Junior Practitioners Research Articles

Clinical Utility of Ultrasonographic Guidance for Arterial Catheterization in Patients with Obesity: A Randomized Controlled Trial

ObjectivesWe aimed to compare the success and complication rates of radial artery catheterizations between ultrasound guidance and conventional palpation technique in obese patients by anesthesia residents with similar levels of experience in both methods. Another objective was to measure the skin-to-artery distance of radial, brachial, and dorsalis pedis arteries using ultrasound with standardized anatomical landmarks. DesignProspective, randomized controlled trial SettingSingle tertiary center ParticipantsEighty adults with a body mass index (BMI) ≥ 30 kg·m-2 InterventionsUltrasound guidance or conventional palpation method Measurements and Main ResultsThe primary outcome was the first-attempt success rate of arterial catheterizations. The skin-to-artery distance of the radial artery in the BMI groups of 40–49 and ≥ 50 kg/m2 was significantly greater than that of the BMI group of 30–39 kg·m-2, mean difference: 1.0 mm [95% confidence interval (CI): 0.4 – 1.7, p=0.0029] for BMI 40–49 vs. 30–39 kg/m2 and 1.5 mm (95% CI: 0.6 – 2.4, p=0.0015) for ≥ 50 vs. 30–39 kg·m-2. Similar findings were observed for the brachial artery. BMI was inversely associated with first-attempt success rates (p=0.0145) and positively with time to successful catheterization (p=0.0271). The first-attempt success and vascular complication rates of catheterization did not significantly differ between the ultrasound guidance group (65.0%; 52.5%) and the conventional palpation group (70.0%, p=0.6331; 57.5%, p=0.6531). ConclusionOur results do not support routine uses of ultrasonography during radial arterial catheterizations for obese adults when junior practitioners performed the procedure.

“Discovering shine through feedback seeking”---feedback seeking among new graduate nurses: a qualitative study

BackgroundFeedback is critical to improving practitioners’ clinical practice and professional growth. Although they are still considered junior practitioners, their feedback-seeking experiences have yet to be investigated. This study aimed to understand the fundamental thoughts and experiences of new graduate nurses regarding feedback-seeking and to identify the main factors that influence their feedback-seeking behaviors.MethodsConducting a descriptive phenomenological study, semi-structured in-depth interviews with newly graduated nurses from four hospitals in Zhejiang Province, China, face-to-face or via video call in the hospital conference room through purposive and snowball sampling. Interview data were evaluated using Colaizzi’s 7-step phenomenological data analysis. The COREQ checklist was followed.ResultsA total of 15 new graduate nurses were interviewed as a sample, and 13 categories emerged from our data. They were categorized into four central elements: (1) perceptions and attitudes, (2) drivers, (3) dilemmas and needs, and (4) transformation and growth.ConclusionsThis study found that new graduate nurses have various needs but face dilemmas in the feedback-seeking process. Nursing managers should be proficient at providing positive leadership, collaborating with clinical mentors to foster an atmosphere where new graduate nurses may obtain honest, transparent, and fair feedback, and exercising caution when providing negative feedback.

Assessing inter- and intra-examiner reliability of orthodontists in devising incisor position objectives on cephalograms: a comparative study between senior and junior practitioners

BackgroundEffective orthodontic treatment planning hinges on accurately defining incisor position objectives (IPO) in cephalograms. The purpose of this study was to estimate the inter-examiner and intra-examiner reliability of different orthodontists in devising IPOs on cephalograms.MethodsTen orthodontists, who were divided into to the senior group (N = 5) and the junior group (N = 5) based on their clinical experience, formulated IPOs for 60 pre-treatment cephalograms twice with an interval of 2 weeks, utilizing SmartOrtho software. The type and magnitude of movement were read directly in the software. A paired t-test assessed the absolute differences between the first and second IPO devising within each group and between the senior and junior groups in each time’s IPO devising. The intra-examiner and inter-examiner reliabilities were calculated.ResultsThere were significant differences in all types of upper incisor movement and lower incisor protrusion/retraction movement between the first and second IPO devising of the senior group. The junior group exhibited significant differences in the twice the upper incisor extrusion/intrusion movement and upper incisor torque movement devising. Additionally, significant differences in all types of incisor movement between the senior and junior groups in each time’s IPO devising. Intra-examiner reliabilities were excellent for both two groups and moderate for the junior group in most types of incisor movement, respectively. The inter-examiner reliability between the two groups ranged from moderate to good across different types of incisor movement.ConclusionsAmong orthodontists, both senior and junior practitioners displayed the best inter-examiner reliability in lower incisor extrusion/intrusion movement. In terms of intra-examiner reliability, senior orthodontists had better intra-examiner reliability in upper incisor position objectives devising than the junior orthodontists. Furthermore, senior orthodontists tended to adopt a more recessive, intrusive, and lingually torqued incisor position approach compared to junior orthodontists.

