronologically during moral case deliberations. Some of these step-by-step plans provide specific moral guidance as to what would constitute a morally acceptable conclusion, while others do not. In this narrative review we will present and discuss the ethical frameworks used for medically complex situations in older people that have been proposed in literature. Twenty-three studies were included in the review, containing seventeen different frameworks. Twenty studies described step-by-step-frameworks, with the number of steps varying from three to twelve. In four studies suggestions were made as how to balance conflicting moral values. Ethical frameworks are meant to assist healthcare professionals who are faced with morally complex decisions in older patients. In our view, these frameworks should contain a step-by-step plan, moral values and an approach to balancing moral values.
Acknowledgements: Authors Rozemarijn Lidewij van Bruchem-Visser, Gert van Dijk, Inez de Beaufort, Francesco Mattace-Raso Journal Archives of Gerontology and Geriatrics
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| | Medical Ethics: Managed Health Care: Protestation and Dissent? | Medical Ethics: Managed Health Care: Protestation and Dissent?
Medical Ethics: Managed Health Care: Protestation and Dissent?
Overview Recent times has put the words ‘dissent’ and ‘protest’ at the centre of our vocabulary. Practitioners are speaking out against perceived injustices, voicing opposition to interventions they disagree with and organising to effect change. ‘Dissent’ is an expression of opinions at variance with those commonly or officially held. ‘Protest’ is closely related to ‘dissent’ but they are different. ‘Protest is an expression or declaration of objection or disapproval, often in opposition to something where a person is considered powerless to prevent or avoid’. Managed care for SA healthcare in general, is a fact of life. In essence, for the purpose of this article, Managed Health Care can be defined as a group of activities intended to reduce costs of health care provision and providing health insurance whilst improving the quality of care. Managed care, in practical terms encompasses the management of cost, management of information and management of risk.
It is important for practitioners to have a reasonable understanding of the principles of managed care and the role of the Managed Care Organisations. At times, there are cries of foul play aimed at the interventions instituted by the managed Care Organisations where, in fact, such interventions are indeed lawful.
Author Harry Rosen
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| | Medical Ethics: Ethics in Practice -The Obligations that Define a Profession | Medical Ethics: Ethics in Practice -The Obligations that Define a Profession
Medical Ethics: Ethics in Practice -The Obligations that Define a Profession
Overview The use of the word ‘profession’ has expanded so far beyond its original meaning that a clear definition has become obscured and marred by colloquial usage. It is not uncommon to find the term ‘professional’ misused to describe sportsmen, tradesmen and even politicians. Yet, when we speak about a ‘professional’ there is a tacit understanding that only individuals engaged in certain occupations belong to that category: doctors, lawyers, teachers. A fundamental distinction between a profession and any other occupation, is that individuals engaged in a profession have an ethical obligation to whomever they provide their services. In other words, a profession is required to have a Code of Ethics. Unlike laws and regulations, which are prescriptive and rigid, the principles of ethics are flexible and how they are applied depends on the individual practitioner. It is these responsibilities and expectations that are the hallmarks of a profession.
Author Harry Rosen
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| | Medical Ethics - A Labour Intensive 2020 | Medical Ethics - A Labour Intensive 2020
Medical Ethics - A Labour Intensive 2020
A PRACTICAL GUIDE TO LABOUR RELATED ETHICAL AND LEGISLATIVE CHALLENGES IN 2020
Overview The year 2020 has created a world characterised by ‘new norms’, not all of which are because of the COVID 19 pandemic. Examples include the introduction of parental leave entitlement in January 2020 which has been on the cards for some time. Nevertheless, considering the avalanche of information relating specifically to the pandemic, much of which is contradictory , confusion persists for both practice owners and employees when faced with challenges encountered in practice and where the desired guidelines appear unclear.
This article addresses commonly encountered experiences in practice in the form of a practical guide to both practitioner and staff member, employer and employee and encompasses Family Responsibility Leave, new Parental Leave legislation, Smoking at Work, Retirement, Chairing Disciplinary Hearings and COVID 19 in the workplace. This article is entitled ‘Labour Intensive 2020’ which indicates a large amount of work in relation to outputs. Indeed, there is work involved to ensure that the appropriate procedures and actions are instituted in accordance with existing ethical and legislative frameworks.
Nevertheless, there is a well-known axiom that states that the amount of energy required to fix something is far greater than the energy required to prevent it.
Author Harry Rosen
| 3 | | R460.00 |  |
| | Medical Ethics: Social Media Violations | Medical Ethics: Social Media Violations
Medical Ethics: Social Media Violations
“I remember when Blackberry and Apple were just fruits.” Overview
In practical terms, social media increase connectivity and is one of the fastest growing industries in the world.
Social media are forms of electronic communication (such as websites for social networking and microblogging) through which users create online communities to share information, ideas, personal messages, and other content (such as videos)
Businesses large and small are turning to social media as an outreach to potential customers worldwide, to advertise their products and services, and to engage with customers. In recent times we have seen how social signals are becoming an important part of search engine optimization.
There is no doubt that a well- planned social media strategy has the potential to make or take down a brand. For example, Lady Gaga (personal branding) quickly became a smash hit, and social media played a major role in her rise to stardom. Facebook, Twitter, Instagram and all other social media websites are great communication tools. After all, they help us be connected to people from all over the world. However, if poorly managed they can cause huge damage.
Author Harry Rosen
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| | Medical Ethics: Ethical Guidelines to Social Media | Medical Ethics: Ethical Guidelines to Social Media
Medical Ethics: Ethical Guidelines to Social Media
Ethical Guidelines Social Media Overview
This guideline was developed to help health practitioners understand their obligations when using Social Media. The guideline applies to all health practitioners registered with the Health Professions Council of South Africa Social Media describes the online tools and electronic platforms that people use to share content such as opinions, information, photos, videos, and audio. The use of Social Media is expanding rapidly as individuals and organisations are embracing user-generated content through social networks, internet forums and personal blogs. Health professionals need to be aware that there are potential risks involved in the sharing of information via Social Media, even if the consequences are unintended. A key objective of the HPCSA and its Professional Boards is to guide the profession and protect the public. Some health practitioners may find Social Media beneficial as it allows them to keep updated on the latest healthcare developments through reputable user generated content. Acknowledgement Journal: Ethical and Professional Rules of the Health Professions Council of South Africa
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| | Medical Ethics: Ethical Guidelines for the Withholding and Withdrawing of Treatment | Medical Ethics: Ethical Guidelines for the Withholding and Withdrawing of Treatment
Medical Ethics: Ethical Guidelines for the Withholding and Withdrawing of Treatment
Overview
Health care practitioners have a responsibility to make the care of their patients their first concern. The guidance in these guidelines is intended to provide an ethical framework of good practice for health care practitioners in circumstances where they are faced with making a decision on whether to withhold or withdraw life-prolonging treatment. It takes account of existing law in this area, that allowing for withholding and withdrawing of life sustaining treatments and that which prohibits killing, active euthanasia, and assisted suicide.
The health care professional may alleviate the suffering of a terminally ill patient by withholding treatment i.e. allowing the natural process of death to follow its course, provided there is consultation with another health care practitioner who is an expert in the field, and where available, discussions with the closest relatives. The HPCSA also expects health care practitioners to observe the provisions of the World Medical Association Declaration on Terminal Illness.
Acknowledgement
Journal: Ethical and Professional Rules of the Health Professions Council of South Africa
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| | Medical Ethics: Artificial Intelligence Ethics – Too Principled to Fail? | Medical Ethics: Artificial Intelligence Ethics – Too Principled to Fail?
Medical Ethics: Artificial Intelligence Ethics – Too Principled to Fail?
Overview
AI Ethics is now a global topic of discussion in academic and policy circles. At least 63 public-private initiatives have produced statements describing high-level principles, values, and other tenets to guide the ethical development, deployment, and governance of AI. According to recent meta-analyses, AI Ethics has seemingly converged on a set of principles that closely resemble the four classic principles of medical ethics. Despite the initial credibility granted to a principled approach to AI Ethics by the connection to principles in medical ethics, there are reasons to be concerned about its future impact on AI development and governance. Significant differences exist between medicine and AI development that suggest a principled approach in the latter may not enjoy success comparable to the former. Compared to medicine, AI development lacks (1) common aims and fiduciary duties, (2) professional history and norms, (3) proven methods to translate principles into practice, and (4) robust legal and professional accountability mechanisms. These differences suggest we should not yet celebrate consensus around high-level principles that hide deep political and normative disagreement.
