Auxiliary Personnel Research Articles

A survey of patient and auxiliary problems as they relate to behavioral dentistry curricula

The attempt to prepare students to manage problems in their dental practices must be preceded by precise identification of specific problems. The purpose of this study was to identify such problems. A random sample of practicing dentists cited collecting fees, poor patient motivation, patient fear, and broken or cancelled appointments as their most commonly encountered patient problems. The most commonly cited auxiliary problems were retraining auxiliary personnel and poor motivation. The dentists gave support to courses addressing these topics in the third and fourth years of the dental curriculum. The survey supports the increasing emphasis on behavioral dentistry curricula and identifies the most relevant topics for such courses.

Mental Health Services for Children in the Eastern Mediterranean Region

The similarities among countries of the WHO Eastern Mediterranean Region make them an entity, but there are among them striking differences as well, which have an influence on the growth and behavior of children and on the provision of social and health services, including those related to mental health. The latest available information (1975) indicates that of a total population in the region of 253 million, an estimated 44.7% are below the age of 15, there being wide variation in the percentages between urban and rural populations, ranging from 5.8% (Yemen) to 78% (Bahrain). Health services reflect similar differences. In Ethiopia, for example, it was found that whereas only about 6% of the population lived in the three largest cities, 60% of the medically qualified workers and 30% of auxiliary health personnel were in these cities, and that there were mental health workers in only two cities. Not surprisingly, the health services in most of the countries cover only a limited proportion of the population not more than 15% to 20% and even fewer people with respect to mental health services. Moreover, the highest percentage of the worldTs nomadic population is found in the Eastern Mediterranean Region, and this population presents socio-economic features that call for a special approach to health care. Economically, there are great disparities: some countries of the region are among those with the highest per capita income, but five countries are included in the list of the least developed. Despite the

A manpower analysis of private practice dentistry thru simulation

A simulation model of solo private practice dentistry has been developed to evaluate the effects of introducing expanded function auxiliary personnel. The model permits the experimental investigation of a variety of staffing patterns and facility configurations. Four task assignment schemes are examined over 208 experiments. Results indicate increases in net revenue of 118% can be realized by the addition of expanded function auxiliary personnel.

"Nursing and auxiliary personnel: A training guide for family planning programs." Advances in Planned Parenthood 11, no. 4 (1976): 185-190

"Nursing and auxiliary personnel: A training guide for family planning programs." Advances in Planned Parenthood 11, no. 4 (1976): 185-190

EXPLORA TOR Y DEVELOPMENT: SHIPS, SUBMARINES, AND BOATS

ABSTRACTThe Navy's Exploratory Development Program for Ships, Submarines and Boats it at the cutting edge of the new technologies needed to create advanced types of naval vehicles. It also includes efforts to overcome deficiencies and to upgrade the capabilities of existing ships and craft. Better ships do not come easily!This paper describes some of the efforts now underway to develop the Navy's ships of the future by first developing and demonstrating the technology needed to upgrade each characteristic vital to unproved naval vehicles.We need ships that are: more seaworthy – yet smaller; lighter – but stronger; faster – though using less fuel; more reliable – but less costly! In order to achieve dozens of such contradictory improvements, tins Exploratory Development Program looks for answers in the fields of: advanced vehicle concepts, fluid dynamics, structures, naval vehicle control, electrical energy conversion, main propulsion machinery, auxiliary shipboard machinery, personnel protection, damage control, and ship silencing. Specific examples of the work in these fields are provided together with some fed for how this interesting program operates.

Dentist-Staff Interpersonal Relationships

The growing demand for dental services has resulted in an expanded utilization of auxiliary personnel in an effort to increase productivity. Enlarged dental teams which have evolved from this effort have also magnified the potential for interpersonal conflicts in the office. Although such conflicts are sometimes unavoidable, they can be reduced through effective preventive management. Careful selection of personnel, well designed training programs, and attention to those factors which assist retention of qualified staff members are important in this process. Finally, the entire team must have common goals and work in a coordinated fashion to achieve ultimate success. The dentist of today must possess the skills of an effective manager as well as those of a competent clinician.