Acknowledgment Author
Brent Mittelstadti Journal
Nature Machine Intelligence November 2019
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| | Medical Ethics: What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics | Medical Ethics: What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics
Medical Ethics: What is the place for philosophy within the field of medicine? A review of contemporary issues in medical ethics
Overview This extended essay seeks to unpack some of the key aspects of philosophy which are applicable to medical thought and practice. It proceeds via an analytical discussion of the contemporary debate in three key areas of medical ethics: euthanasia, concepts of health and disease and psychiatry. The main claims are as follows:
1. The case for legalising euthanasia is strong on philosophical grounds but there are numerous practical obstacles. 2. Elements from the normative and naturalistic definitions of disease are necessary for a thorough definition that dodges common objections to either. 3. Mental health cannot be subsumed under a purely physicalist model of health rendering it distinctly different from other fields in Medicine.
Through a detailed discussion of three salient issues in the philosophy of medicine, it is argued that the application of profound philosophical thought to medicine and its practices reveals a depth that necessitates exploration before simply following the aims of curing all. Philosophical rigour matched with modern medicine has the potential to engage patients and help them make independent, informed decisions and assist physicians to think more clearly, analytically and empathetically.
Acknowledgement
Author Richard Fenton Journal Philosophy, Ethics and Humanities in Medicine
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| | Medical Ethics: Medical Students’ Perspectives on Euthanasia and Physician Assisted Suicide and Their Views on Legalising These Practices in SA | Medical Ethics: Medical Students’ Perspectives on Euthanasia and Physician Assisted Suicide and Their Views on Legalising These Practices in SA
Medical Ethics: Medical Students’ Perspectives on Euthanasia and Physician Assisted Suicide and Their Views on Legalising These Practices in SA
Overview
Euthanasia/physician assisted suicide have been a controversial and sometimes taboo topic for a long time, not only in SA but also internationally. A recent (SA) judicial case has seen the topic debated again. Consensus on accepting or abolishing these practices in SA has yet to be reached. All relevant role players need to be adequately engaged before policy can be informed.
The objectives were to determine the views of future doctors (medical students) regarding euthanasia and physician-assisted suicide (PAS) and to ascertain their stance on its legalisation in South Africa (SA).
Many factors influenced participants’ responses, but differences in opinion between and within the various religious groups were particularly evident in the responses received/ More than half the respondents in this study were open to legalising euthanasia/PAS, substantially more than in previous studies. However, only 41.9% of respondents would consider performing euthanasia/ PAS, for certain patients. Views of other healthcare workers as well as the public are required before policy can be informed.
Acknowledgement
Authors R K Jacobs and M Hendricks
Journal SAMJ RESEARCH
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| | QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient | QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient
QTc interval prolongation during favipiravir therapy in an Ebolavirus-infected patient
Overview
Life-threatening arrhythmia may be induced by corrected QT (QTc) interval prolongation. Several antimicrobial drugs have been associated with QTc interval prolongation. Favipiravir is an inhibitor of the RNA-dependent RNA polymerase of many RNA viruses, including influenza viruses, arenaviruses, phleboviruses, hantaviruses, flaviviruses, enteroviruses, and noroviruses. Favipiravir has also been used in the recent epidemic of Ebolavirus (EBOV) in West Africa. To date, no significant effects of favipiravir on the QT/QTc interval have been detected. We report a case of QTc interval prolongation during favipiravir therapy in an EBOV-infected patient treated at our institution.
In conclusion, we suggest that favipiravir administered at high doses, together with the cofactors discussed above, may have contributed to inducing a QTc interval prolongation in our EBOV patient. If feasible, ECG monitoring could be advisable during high-dose favipiravir therapy, especially when patients experience electrolyte disturbances and concomitant use of drugs with QTc-prolonging potential. Encephalitis or central nervous system (CNS) pathology may have a role in prolonging QT interval. Acknowledgement
Authors Pierangelo Chinello, Nicola Petrosillo, Silvia Pittalis, Gianluigi Biava, Giuseppe Ippolito, Emanuele Nicastri, on behalf of the INMI Ebola Team
Journal PLoS Neglected Tropical Diseases
Publisher Cross Mark
| 3 | | R390.00 |  |
| | Ebolaviruses: New roles for old proteins | Ebolaviruses: New roles for old proteins
Ebolaviruses: New roles for old proteins
Overview
In 2014, the world witnessed the largest Ebolavirus outbreak in recorded history. The subsequent humanitarian effort spurred extensive research, significantly enhancing our understanding of ebolavirus replication and pathogenicity. The main functions of each ebolavirus protein have been studied extensively since the discovery of the virus in 1976; however, the recent expansion of ebolavirus research has led to the discovery of new protein functions. The international containment effort spurred extensive research that is enhancing.
These newly discovered roles are revealing new mechanisms of virus replication and pathogenicity, whilst enhancing our understanding of the broad functions of each ebolavirus viral protein (VP). Many of these new functions appear to be unrelated to the protein's primary function during virus replication. Such new functions range from bystander T-lymphocyte death caused by VP40-secreted exosomes to new roles for VP24 in viral particle formation. This review highlights the newly discovered roles of ebolavirus proteins in order to provide a more encompassing view of ebolavirus replication and pathogenicity. This review highlights the newly discovered roles of ebolavirus proteins in order to provide a more encompassing view of ebolavirus replication and pathogenicity.
Acknowledgement Authors Diego Cantoni and Jeremy S. Rossman Journal PLoS Neglected Tropical Diseases Publisher Cross Mark
| 3 | | R420.00 |  |
| | Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights | Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights
Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights
Medical Ethics: Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights
Overview
South Africa is a country with two distinct health sectors, which are both characterised by inequalities. Within this context, patients with end stage renal disease face unique and sometimes impenetrable barriers to accessing dialysis. There are a number of reasons for this situation, which include the South African government’s endorsement of discordant, unequal policies, which disadvantage the most vulnerable; a lack of robust national guidelines; and divisive rationing practices, which are ad hoc and place the burden of responsibility for rationing dialysis on the clinician.
In this paper, we trace the socio-economic mechanisms of how we have come to be in this situation, and overlay this with a detailed examination of South African legislation. Finally, we make comprehensive practical recommendations for rectifying the situation, which include engagement with key stakeholders, public-private partnerships, and more equitable funding mechanisms.
Acknowledgement
Authors Harriet Etheredge and June Fabian
Journal Healthcare (Basel) Volume 5 Issue 3
| 3 | | R455.00 |  |
| | Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa | Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa
Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa
Medical Ethics: Because I want to be informed, to be part of the decision-making”: Patients’ insights on informed consent practices by healthcare professionals in South Africa
Overview
Informed consent (IC) is a legally enforceable right in South Africa based on constitutionally protected rights to bodily integrity and well-being. In terms of the law, patients cannot be involved in medical treatment or research without IC. Healthcare providers must inform patients about diagnosis, risks, benefits, treatment options, and right of refusal in a language that patients understand based their literacy level. This study reports an empirical study on patients’ perceptions of IC as practiced by doctors and nurses in South Africa.
This study reveals that South African patients are aware of the right to IC, but many were vulnerable due to indigence. Barriers to IC include poverty, language, and low educational level. South African patients prefer disclosure of all material risks, better communication skills by healthcare workers, and a shift toward informed or shared healthcare decision-making.
Acknowledgement
Author Chima SC
Journal Nigerian Journal of Clinical Practice Suppl:S46-56.
Publisher: Wolters Kluwer - Medknow
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| | Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s). | Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s).
Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s).
Characteristics and predictors for Gastro-intestinal haemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s).
Overview
Gastrointestinal (GI) bleeding is a leading cause of death in dengue. This study aims to identify predictors for GI bleeding in adult dengue patients, emphasizing the impact of existing co-morbid disease(s). Of 1300 adults with dengue virus infection, 175 (mean age, 56.5±13.7 years) patients with GI bleeding and 1,125 (mean age, 49.2±15.6 years) without GI bleeding (controls) were retrospectively analyzed.
Our study is the first to disclose that end stage renal disease and previous stroke, with additional co-morbidities, were strongly significant associated with the risk of GI bleeding in patients with dengue virus infection. Identification of these risk factors can be incorporated into the patient assessment and management protocol of dengue virus infection to reduce its mortality. Our study emphasizes that, in addition to older age and thrombocytopenia , end stage renal disease and previous stroke, with additional co-morbidities, are important clinical predictor of GI bleeding in adult patients with DENV infection. More studies, particularly prospective studies are required to validate these findings for better generalization of their clinical utility.
Acknowledgement
Author Wen-Chi Huang, Ing-Kit Lee, Yi-Chun Chen, Ching-Yen Tsai and Jien-Wei Liu.
Journal PLoS ONE Volume 13 Issue 2
Publisher Cross Mark
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819790/pdf/pone.0192919.pdf
| 3 | | R470.00 |  |
| | Structure and assembly of the Ebola virus nucleocapsid | Structure and assembly of the Ebola virus nucleocapsid
Structure and assembly of the Ebola virus nucleocapsid
Structure and assembly of the Ebola virus nucleocapsid
Overview
Ebola and Marburg viruses are filoviruses: filamentous, enveloped viruses that cause haemorrhagic fever1. Filoviruses are within the order Mononegavirales2 which also includes rabies virus, measles virus, and respiratory syncytial virus. Mononegaviruses have non-segmented, single-stranded negative-sense RNA genomes that are encapsidated by nucleoprotein (NP) and other viral proteins to form a helical nucleocapsid (NC). NC acts as a scaffold for virus assembly and as a template for genome transcription and replication. Insights into NP-NP interactions have been derived from structural studies of oligomerized, RNA-encapsidating NP3–6 and cryo-electron microscopy (cryo-EM) of NC7–12 or NC-like structures11–13. There have been no high-resolution reconstructions of complete mononegavirus NCs.
Here, we have applied cryo-electron tomography and sub-tomogram averaging to determine the structure of Ebola virus NC within intact viruses and recombinant NC-like assemblies. These structures reveal the identity and arrangement of the NC components, and suggest that the formation of an extended alpha-helix from the disordered C-terminal region of NP-core links NP oligomerization, NC condensation, RNA encapsidation, and accessory protein recruitment. Acknowledgement
Author William Wan, Larissa Kolesnikova, Mairi Clarke, Alexander Koehler, Takeshi Noda, Stephan Becker and John A. G. Briggs.
Journal Nature. 2017 November 16; 551(7680-397)
Publisher URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714281/pdf/emss-74396.pdf
| 3 | | R455.00 |  |
| | Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening | Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening
Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening
Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening Overview
The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening.
During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. This model of a mobile laboratory equipped with Xpert Ebola test, staffed by local laboratory technicians, could serve to strengthen outbreak preparedness and response for future outbreaks of EVD in Liberia and the region.
Acknowledgement
Authors Philomena Raftery, Orla Condell, Christine Wasunna, Jonathan Kpaka, Ruth Zwizwai, Mahmood Nuha, Mosoka Fallah, Maxwell Freeman, Victoria Harris, Mark Miller, April Baller, Moses Massaquoi, Victoria Katawera, John Saindon, Philip Bemah, Esther Hamblion, Evelyn Castle, Desmond Williams, Alex Gasasira, Tolbert Nyenswah.
Journal PLoS Neglected Tropical Diseases Volume 12 Issue 1
Publisher
Cross Mark
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755746/pdf/pntd.0006135.pdf
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| | Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein | Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein
Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein
Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein
Overview
We have produced a new Ebola virus pseudotype, E-S-FLU, that can be handled in biosafety level 1/2 containment for laboratory analysis. The E-SFLU virus is a single-cycle influenza virus coated with Ebolavirus glycoprotein, and it encodes enhanced green fluorescence protein as a reporter that replaces the influenza virus hemagglutinin. Infection of cells with the E-S-FLU virus was dependent on the Niemann-Pick C1 protein, which is the well-characterized receptor for Ebola virus entry at the late endosome/lysosome membrane. The E-S-FLU virus was neutralized specifically by an anti-Ebolavirus glycoprotein antibody and a variety of small drug molecules that are known to inhibit the entry of wild-type Ebola virus.
To demonstrate the application of this new Ebola virus pseudotype, we show that a single laboratory batch was sufficient to screen a library of 1,280 pharmacologically active compounds for inhibition of virus entry. The E-S-FLU virus is a new tool for Ebola virus cell entry studies and is easily applied to high throughput screening assays for small-molecule inhibitors or antibodies. Acknowledgement
Author Julie Huiyuan Xiao, Pramila Rijal, Lisa Schimanski, Arun Kumar Tharkeshwar, Edward Wright, Wim Annaert and Alain Townsend.
Journal Journal of Virology
Publisher Cross Mark
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790926/pdf/e00941-17.pdf
| 3 | | R445.00 |  |
| | Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview | Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview
Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review Overview
Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: systematic review
Overview
Cardiovascular evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published since 2016. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Sub-group analyses were implemented by study design, risk of bias (ROB) and co-prevalence of Schistosoma species infection. Influential studies were excluded in sensitivity analysis to examine stability of pooled estimates. Despite the empirical debate regarding the cognitive benefit of de-worming for STH, the current ethical, clinical and health policy environments remain strongly skewed in favor of de-worming for child growth, prevention of anaemia and potentially avoidance of preventable cognitive deficits Acknowledgement
Author
Noel Pabalan, Eloisa Singian, Lani Tabangay, Hamdi Jarjanazi, Michael J. Boivin, Amara E. Ezeamama
Journal PLoS Neglected Tropical Diseases
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5766095/pdf/pntd.0005523.pdf
Publisher Cross Mark
| 3 | | R465.00 |  |
| | Medical Ethics: Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa. | Medical Ethics: Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa.
Medical Ethics: Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa.
Overview
The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa.
This article discusses some of the ethical challenges that were encountered in these research projects. Among these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor.
In conclusion it is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa. Acknowledgement
Author: Heathfield LJ, Maistry S, Martin LJ, Ramesar R, de Vries J
Journal: BMC medical ethics.
Publisher: BioMed Central
| 3 | | R370.00 |  |
| | Efficacy of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate for remineralization of primary teeth: a randomized clinical trial. | Efficacy of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate for remineralization of primary teeth: a randomized clinical trial.
Efficacy of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate for remineralization of primary teeth: a randomized clinical trial.
Overview Objective:
We aimed to evaluate the efficacy of oral hygiene instruction, fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) for remineralizing white spot lesions (WSL), and the effect of these on the dmft index in primary teeth. Subjects and Methods:
In this 1-year, randomized clinical trial, 140 children aged 12-36 months with WSL in the anterior maxillary teeth were selected and randomly divided into 4 groups of 35 children each. At baseline and 4, 8 and 12 months after the intervention, the size of WSL in millimeters and the dmft index were recorded. Results
In group 1, the mean percent WSL area and dmft index values had increased significantly at 12 months after baseline (p < 0.001). The interventions led to significant decreases in the size of the WSL; the greatest reduction was in group 4 (63%) followed by group 3 (51%) and group 2 (10%) after 12 months. The smallest increase in the dmft index was in group 4 (0.17), followed by groups 3 (0.3) and 2 (0.42). However, there were no significant differences between the groups (p < 0.001). Conclusions:
Oral hygiene along with four fluoride varnish applications or constant CPP-ACP during the 12- month period reduced the size of WSL in the anterior primary teeth and caused a small increase in dmft index values. Acknowledgement
Author: Memarpour M, Fakhraei E, Dadaein S, Vossoughi M
Journal: Medical principles and practice: international journal of the Kuwait University, Health Science Centre.
Publisher: 2015 S. Karger AG, Basel
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588292/pdf/mpp-0024-0231.pdf
| 3 | | R370.00 |  |
| | Medical Ethics: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis. | Medical Ethics: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis.
Medical Ethics: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis.
Overview:
Methods: Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors' sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation. Results:
Overall, 32 reports examining the association between doctors' sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses. Conclusion:
Male doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time. Acknowledgement
Author: Unwin E, Woolf K, Wadlow C, Potts HW, Dacre J
Journal: BMC medicine.
Publisher: Crossmark
https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-015-0413-5?site=bmcmedicine.biomedcentral.com
| 3 | | R400.00 |  |
| | Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications. | Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.
Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.
Overview
Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation. Acknowledgement
Author: Vassalini M, Verzeletti A, De Ferrari F
Journal: Monaldi archives for chest disease
Publisher: PIME Editrice
http://www.monaldi-archives.org/index.php/macd/article/view/25/728
| 3 | | R430.00 |  |
| | Medical Tourism. | Medical Tourism.
Overview
BACKGROUND: Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. OBJECTIVE:
This article provides an outline of the current research around medical tourism, especially its impact on Australians. DISCUSSION:
Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad Acknowledgement
Author: Leggat P
Journal: Australian family physician.
Publisher: Focus Environmental
| 3 | | R360.00 |  |
| | Denial of abortion in legal settings. | Denial of abortion in legal settings.
Denial of abortion in legal settings.
Overview
Background: Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. Methods: In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. Results: The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. Conclusions: The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services.