An outreach cancer education program: a model for continuing education in the dental office

During the period 1970-1973, only 2.5 percent of the dentists practicing in Kentucky attended cancer continuing education courses offered by the University of Kentucky College of Dentistry. In the fall of 1973 a different approach to cancer education was launched: Learn about Oral Cancer in Your Office. Self-instructional materials, developed in the College of Dentistry, were taken to the dentist's office on an appointment basis. This method had great appeal and significantly increased the number of dentists involved in cancer continuing education. Other positive results of this approach were a greater awareness on the part of the dentist of his role in cancer detection, a desire amont the participants to alter the pattern of practice to include cancer detection techniques, and exposure of dental auxiliary personnel to cancer education material.

The Ethics of Supervising Family Planning in Developing Nations

Western-style medicine based on specialists and hospitals is called inappropriate for developing countries and even inappropriate for the poor in the U.S. This physician-dominated health care is beginning to develop roles for auxiliary medical personnel in both curative and preventive care roles which might be applied in developing countries. Some have even called the Western system highly immoral because it focuses resources on the diseases which involve the elite and fails to attack the problems which affect the masses. The Chinese system with trained farmers functioning as barefoot doctors is cited as a possible model. It is false to assume that only physicians can dispense contraceptives. A report from Bangladesh shows that local women trained to work in the operating room were eventually able to perform a minilap procedure with performance comparable to physicians. Several studies have shown that trained persons can insert IUDs well and a program in Thailand using a checklist of contraindications has enabled nurse-midwives to prescribe oral contraceptives with no appreciable increase in complications. It is assumed that a physician can do a pelvic examination and as a result doctors often receive only cursory training in IUD insertion. By comparison paramedical personnel receive thorough training. This is why they often have rates better than doctors in some areas. Tables show that the mortality rate due to thromboembolic disease among pill users in developed countries is 1-3/100000 no greater than the postpartum incidence of thromboembolism and far greater than the maternal mortality rates in developing countries (250-1000/100000 live births). On a strictly risk/benefit ratio it is unethical to deny care for the majority of the population by insisting that contraception be dispensed only with medical supervision.

DISTRIBUTION OF ORAL CONTRACEPTIVES

Health delivery models are changing and pharmaceutical laws are changing along with them. In the newly emerging model health workers dispense drugs free or at cost to consumers. The major advantages are that more extensive services and better quality care can be provided to more people by specially trained personnel and the available physicians can be more effectively and efficiently utilized. A number of countries have adopted new laws and health regulations to accommodate this new delivery model. A physicians prescription is not required for oral contraceptives in Antigua Grenada Hong Kong Iraq Jamaica Morocco Nepal Pakistan and the Philippines. In Fiji a prescription for oral contraceptives is required for the 1st time only. In the Republic of Korea South Africa Sri Lanka and Thailand a prescription for oral contraceptives is required by health or auxiliary personnel or by government authorized personnel. A prescription is still required for orals in France but it is valid for 1 year and supplied for 3 months at a time. The cost is reimbursable under Social Security Insurance. Classification of drugs under this new health model tend toward criteria based on preventive rather than curative agents.

Distribution of oral contraceptives: legal changes and new concepts of preventive care.

Health delivery models are changing and pharmaceutical laws are changing along with them. In the newly emerging model health workers dispense drugs free or at cost to consumers. The major advantages are that more extensive services and better quality care can be provided to more people by specially trained personnel and the available physicians can be more effectively and efficiently utilized. A number of countries have adopted new laws and health regulations to accommodate this new delivery model. A physicians prescription is not required for oral contraceptives in Antigua Grenada Hong Kong Iraq Jamaica Morocco Nepal Pakistan and the Philippines. In Fiji a prescription for oral contraceptives is required for the 1st time only. In the Republic of Korea South Africa Sri Lanka and Thailand a prescription for oral contraceptives is required by health or auxiliary personnel or by government authorized personnel. A prescription is still required for orals in France but it is valid for 1 year and supplied for 3 months at a time. The cost is reimbursable under Social Security Insurance. Classification of drugs under this new health model tend toward criteria based on preventive rather than curative agents.