Acknowledgement Author:
Gerdts C, DePiñeres T, Hajri S, Harries J, Hossain A, Puri M, Vohra D, Foster DG Journal:
The journal of family planning and reproductive health care. Publisher:
BMJ Publishing Group Limited
| 3 | | R420.00 |  |
| | Antimicrobial Photodynamic Therapy as an Adjunct to Nonsurgical Periodontal Therapy. | Antimicrobial Photodynamic Therapy as an Adjunct to Nonsurgical Periodontal Therapy.
Antimicrobial Photodynamic Therapy as an Adjunct to Nonsurgical Periodontal Therapy.
OVERVIEW
Adjunctive photodynamic therapy (PDT or aPDT) is a low-power laser (diode laser, 660 to 810 nm) used in combination with a photosensitizing agent for an¬timicrobial purposes in the nonsurgical treatment of periodontitis. Mechanical therapy, including peri¬odontal debridement or scaling and root planing, has been shown to effectively reduce periodontal patho¬gens, inflammation, bleeding and probing depths, and to increase clinical attachment levels.
The effec¬tiveness of mechanical nonsurgical periodontal ther¬apy (NSPT), aimed at the reduction or elimination of periodontal pathogens and conditions which harbor them, is diminished in the presence of difficult ac¬cess including deep pockets, furcation defects and root concavities.
Many periodontal pathogens are susceptible to low-power lasers in the presence of photosensitive dyes, for example, methylene blue, toluidine blue or phenothiazine chloride. These light-activated photosensitizers are cytotoxic to microor¬ganisms associated with periodontal disease, result¬ing in cell death. Thus, aPDT has been suggested as an antimicrobial adjunct to NSPT.
The term pho¬totherapy differs from aPDT, as phototherapy refers to the use of lasers in conjunction with mechanical periodontal treatment to perform soft tissue debride¬ment or curettage as well as to reduce periodontal pathogens in the periodontal pocket.
ACKNOWLEDGEMENT Author: Denise M. Bowen, RDH, MS
Journal: The Journal of Dental Hygiene PUBLISHER: American Dental Hygienist Association
| 3 | | R420.00 |  |
| | Association between Early Childhood Caries, Feeding Practices and an Established Dental Home. | Association between Early Childhood Caries, Feeding Practices and an Established Dental Home.
Association between Early Childhood Caries, Feeding Practices and an Established Dental Home.
OVERVIEW
Early Childhood Caries (ECC) is a significant public health concern disproportionately affecting low-income children. The purpose of this study was to assess the association between the establishment of a dental home and ECC prevalence in a group of Medicaid-enrolled preschool children, and to explore feeding practices associated with an increased prevalence of ECC in Medicaid-enrolled preschool children with an established dental home was evaluated.
A cross-sectional survey was conducted among Medicaid-enrolled children between 2 and 5 years of age with an established dental home and no dental home to compare feeding practices, parental knowledge of caries risk factors and oral health status.
It was found that children with an established dental home had lower rates of biofilm (p<0.05), gingivitis (p<0.05) and mean decayed, missing and filled teeth (DMFT) scores (p<0.05). Children with no dental home consumed more soda and juice (p<0.05) daily, and ate more sticky fruit snacks (p<0.05) than children with an established dental home. Establishment of a dental home had a strong protective effect on caries and DMFT index (odds ratio=0.22) in both univariate and confounding adjusted analyses.
The results suggest establishment of a dental home, especially among high-risk, low-income populations, decreases the prevalence of ECC and reduces the practice of cariogenic feeding behaviors
ACKNOWLEDGEMENT
AUTHORS: Erin A. Kierce, RDH, MS, MPH; Linda D. Boyd, RDH, RD, EdD; Lori Rainchuso, RDH, MS; Carole A. Palmer, EdD, RD, LDN; Andrews Rothman, MS, EIT
JOURNAL: The Journal of Dental Hygiene
PUBLISHER: American Dental Hygienist Association http://www.adha.org/jdh
| 3 | | R385.00 |  |
| | Current status of the classification of periodontal diseases. | Current status of the classification of periodontal diseases.
Current status of the classification of periodontal diseases.
OVERVIEW
The professions of dentistry and dental hygiene exist largely due to 2 main diseases: dental caries and periodontal disease, both of which affect large segments of the population. Periodontitis is defined as the inflammatory process resulting in bone loss around teeth. The presence of gingival inflammation, bleeding on probing (BOP), clinical attachment loss (CAL), periodontal pockets, and alveolar bone loss are the criteria needed to diagnose periodontitis.1
Although the identification of periodontitis is a relatively straightforward process in clinical practice, its classification into different forms of disease and severity remains a challenging clinical issue. Periodontal diseases and conditions remain challenging to classify.
Recently, the American Academy of Periodontology (AAP) has suggested interpretations to this periodontal disease classification to address its limitations, such as the primary emphasis on clinical attachment levels as the main classification criterion, as well as the difficulty in distinguishing between aggressive and chronic periodontitis and in determining localized versus generalized periodontitis.2
This article reviews the history of periodontal disease classification and presents recommendations for clinicians on how to classify different forms of periodontal diseases.
ACKNOWLEDGEMENT
AUTHORS: Bonnie Hoath, BDSc, RDH; Colin Wiebe, DDS, DipPerio, MSc; Maria Isabel Garcia Fulle De Owen, DDS, DipPerio, MSc; Georgios Giannelis, DDS, DipPerio, MSc; Hannu Larjava, DDS, DipPerio, PhD
JOURNAL: Canadian Journal of Dental Hygiene
PUBLISHER:Ottawa Canadian Dental Hygienists Association http://www.cdha.ca
| 3 | | R420.00 |  |
| | Ebola Virus Disease: Clinical Review. | Ebola Virus Disease: Clinical Review.
Ebola Virus Disease: Clinical Review.
Overview
Ebola transmission may occur as a result of close contact with body fluids of infected patients. The incubation period for Ebola after infection is said to be 5-9 days, with a range of 1-21 days in 95% or more of patients,2 3 with the patients not considered infectious until they develop symptoms.
This article is therefore a clinical review whose objective is to investigate what makes the differential diagnosis of Ebola broad. This article therefore examines the causes of the Ebola virus as we as the pathophysiology of this infection. This article equally went further to examine the infection prevention and control measures are used to curb the spread of Ebola from one country to another.
The hypothesis here was that there is high likelihood of infected people travelling, thus, all countries are expected to have tested and practiced protocols ready for screening and managing Ebola patients. Of course the article also outlined some of the clinical features as well as the symptoms of the virus.
ACKNOWLEDGEMENT
AUTHORS: Nicholas J Beeching, Manuel Fenech, Catherine F Houlihan
JOURNAL: BMJ Open
| 3 | | R400.00 |  |
| | Effectiveness of early pediatric dental homes: A scoping review. | Effectiveness of early pediatric dental homes: A scoping review.
Effectiveness of early pediatric dental homes: A scoping review.
OVERVIEW
This article is important to Dental Hygienists because the early pediatric dental home is a promising model to improve pediatric oral health based on clinical, behavioural, and cost effectiveness outcome measures.
Dental hygienists and other dental practitioners should encourage families with infants and toddlers to start seeing a dental professional no later than age one for routine professional oral health care
This scoping review examines literature on the effectiveness of early pediatric dental homes based on clinical, behavioural, and cost parameters. The existing body of evidence generally supports the effectiveness of early pediatric dental homes for improving clinical outcomes (i.e., dmft scores) and behavioral outcomes (i.e., including utilization of future dental care services), and offering potential cost savings. However, exact quantifications of the impact on clinical and behavioral outcomes as well as cost savings vary due to heterogeneity of study design and methodological considerations related to level of evidence. Current research generally substantiates the establishment of a dental home model as an effective practice to improve early pediatric oral health.
ACKNOWLEDGEMENT
AUTHORS: Jacqueline VanMalsen, BSc(DH), RDH; Sharon M Compton, PhD, RDH
JOURNAL: The Canadian Journal of Dental Hygiene
PUBLISHER: The Canadian Dental Hygienist Association http://www.cdha.ca
| 3 | | R425.00 |  |
| | Effectiveness of Professionally-Applied Silver Diamine Fluoride in Arresting Dental Caries. | Effectiveness of Professionally-Applied Silver Diamine Fluoride in Arresting Dental Caries.
Effectiveness of Professionally-Applied Silver Diamine Fluoride in Arresting Dental Caries.
OVERVIEW
The purpose of Linking Research to Clinical Practice is to present evidence based information to clinical dental hygienists so that they can make informed decisions regarding patient treatment and recommendations.
Silver diamine fluoride has been shown to be effective in preventing and arresting dental caries. It provides an economical, noninvasive mechanism for dental hygienists to manage caries in community-based programs. The first product was cleared for marketing by the Federal Drug Administration (FDA) in 2014 as a cavity varnish for treatment of hypersensitivity in adults over 21 years of age; therefore, its use as a caries preventive or arresting agent is off label. This FDA clearance parallels that of sodium fluoride varnish.
Systematic reviews of clinical trials in children and elderly adults provide evidence for the effectiveness of silver diamine fluoride in arresting dentin caries when applied every 6 months for a period of 2 to 3 years. Without excavation of soft dentin, silver diamine fluoride reacts with protein in the dentinal tissue and deposits a layer of silver protein that resists acids produced by bacteria and promotes the formation of hydroxyapatite and fluorapatite. The silver is antibacterial, and the decayed tooth surface hardens, and the lesion becomes smaller.1
ACKNOWLEDGEMENT
AUTHORS: Denise M. Bowen, RDH, MS
JOURNAL: The Journal of Dental Hygiene
PUBLISHER: American Dental Hygienist Association http://www.adha.org/jdh
| 3 | | R390.00 |  |
| | Hypodontia: An update on its etiology, classification, and clinical management. | Hypodontia: An update on its etiology, classification, and clinical management.
Hypodontia: An update on its etiology, classification, and clinical management.
OVERVIEW
Hypodontia, or tooth agenesis, is the most prevalent craniofacial malformation in humans. It may occur as part of a recognised genetic syndrome or as a non-syndromic isolated trait. Excluding third molars, the reported prevalence of hypodontia ranges from 1.6 to 6.9%, depending on the population studied.
Most affected individuals lack only one or two teeth, with permanent second premolars and upper lateral incisors the most likely to be missing. Both environmental and genetic factors are involved in the aetiology of hypodontia, with the latter playing a more significant role. Hypodontia individuals often present a significant clinical challenge for orthodontists because, in a number of cases, the treatment time is prolonged and the treatment outcome may be compromised.
Hence, the identification of genetic and environmental factors may be particularly useful in the early prediction of this condition and the development of prevention strategies and novel treatments in the future
ACKNOWLEDGEMENT
AUTHORS: Azza Husam Al-Ani,1 Joseph Safwat Antoun,1 William Murray Thomson,1 Tony Raymond Merriman,2 and Mauro Farella1 JOURNAL: BioMed Research Internationa PUBLISHERS: Hindawi URL: https://www.hindawi.com/
| 3 | | R375.00 |  |
| | Medical Ethics: A Private Right Called Bill. | Medical Ethics: A Private Right Called Bill.
Medical Ethics: A Private Right Called Bill.
OVERVIEW
Privacy is defined by a number of English dictionaries as the quality or condition of being secluded from the presence or view of others. More appropriately privacy is also defined as’ the state of being free from unsanctioned intrusion’.
In 2014, with the advent information technology advances, social networking, sale of database information and negligent protection of personal information, in general, amongst others, the necessity to protect personal and private information has been recognized by the law makers. As such, protection of personal information has been incorporated in various forms of legislation, including the SA Constitution, The Patients’ Rights Charter, the Health Professions Act and the very recent Protection of Personal Information Act (POPI).
The Health Professions Council obligates all registered practitioners to comply with Continuing Professional Development (CPD). The importance of Ethics, Human Rights and Medical Law is emphasized. This article thus encompasses all three in the form of an overview related to the respect for privacy. Of significance is the Bill of Rights.
| 3 | | R400.00 |  |
| | Medical Ethics: Communication in the Doctor Patient Relationship. | Medical Ethics: Communication in the Doctor Patient Relationship.
Medical Ethics: Communication in the Doctor Patient Relationship.
OVERVIEW
The word ‘communication’ is derived from the Latin, ‘communis’ meaning ‘commonness’. In essence, effective communication is the establishment of a common frame of reference between practitioner and patient i.e. ‘all on the same page‘.
At least as long ago as the writing of the Hippocratic Oath, it was well understood that physicians’ communication with their patients was an essential part of successful therapy. The relationship between a practitioner and patient should be based upon trust, which develops primarily through communication. In much of health care, accurate diagnosis and appropriate treatment depend upon the patient’s truthful and complete disclosure of personal health information.
Communication is also a process involving the ‘transmitter’ and receivers. These roles, with particular reference to the practitioner/patient relationship, are interchangeable. There are skills required as there are ethical considerations.
| 3 | | R350.00 |  |
| | Medical Ethics: Decision Making in a Professional Practice. | Medical Ethics: Decision Making in a Professional Practice.
Medical Ethics: Decision Making in a Professional Practice.
OVERVIEW
The terms "Ethics" and "Morals" are derived respectively from the Greek and Latin words for "customs, practices and rituals", and what ethicist Robert Bellal has called "the habits of the heart".
Although customs may appear to be superficial behaviors, they often reflect the society's deepest, conscious sense of right and wrong. Ethics as a discipline is the study and analysis of values and standards related to duty, responsibility and right and wrong behaviour.
The obligations that health care professionals have towards their patients, each other and society, derive from ethical values held by the Practitioners discipline and the larger community. Since the time of Hippocrates, some of the more important moral values in health care have included trust, respect for life, benefiting others, avoiding harm to others, confidentiality and collegiality. Reflection of ethical issues is an essential compliment to the professional's specialised knowledge and skills in meeting basic human needs.
| 3 | | R350.00 |  |
| | Medical Ethics: Ethics of the Placebo in Clinical Practice. | Medical Ethics: Ethics of the Placebo in Clinical Practice.
Medical Ethics: Ethics of the Placebo in Clinical Practice.
OVERVIEW The placebo is not easy to define. As a matter of fact, some scholars are despaired of the possibility of ever finding an adequate definition for the term. However, many current definitions invoke the non-specific nature of the treatment effects as the leading feature of the placebo.
The object of this article was however to address the question of the placebo in clinical practice. This article nonetheless argued that the placebo could be an effective treatment. The article further argued that the use of the placebo does not entail deception. This article equally highlighted guidelines under which the placebo may be used for clinical purposes. This article further suggested that in selected cases, the use of the placebo may also be morally imperative. It is imperative to state that the arguments in this article were presented by three case vignettes.
The article was concluded that the placebo can be beneficial to physicians of many clinical situations
ACKNOWLEDGEMENT
AUTHORS: Lichtenberg U Heresco-Levy, U Nitzan
JOURNAL: BMJ Journal of Medical Ethics
| 3 | | R425.00 |  |
| | Medical Ethics: Healthcare Professional’s Patient Relationship. | Medical Ethics: Healthcare Professional’s Patient Relationship.
Medical Ethics: Healthcare Professional’s Patient Relationship.
OVERVIEW
This online course discusses respect and equal treatment; ending a patient-HP relationship; HIV/Aids; sexual attraction; treating family members; communication and consent with a case study included; obstacles for good communication plus case study; abusing medical resources including case study; futile treatment.
The health care profession-patient relationship is the cornerstone of medical practice and therefore of medical ethics. The Declaration of Geneva requires of the health care profession that “The health of my patient will be my first consideration,” and the International Code of Medical Ethics states, “A health care profession shall owe his patients complete loyalty and all the resources of his science.” The traditional interpretation of the health care professional-patient relationship as a paternalistic one, in which the health care professional made the decision and the patient submitted to them, has been widely rejected in recent years, both in ethics and in law.
Since many patients are either unable or unwilling to make decisions about their medical care, however, patient autonomy is often very problematic. This on-line course will deal with two topics that pose particularly vexing problems to Health Care Professionals in their daily practice: respect and equal treatment, communication and consent.
| 3 | | R420.00 |  |
| | Medical Ethics: How parents and practitioners experience research without consent involving Children with life threatening conditions. | Medical Ethics: How parents and practitioners experience research without consent involving Children with life threatening conditions.
Medical Ethics: How parents and practitioners experience research without consent involving Children with life threatening conditions.
INTRODUCTION
Improvements to life-saving treatments for critically ill children have been limited by the ethical and practical challenges involved in seeking consent for clinical trial entry.1 The process of seeking informed consent requires time, but this is severely constrained in emergency situations, such as acute resuscitation and critical care,2 where even minimal treatment delays are likely to be harmful.3 Parents are not always present when a child requires emergency treatment or a mother of a critically ill neonate may be sedated. Children’s critical care set-tings are intensely emotional, and some parents may not wish to be approached about research when their child is critically ill.4 Such challenges pose dif?culties for doctors and nurses recruiting to clinical trials in ensuring that parental consent has been informed, the participation voluntary and the recruitment process adhered to ethical principles.5 The last decade has seen inter-national efforts to ?nd alternatives to prospective informed consent so that vital research can continue to advance evidence-based children’s medicine.1
| 3 | | R460.00 |  |
| | Medical Ethics: The Truth Be Told. | Medical Ethics: The Truth Be Told.