Mercury toxicity in the dental office: a neglected problem

Amalgam has proved to be among the most versatile and durable of all restorative materials used in the treatment of dental disease. If it is handled and controlled properly, problems with its use should not develop. Safe mercury vapor levels can be maintained if good mercury hygiene practices are exercised. Materials and devices are available for aiding the dentist in adequate mercury control procedures. With the cooperation of each member of the dental team, compliance with all the criteria imposed by governmental regulatory agencies can be accomplished. These criteria have been established for the health protection of the dentist and his auxiliary personnel. Each practioner and office staff member should realize the potential hazards associated with mercury, and effect good mercury hygienic measures and control procedures.

Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment

The present investigations have shown that, although there are definite risks in undertaking orthodontic treatment with fixed appliances, such treatment need not cause any appreciable damage when accepted orthodontic principles are followed in cooperative patients with good oral hygiene and regular fluoride treatment. On the other hand, when these principles are neglected, the damage may be considerable and the benefits from orthodontic treatment questionable. Progressively increasing evidence from preventive dentistry that the bacterial plaque is the single most important causative factor in periodontal breakdown, and is important also in causing dental caries, opens unique possibilities for the orthodontist and his auxiliary personnel with simple means to increase their patient's oral hygiene awareness. This would not only reduce the prevalence and severity of iatrogenic damage, but would increase the long-term benefits of the orthodontic therapy. Orthodontists may thus provide young adults with an improved esthetic facial appearance, a perfectly functioning occlusion, and the desire, interest, and possibilities of maintaining the dentition in this condition for all or most of their lives (Figs. 3 to 5, 12, and 13).

A Didactic-Experiential Model for an Inservice Workshop on Drug Abuse Education

This one-day workshop on drug education program development combined didactic features with innovative group techniques to generate a practical list of needs, resources and possible programs for use in public schools. Participants discovered that by using specialized inservice training and auxiliary paraprofessional personnel, many of the needs of their schools in the area of drug education might be met without relying on the assistance of outside “expert” consultants. The workshop leaders used psychodrama as a vehicle for cognitive exploration of possible resources and obstacles to proposed drug education programs. The closing activity was the establishing of contracts with individuals or teams from the same schools to implement the program ideas generated in the workshop.

Preventive dentistry in private practice: a survey in Kentucky

General practitioners in Kentucky were surveyed to establish a profile of preventive practice in the state and to identify factors influencing the profile. Both questionnaire and interview methods were used. A Kentuckian has a 55% chance of seeing a dentist who advises all his patients about prevention, and an 87% chance of seeing one who adivses some of his patients. Persons between the ages of 6 and 24 are most likely to receive preventive services. The dentist is selective about who receives a preventive-oriented examination, and he is more likely to perform the services than auxillaries. The profile shows the need for a greatly increased emphasis on preventive dentistry in undergraduate and continuing education courses and for the increased use of auxiliary personnel in the delivery of preventive services.

New light on the transmissibility of viral hepatitis in dental practice and its control

Evidence of an increase in the nonparenteral spread of viral hepatitis is of much concern in dentistry and supports the need for sterilization of all instruments used in intraoral treatments. Methods for the rapid sterilization of all dental handpieces and air-water syringes are still inadequate for routine clinical use. It may be possible to improve surface disinfection of these items by more thorough, repeated cleansing with common disinfectants and by the use of stronger germicidal agents such as aldehydes. However, for handpieces and some other equipment, effective sterilization methods must be developed or the instruments must be modified so they can be safely and rapidly sterilized. Surface disinfectants that will destroy hepatitis viruses are needed for disinfection of the dental unit. The use of gloves is also an important consideration for the protection of both the dentist and his patient. The high attack rate of hepatitis among surgeons, as well as patient protection, make the wearing of gloves during surgery imperative. Evidence that aerosolborne viruses would be removed by filtered laminar air flow or by face masks is not available, but use of these devices reduces exposure of personnel to aerosols in general and appears to be highly desirable. Sterilization of all possible instruments is advocated for use in all institutions and dental offices. Careful monitoring of the effectiveness of sterilization also is advocated. These concepts and new information on which they are based should be incorporated into dental curriculums and continuing education courses for all dentists and auxiliary personnel.