Medical Ethics: The Truth Be Told.
OVERVIEW
“We're having a little problem with lying at my house: My son won't do it”. "Do you like my new car?" asks his work colleague. My son is paralyzed into muteness by his conscience. His friend is hurt. "Couldn't you find something nice to say about it, like the colour?" I ask. I am thinking of the story about Judy Garland, who, after seeing a pal in a terrible play, swept into her friend's dressing room with the line, "How do you do it, my dear, night after night?"
The philosopher Immanuel Kant argued that truth-telling is a "perfect duty," one so basic that it cannot be overridden by other values—not even saving the life of a friend, let alone sparing someone's feelings. In Kant's formulation, if asked outright, a person would be obligated to tell a murderer the whereabouts of his intended victim. Of course, many have responded to Kant with penetrating philosophical counter-arguments
Philosophers Maguire and Fargnoli use Kant's stance on lying to explore the limits of the quest for universal moral principles. "Universalization is an unrealistic and inaccurate abstraction that passes over the fact that there are exceptions to valid moral principles," they write. "To protect other values, like the life of an intended victim or a legitimate secret, exceptions to truth-telling must be made."
| 3 | | R420.00 |  |
| | Medical Ethics: Uninformed Consent. | Medical Ethics: Uninformed Consent.
Medical Ethics: Uninformed Consent.
OVERVIEW
There is an argument put forward by medical schemes, administrators and their agents that access to record cards of patients is an automatic right as members of medical schemes, when joining a medical scheme, acknowledge that they are obligated to adhere to the scheme rules which includes provision of personal information; hence consent has been granted.
Importantly, the HPCSA Ethical Rules and recently introduced legislation such as the Protection of Private Information Act dictate that express informed consent must be obtained prior to the performance of professional acts or sharing of personal information.
Consent, therefore based on an assumption or in the absence of express informed consent can only be regarded as uninformed consent. This includes implied consent whereby a patient pitches for an examination or sits in the chair and interpreted by the practitioner as consent.
| 3 | | R320.00 |  |
| | Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics | Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics
Medical Ethics: What Do International Ethics Guidelines Say In Terms of The Scope of Medical Research Ethics
OVERVIEW The question of ‘which is an ethical issue and which is not’ often arises doing research ethics. There are however many internationally known ethic guidelines and depending on which ethics guideline we consult, we may have various answers to this question. It is however ironical that we do not have a harmonized document which tells us what these various guidelines say and shows us the areas of consensus.
For this study, we extracted relevant information or imperatives from five internationally-known ethics guidelines and took note where the imperatives came from. Results of this research nonetheless indicated that there is no consensus on many of the imperatives and that in only 8.2 % of the imperatives were there at least moderate consensus. The results further indicated that there was a lack of consensus in most of imperatives from the five internationally-known ethics guidelines.
The reason was however partly attributed to the differences among the guidelines in terms of their levels of specification as well as conceptual/ideological differences.
ACKNOWLEDGEMENT AUTHORS: Rosemarie D. L. C. Bernabe, Ghislaine J. M. W. van Thiel and Johannes J. M. van Delden
JOURNAL: BMC Medical Ethics
| 3 | | R330.00 |  |
| | Oral Health Related Quality Of Lfe (OHRQoL) Following Third Molar Surgery in Sub-Saharan Africans: An observational study. | Oral Health Related Quality Of Lfe (OHRQoL) Following Third Molar Surgery in Sub-Saharan Africans: An observational study.
Oral Health Related Quality Of Lfe (OHRQoL) Following Third Molar Surgery in Sub-Saharan Africans: An observational study.
Overview
Surgical extraction of the impacted third molar is one of the commonest minor oral surgical procedures carried out in oral surgery. Problems created by the disturbances in post-extraction wound healing and physiologic sequelae of third molar surgery can significantly affect the patient's quality of life.
The study population consisted of 135 subjects that required surgical extraction of mandibular third molar under local anaesthesia and met the inclusion criteria. Patients were assessed pre-operatively and post-operatively on days 1,3,5,7, and 14 using the United Kingdom Oral Health Related Quality of Life questionnaire (UK-OHRQoL).
This study also showed that surgical removal of impacted teeth exerted a negative influence on patient's Quality of life (QoL) across various physical, social, psychological aspects of life There was a deterioration in oral health related quality of life in the immediate postoperative period particularly POD 1 and 3 following third molar surgery, which slowly returned to preoperative level by 7th day. Routines such as eating, laughing and smiling, work and speech were also affected. Patients need to be informed of these symptoms after third molar removal to enable them to prepare very well for the procedure and its sequelae. Acknowledgement
Author: Ramat Oyebunmi Braimah, Kizito Chioma Ndukwe, Foluso John Owotade, Stephen Babatunde Aregbesola
Journal: PanAfrican Medical Journal
Publisher African Field Epidemiology Network (AFENET)
| 3 | | R360.00 |  |
| | Patient Safety Strategies Targeted at Diagnostic Errors. | Patient Safety Strategies Targeted at Diagnostic Errors.
Patient Safety Strategies Targeted at Diagnostic Errors.
OVERVIEW
It is apparent that missed, delayed or incorrect diagnosis can lead to inappropriate patient care, poor patient outcome and increased cost. An operational definition of diagnostic errors include diagnosis that are either unintentionally delayed, wrong or missed.
This study was therefore a systematic review aimed at analysing evaluations of interventions to prevent diagnostic errors. Data for this research was however collected through searches from MEDLINE (1966 to October 2012), the Agency for Healthcare Research and Quality’s Patient Safety Network, bibliographies, and prior systematic reviews. During the study, two independent reviewers extracted study data and rated study quality. There were 109 studies that addressed 1 or more interventions such as personnel changes.
The interventions included educational interventions, technique, structured process changes, technology-based systems interventions as well as review methods. However, evidence seemed strongest for technology-based systems (e.g., text message alerting) as well as specific techniques like testing equipment adaptations.
ACKNOWLEDGEMENT
AUTHOR: Kathryn M. McDonald MM, Brian Matesic BS, Despina G. Contopoulos-Ioannidis MD, Julia Lonhart BS BA, Eric Schmidt BA, Noelle Pineda BA, and John P.A. Ioannidis MD DSc JOURNAL: Annals of Internal Medicine PUBLISHER: ACP URL: https://www.acponline.org/
| 3 | | R400.00 |  |
| | Patterns Of Analgesic Use To Relieve Tooth Pain Among Residents In British Columbia, Canada. | Patterns Of Analgesic Use To Relieve Tooth Pain Among Residents In British Columbia, Canada.
Patterns Of Analgesic Use To Relieve Tooth Pain Among Residents In British Columbia, Canada.
Overview
The use of prescription opioids has increased dramatically in Canada in recent decades. This rise in opioid prescriptions has been accompanied by increasing rates of opioid-related abuse and addiction, creating serious public health challenges in British Columbia (BC), one of Canada's most populated provinces. Our study explores the relationship between dental pain and prescription opioid use among residents in BC. We used data from the 2003 Canadian Community Health Survey (CCHS), which asked respondents about their use of specific analgesic medications, including opioids, and their history of tooth pain in the past month.
Our results showed that conventional non-opioid based analgesics (such as aspirin or Tylenol) and opioids were more likely to be used by those who had experienced a toothache in the past month than those who did not report experiencing a toothache. The use of non-opioid painkillers to relieve tooth pain was associated with more recent and more frequent dental visits, better self-reported oral health, and a greater income.
We conclude that programs and policies targeted at improving the dental health of the poor may help to reduce the use of prescription opioids, thereby narrowing health inequalities within the broader society. Acknowledgement Authors: Jamie Moeller, Julie Farmer, Carlos Quiñonez
Journal: PLoS ONE
Publisher: PubMed Central
| 3 | | R375.00 |  |
| | Practice Issues. | Practice Issues.
OVERVIEW
It is important to note that the responses to the various questions are the views independently expressed and are not necessarily opinions shared by cpdexpress.co.za. As matters involving Ethics and the law are subject to interpretation, the responses cannot, in any way, be regarded as binding or necessarily endorsed by the regulatory authorities.