The Role of the Dentist in the Emergency Room

Although most of the problems seen by the dentist in the hospital emergency room are not life-endangering, they can still cause considerable difficulty for the patient and anxiety for the doctor when not treated quickly and effectively. To manage an emergency effectively requires a prepared plan of action. Such planning must participation of the physicians, nurses, and auxiliary emergency room personnel. Since oral and maxillofacial emergencies may present unfamiliar problems to them, they must be instructed in advance about their role in proper care of such patients. Likewise, the dentist must familiarize himself with the emergency room- its operation and its facilities. Through such cooperative efforts, effective patient management will be provided no matter what unforeseen situation may suddenly arise.

Professional opinions in the identification of dental manpower shortage areas

A study was initiated by the Minnesota Dental Association to identify criteria that dental practitioners use in defining a dental manpower shortage area and to determine the perceived effectiveness and acceptability of solutions to the manpower shortage problem. This report from the association presents the study findings. The five factors, in order of importance, that should be considered in a definition of a manpower shortage area are the public's "dental IQ," the ratio of dentists to population, the availability of dental appointment times, the age and productivity of practicing dentists in the area, and the distance patients must travel to the dentist. Minnesota dentists perceived dental placement techniques to be more effective and acceptable than financial incentives or the use of auxiliary personnel in solving the dental manpower shortage problem.

Viral hepatitis as an occupational hazard of dentists

To estimate the risk of viral hepatitis for practicing dentists, a questionnaire survey was conducted in the greater Los Angeles area among the part-time faculty of the University of Southern California School of Dentistry. An icteric episode diagnosed as hepatitis had been experienced by 11, representing 3.9% of the 285 dentists to whom questionnaires were mailed or 4.5% of the 242 respondents. All illnesses occurred after graduation from dental school, and five were after 1967. For general dentists, the minimal frequency was 2.7 (5 of 187 in the sample). Specialists with emphasis in surgical forms of dentistry had hepatitis with a significantly higher frequency: 3 of 19 oral surgeons; 1 of 13 periodontists; and 1 of 9 endodontists. The risk did not vary in this sample with the proportion of young adult patients (15 to 29 years of age) in the practice or recognizable illicit self-injection among patients. Auxiliary dental personnel seem to have a lower risk than dentists themselves. Measures to reduce the hazard are indicated, but at present these are confined to greater care in avoiding percutaneous introduction.

Description of a new cephalostat and its performance.

Studies of the growth of the facial skeleton and evaluation of orthodontic treatment are some of the most common applications of roentgen cephalometry. Such studies require repeated examination of the patient. This in turn requires good reproduction of the relative positions of the focus of the roentgen tube, the subject and the plane of the film. The roentgen tube and the plane of the film can be fixed to one another. The problem is however, to position the subject in a reproducible relation to the roentgen tube and the plane of the film. MOORREES & KEAN (1958) showed that the head can be positioned unsupported with a remarkably good reproducibility, as judged from two observations at an interval of one week. They roentgenogaphed the subjects sitting at ease looking at themselves in a mirror. However, since BROADBENT'S (1931) and HOFRATH'S (1931) introduction of cephalostats as an aid for obtaining standard lateral head roentgenograms, roentgen cephalometric analyses have been based almost exclusively on roentgenograms obtained with the subject positioned in a cephalostat. Examples of different cephalostat constructions have been published by KROGMAN & SASSOUNI (1957). Most cephalostats are technically complicated, a fact which makes them difficult to handle for auxiliary personnel. The aim of our investigation was to construct a cephalostat which would be simple to operate for assisting personnel. This paper describes a new cephalostat and its performance.

Manpower in Obstetrics???Gynecology in a Period of Declining Birth Rate

This paper examines the reallocation of obstetrician time and the possible use of physician substitutes in relation to the changeover to a low birth rate and the need for family planning services in the United States. Published data from the American College of Obstetricians and Gynecologists, the American Medical Association, and other sources are used to develop a composite picture of ob-gyn workloads, and physician time expended and income earned in obstetrics and family planning are compared. Estimates of the unmet need for family planning services are developed. The steady decline in the annual births in the United States over the past decade along with the increase in the number of obstetrician-gynecologists is considered in the context of this need. Use of auxiliary health personnel to stimulate market demand for services of the specialists through lower prices is explored, and the minimum size of the geographical market area and other assumptions required for this effect to occur are specified. Schemes for parttime service of auxiliaries are discussed.