There are ethical dilemmas regarding patients, colleagues and associates that one doesn’t even consider until they become issues in their practice. There are many questions to be asked regarding ethics, touting, canvassing, advertising, competition and many other issues that need to be addressed and this article addresses most of them.
| 3 | | R450.00 |  |
| | Private Practice: The Do's And Don'ts. | Private Practice: The Do's And Don'ts.
Private Practice: The Do's And Don'ts.
OVERVIEW
You have studied extensively to become a healthcare professional in your field of study. You have learned and become adept at identifying a vast range of conditions. You can diagnose and effectively treat those conditions within the scope of the discipline.
Now you are faced with a plethora of dilemmas. What is fair value for your services? What appliances are appropriate and reasonable? What commercial and legal structures are appropriate for you? What influence may these commercial and legal structures have on your clinical recommendations? Who may have access to your record cards? What responsibility can you delegate to your staff? Who carries final responsibility for payment of your claims – member or medical aid? What constitutes anti-competitive behavior?
This is a very informative article that will help you to run your practice within the various guidelines.
| 3 | | R400.00 |  |
| | Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models. | Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models.
Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models.
OVERVIEW
The three types of peer review models mostly operated by scholarly journals include single blind, where the reviewers know the identity of the authors but not vice versa; open peer review, where authors and reviewers both know each other’s identity, and finally, the double-blind peer review where the author and reviewer names are both blinded.
The objective of this research was to assess whether reports from reviewers recommended by authors show a bias in quality and recommendation for editorial decision, compared with reviewers suggested by other parties, and whether reviewer reports for journals operating on open or single-blind peer review models differ about report quality and reviewer recommendations. The design of this study was nonetheless, a retrospective analysis of the quality of reviewer reports using an established Review Quality Instrument, and analysis of reviewer recommendations and author satisfaction surveys.
The samples used for this research were two hundred reviewer reports submitted to BMC Infectious Diseases, 200 reviewer reports submitted to BMC Microbiology and 400 reviewer reports submitted to the Journal of Inflammation.
ACKNOWLEDGEMENT
AUTHORS: Maria K Kowalczuk, Frank Dudbridge, Shreeya Nanda, Stephanie L Harriman, Jigisha Patel, Elizabeth C Moylan JOURNAL: Communication Research PUBLISHER: BMJ Open URL: http://bmjopen.bmj.com
| 3 | | R355.00 |  |
| | Saliva Defender of the Mouth and Mirror to the Body. | Saliva Defender of the Mouth and Mirror to the Body.
Saliva Defender of the Mouth and Mirror to the Body.
OVERVIEW Saliva is an active and versatile fluid in the body that plays a key role in maintaining and preserving the health of the oral environment. In addition to how it serves the oral cavity, saliva is an instrumental tool in gauging the body’s overall systemic health. Therefore, while central to the mouth, the scope of the function of saliva goes beyond the mouth and is so vast that it contributes to the health matters of the entire body, working to keep it at a level of homeostasis.
The goal of this paper is to inform the reader about the characteristics of saliva as a critical medium to systemic health, the role it plays in oral health and the overall well-being of an individual.
An exploration of the component parts of saliva will be provided, to give a background understanding to its vital and multi-functional role. Next, a breakdown of the variety of purposes that saliva serves will be presented. Finally, factors associated with impaired salivary function will be examined.
ACKNOWLEDGEMENT AUTHORS: Dailee Louis and Mehmouna Aslam, BS.
JOURNAL: The Dental Assistant PUBLISHER: The Dental Assistant Journal https://www.adaausa.org
| 3 | | R390.00 |  |
| | Sjögren’s syndrome: oral manifestations and treatment, a dental perspective. | Sjögren’s syndrome: oral manifestations and treatment, a dental perspective.
Sjögren’s syndrome: oral manifestations and treatment, a dental perspective.
OVERVIEW Sjögren’s syndrome is a systemic autoimmune disease affecting approximately 3 million Amer¬icans, primarily peri-menopausal women. The syndrome is characterized by dysfunction and destruction of exocrine glands leading to oral and ocular manifestations, xerostomia and keratitis sicca. Sjögren’s syndrome commonly remains either undiagnosed or is diagnosed years after the onset of symptoms.
Di¬agnosis is based on the concurrent presence of various signs and symptoms of the disease as established by 6 diagnostic standards set by the American European Consensus Group standards: oral symptoms, ocular symptoms, evidence of oral signs, evidence of ocular dryness, evidence of salivary gland involve¬ment with positive Anti-Ro/La autoantibodies and a positive gland biopsy.
With an aging population and heavier reliance on medications and treatments which cause xerostomia, oral health professionals are likely to encounter a higher incidence of xerostomia and Sjögren’s syndrome more than ever before. The dental professional must recognize the signs and symp¬toms of xerostomia, include Sjögren’s syndrome in their differential diagnosis, and communicate those findings and concerns to other health care providers, including the primary care physician, rheumatolo¬gist and ophthalmologist for evaluation in a timely fashion. This article discusses the dental professional’s role in formulating a preventive oral health plan.
ACKNOWLEDGEMENT AUTHORS: Deborah L. Cartee, RDH, MS; Shannon Maker, RDH, BS; Debra Dalonges, RDH, BS; Marion C. Manski, RDH, MS
JOURNAL: The Journal of Dental Hygiene Assistant PUBLISHER: The American Dental Assistants Association https://www.adaausa.org
| 3 | | R380.00 |  |
| | Streptococcus Mutans and tooth Decay. | Streptococcus Mutans and tooth Decay.
Streptococcus Mutans and tooth Decay.
OVERVIEW Ever since the dental profession developed, dentists have been trying to treat and properly inform people about the prevention of tooth decay. Researchers have linked as many as two to three hundred different bacterial species to the production of the decay. However, one specific bacteria has been linked to be the main pathogenic cause of cavities, Streptococcus Mutans.
Tooth decay is the breakdown of enamel on the dentin in the oral cavity. It can be a problem for anyone of any age. However, decay is more common among children. Streptococcus Mutans are facultative anaerobes that are found in the human oral cavity. They are gram-positive cocci shaped bacteria and is a major cause of tooth decay. Tooth decay can dramatically influence the health of a person if not taken care of.
Streptococcus Mutans can be found located on the teeth appearing as a chalky white spot on the surface of the tooth indicating an area of demineralization of enamel, which is commonly referred to as a carious lesion. Tooth decay can damage, not only health, but has an impact on one’s self-esteem as well.
ACKNOWLEDGEMENT AUTHORS: Kaley Johnson, CDA Certified Dental Assistant Dr Harold Brown
JOURNAL: The Journal of Dental Hygiene Assistant PUBLISHER: The American Dental Assistants Association https://www.adaausa.org
| 3 | | R370.00 |  |
| | The Frequency of Dietary Advice Provision in a Dental Hygiene Clinic: A Retrospective Cross-Sectional Study. | The Frequency of Dietary Advice Provision in a Dental Hygiene Clinic: A Retrospective Cross-Sectional Study.
The Frequency of Dietary Advice Provision in a Dental Hygiene Clinic: A Retrospective Cross-Sectional Study.
OVERVIEW
There exists a close relationship between diet and oral health. There is equally a wealth of infor¬mation that demonstrates the impact diet has on dental diseases, such as dental caries as well as ero¬sion.
Dental caries occurs when bacteria in the oral cavity metabolize fermentable carbohydrates and organic acids are produced, causing demin¬eralization of hard tooth structure. Hence, the aim of this cross-sectional study was to assess the frequency of dietary advice provision by dental hygiene students. The data for this study was obtained from clinical records of third-year students of Bachelor of Oral Health at the University of Newcastle. This study however investigated the associations between demographics, treatment provided and frequency of dietary advice. Results from this study nevertheless indicated that dietary advice was provided infrequently by dental hygiene students, with only 6.48% of all patients seen during the 12-month period receiving dietary advice. This finding was equally an indication that dietary advice is provided infrequently by dental hygiene students.
It was concluded that more research is required to strengthen the findings and equally investigate barriers to dietary advice provi¬sion, as well as perceptions of dental practitioners regarding dietary advice.
ACKNOWLEDGEMENT
AUTHORS: Melanie J. Hayes, Johanna Franki, Jane A. Taylo, JOURNAL: Journal of Dental Hygiene PUBLISHER: American Dental Hygienists’ Association URL: http://www.adha.org
| 3 | | R350.00 |  |
| | The Temporomandibular Joint: Examination of the TMJ. | The Temporomandibular Joint: Examination of the TMJ.
The Temporomandibular Joint: Examination of the TMJ.
Patricia H Trott.
This course will concentrate on examination of the TMJ and also briefly cover examination of other structures for dysfunction related to the TMJ. Examination is discussed under two main sections:
Subjective examination, in which patients are questioned about their symptoms, how they interfere with daily activities and the history of the symptoms; Objective examination, the physical examination of musculoskeletal structures.
Examination of the TMJ should include the examination of dental occlusion, masticatory muscles, suprahyoid muscles, the upper cervical spine and the cervical musculature, as all these structures are functionally interdependent.
The functional interdependence of the TMJs with dental occlusion and with the upper cervical spine is outlined. Due to this interdependence and to overlapping presentation of pain referral from the TMJs and from the upper cervical spine, it is essential that the clinician examine in details these structures as possible sources of symptoms in patients with facial pain and headache.
| 3 | | R400.00 |  |
| | The Temporomandibular Joint: Integrated Approach Manual Therapy and Exercise. | The Temporomandibular Joint: Integrated Approach Manual Therapy and Exercise.
The Temporomandibular Joint: Integrated Approach Manual Therapy and Exercise.
OVERVIEW
At the time of initial consultation Catherine was a 33-year-old female production operator in a factory and has one young child. She was sedentary, but had been a ballet dancer until her mid-twenties. Catherine was referred by an ear nose and throat (ENT) surgeon who stated in his accompanying letter: ‘Her problems are well advanced, but I think the under-lying cause needs to be managed before embarking on arthroscopy and surgical treatment’. Her dentist had eliminated the teeth as a source of pain.
TMJ affects millions of people around the world, most of whom are young women. Because the condition is multifactorial in nature (articular, myofascial, intra articular disc, cervical spine and stress) it is a challenging disorder to treat,
This online course will demonstrate how manual therapy techniques can be applied to render the movement painless as well as help to maintain correct anatomical relationships between the affected components while normal movement patterns are re-established.
| 3 | | R400.00 |  |
| | The Temporomandibular Joint: Treatment of the TMJ: Part 1. | The Temporomandibular Joint: Treatment of the TMJ: Part 1.
The Temporomandibular Joint: Treatment of the TMJ: Part 1.
OVERVIEW
The reader is encouraged to take examination of TMJ part 1 and part 2 prior to embarking on this home study.
The management of the common clinical syndromes presented in this course are: myofascial pain dysfunction (MPD) syndrome; post-fracture of the mandible and/or maxilla; post-extraction of wisdom teeth; TMJ osteoarthritis; TMJ clicking; Pain secondary to new or remodeled dentures; TMJ locking; headache, earache, facial pain presentation of these clinical symptoms will serve to emphasise that in many cases, the symptoms are multifactorial in aetiology and may require diagnostic and treatment skills of dentists, doctors and physiotherapists.
In this course, the author builds on material presented in previous two correspondence studies which details with examination of the temporomandibular joint (TMJ). The list of syndromes described is by no means exhaustive, rather it represents those most frequently presenting to the author, either in her position as a lecturer in this field (to the Schools of Physiotherapy and Dentistry) or in her private practice.
This multidisciplinary approach has been found to offer solutions to complex problems.
| 3 | | R400.00 |  |
| | The Temporomandibular Joint: Treatment of the TMJ: Part 2. | The Temporomandibular Joint: Treatment of the TMJ: Part 2.
The Temporomandibular Joint: Treatment of the TMJ: Part 2.
OVERVIEW
The reader is encouraged to take examination of TMJ part 1 and part 2 prior to embarking on this home study.
The management of the common clinical syndromes presented in this course are: myofascial pain dysfunction (MPD) syndrome; post-fracture of the mandible and/or maxilla; post-extraction of wisdom teeth; TMJ osteoarthritis; TMJ clicking; Pain secondary to new or remodeled dentures; TMJ locking; headache, earache, facial pain presentation of these clinical symptoms will serve to emphasise that in many cases, the symptoms are multifactorial in aetiology and may require diagnostic and treatment skills of dentists, doctors and physiotherapists.
In this course, the author builds on material presented in previous two correspondence studies which details with examination of the temporomandibular joint (TMJ). The list of syndromes described is by no means exhaustive, rather it represents those most frequently presenting to the author, either in her position as a lecturer in this field (to the Schools of Physiotherapy and Dentistry) or in her private practice.
This multidisciplinary approach has been found to offer solutions to complex problems. This is the 2nd part of this online course.
| 3 | | R400.00 |  |
| | Therapeutic oral rinsing with commercially available products: Position paper and statement from the Canadian Dental Hygienists Association. | Therapeutic oral rinsing with commercially available products: Position paper and statement from the Canadian Dental Hygienists Association.
Therapeutic oral rinsing with commercially available products: Position paper and statement from the Canadian Dental Hygienists Association.
OVERVIEW Mechanical methods of oral hygiene have been shown insufficient in controlling biofilm and preventing the initiation and progression of gingival inflammation and disease. This position paper updates and replaces the 2006 Canadian Dental Hygienists Association position paper on oral rinsing to guide dental hygienists and other dental professionals in making client recommendations. These findings provide the impetus for additional research and the broader use of therapeutic oral rinses by adults.
Based on the current research, dental hygienists are encouraged to recommend oral rinsing with a commercially available therapeutic over-the-counter oral rinse (mouthwash) to their adult clients as a long-term complement to usual mechanical plaque control measures. An accumulation of research, including well-conducted long-term clinical studies (=6 months), has shown that oral rinses with a fixed combination of 3 essential oils along with other ingredient(s) produce statistically and clinically significant reductions in plaque and gingival inflammation beyond that accomplished by mechanical means alone.
While prescription chlorhexidine gluconate oral rinse has been the gold standard about reductions in plaque and gingival inflammation parameters, it is recommended for short-term use only due to a negative side effect profile.
ACKNOWLEDGEMENT AUTHORS: Joanna Asadoorian, PhD, RDH
JOURNAL: The Canadian Journal of Dental Hygiene PUBLISHER: The Canadian Dental Hygienist Associations http://www.cdha.ca
| 3 | | R375.00 |  |
| | Tobacco Interventions by Dentists and Dental Hygienists. | Tobacco Interventions by Dentists and Dental Hygienists.
Tobacco Interventions by Dentists and Dental Hygienists.
OVERVIEW
Tobacco use is a modifiable risk factor for oral disease. Dental professionals can reduce the burden of oral and overall health by influencing tobacco use. Results of electronic searches for literature indicated progress in tobacco interventions in dentistry. Patients believed that dentists should routinely offer smoking cessation services, and those interested in quitting felt comfortable receiving advice about quitting.
Dental professionals were aware of the importance of tobacco interventions. However, tobacco intervention practices were limited or restricted, and dental professionals have not fully embraced opportunities for tobacco intervention. A consistently reported barrier was the lack of training. Although various factors were identified as barriers and facilitators, few study assessed structure for the implementation of tobacco interventions.
Tobacco-related education of undergraduate students has been recognized as an important issue. Globally, most dental students recognized themselves as role models in society and believed they should receive training. However, few reported receiving such formal training.
Dental researchers and educators around the world should explore new knowledge and exchange experiences to make full use of the unique opportunity of providing dental interventions against tobacco use.
ACKNOWLEDGEMENT
Authors: Takashi Hanioka, Miki Ojima, Yoko Kawaguchi, Yukio Hirata,Hiroshi Ogawe, Yumiko Mochizuki
Journal: Occupational Safety and Health Research Institute
Publisher: Elsevier
| 3 | | R390.00 |  |
| | Zika Virus Outbreak in Rio de Janeiro, Brazil. | Zika Virus Outbreak in Rio de Janeiro, Brazil.
Zika Virus Outbreak in Rio de Janeiro, Brazil.
OVERVIEW Brazil was faced with the cocirculation of three above viruses of major public health importance in the year 2015. The emergence of the Zika (ZIKV) virus however brought about serious public health challenges to both public health authorities and clinicians.
It is however imperative to note that clinical features between diseases caused ZIKV, Dengue (DENV) and Chikungunya (CHIKV) as well as the lack of validated serological assays for ZIKV makes accurate diagnosis difficult. This article was therefore the firs published description of the outbreak of Zika virus in Latin America. Recent findings about Zika virus suggest that in a minority of ZIKV cases, neurological diseases can develop and that babies born from mothers with a ZIKV-illness during pregnancy could suffer from congenital abnormalities such as a small brain or a small head.
After analysing the virus, it was then suggested that the clinical characteristics of both the confirmed and the unconfirmed cases proved to be very similar.
ACKNOWLEDGEMENT AUTHORS: Patricia Brazil et al
JOURNAL: PLOS Negleted Tropical Disease
| 3 | | R375.00 |  |