The Battle against Antibiotic Resistance: Exploring Perceptions, Misconceptions, Attitudes, Practices, and Awareness Factors Influencing Antibiotic Resistance among General and Clinical Populations

Antibiotic resistance is rapidly advancing and becoming a higher risk over time; previously manageable infections have turned untreatable. Objective: To assess the perceptions, misconceptions, attitudes, practices, and awareness factors influencing antibiotic resistance among general and clinical populations. Methods: A total of 348 participants from the general public and 523 junior and senior medical practitioners in Peshawar, Pakistan, were included in this comparative observational cross-sectional study. Data were collected using a standardized questionnaire, which was later assessed by Chi-square test through SPSS version 26.0. Results: The results revealed a lack of awareness and knowledge regarding antibiotic resistance among both groups. Only 32% of the general public correctly identified the definition of antibiotic resistance, while 76% of medical practitioners demonstrated a basic understanding of the concept. However, a significant number of participants from both groups recognized the problem of bacterial infections resistant to all antibiotics and the contribution of self-medication to antibiotic resistance. In terms of self-medication practices, approximately 60% of the general public reported self-medicating with antibiotics without consulting a healthcare professional. Among medical practitioners, the rate of self-medication was significantly lower, but a small proportion still admitted to prescribing antibiotics without appropriate diagnosis or indications. The majority of participants, however, did not intend to prescribe/suggest unnecessary antibiotics. Conclusions: The findings indicated that both groups were cognizant of the issue, yet certain misconceptions persisted within each group.

Perceptions and use of complementary and integrative health practices among rehabilitation professionals: A survey

Despite increasing use of complementary and integrative health (CIH) by rehabilitation providers, information on rehabilitation professionals’ perceptions and utilization of CIH is limited. The purpose of this study was to investigate rehabilitation professionals’ perceptions, utilization, barriers and research of CIH in the United States. A cross-sectional online survey was conducted on the perceptions, utilization, barriers and research regarding CIH. Survey invitations were posted on community boards of rehabilitation associations and sent to rehabilitation institutions listserv in 2020. Of 405 respondents, the majority of respondents were physical therapists (PTs) (34%), then, occupational therapists (OTs) (20%), and physicians (16.8%). Most respondents (68%) worked in settings offering integrative health. Forty three percent of respondents were trained and 22% were certified in CIH practice. Breathing exercises, meditation, massage, and yoga were the most commonly utilized practices for self-care and patient care. Physicians and PTs were more likely than OTs to initiate discussion about CIH with patients ( p =.001 and p =.046 respectively), and senior practitioners were more likely to initiate these discussions than junior practitioners ( p =.037 and p <.001, respectively). Peer-reviewed publications, clinical experience, and personal experience with CIH were the most selected factors affecting respondents’ attitudes toward CIH practices. Rehabilitation clinicians reported that insufficient provider reimbursement and insufficient skills were the primary obstacles to CIH practice. Rehabilitation researchers reported that insufficient funding as the primary obstacle to conducting CIH research. Rehabilitation professionals commonly utilize CIH in practices for self-care and patient care, and they perceive insufficient training, clinical reimbursement and research funding as the main barriers to advancing CIH.

Verbal notification of radiology results: are radiologists meeting expectations?

Delayed communication of radiographic findings is associated with poor patient outcomes and significant medicolegal risk. Radiologists verbally contact referring practitioners with urgent findings, although practitioner's expectations regarding notification have rarely been examined. To assess differences in preferred practice between radiologists and referring practitioners in the verbal communication of urgent radiology findings. For 33 clinical stems, respondents were asked if they would issue (radiologists) or expect to receive (referring practitioners) verbal notification of results or routine written communication only. Surveys were emailed to radiologists and referring practitioners of varying experience at a tertiary referral hospital in Melbourne, Victoria. A total of 97 survey responses was received. Eighty responses were from referring practitioners and 17 from radiologists. Referring practitioners were seen to slightly prefer verbal notification more often than issued by radiologists overall (61%; 95% confidence interval (CI) 57-66% verbal notification expected vs 58%; 95% CI 52-64% issued). More senior referring practitioners with greater than 10 years' experience expected verbal notification more often (67%; 95% CI 59-75%), and more senior radiologists issued verbal reports less often (54%; 95% CI 39-69%). More junior referring practitioners, for example, registrars or fellows, expected notification less often overall (59%; 95% CI 43-76%). Subgroup analysis demonstrated statistically significant differences in notification preferences for certain clinical scenarios. Overall results show fair correlation between referrer's expectations of verbal notification and the provision of verbal notification by radiologists. However, there were discrepancies in the practice and preferences of more junior and senior practitioners in certain clinical scenarios.

The Clinical Variant Analysis Tool: Analyzing the evidence supporting reported genomic variation in clinical practice

PurposeGenomic test results, regardless of laboratory variant classification, require clinical practitioners to judge the applicability of a variant for medical decisions. Teaching and standardizing clinical interpretation of genomic variation calls for a methodology or tool. MethodsTo generate such a tool, we distilled the Clinical Genome Resource framework of causality and the American College of Medical Genetics/Association of Molecular Pathology and Quest Diagnostic Laboratory scoring of variant deleteriousness into the Clinical Variant Analysis Tool (CVAT). Applying this to 289 clinical exome reports, we compared the performance of junior practitioners with that of experienced medical geneticists and assessed the utility of reported variants. ResultsCVAT enabled performance comparable to that of experienced medical geneticists. In total, 124 of 289 (42.9%) exome reports and 146 of 382 (38.2%) reported variants supported a diagnosis. Overall, 10.5% (1 pathogenic [P] or likely pathogenic [LP] variant and 39 variants of uncertain significance [VUS]) of variants were reported in genes without established disease association; 20.2% (23 P/LP and 54 VUS) were in genes without sufficient phenotypic concordance; 7.3% (15 P/LP and 13 VUS) conflicted with the known molecular disease mechanism; and 24% (91 VUS) had insufficient evidence for deleteriousness. ConclusionImplementation of CVAT standardized clinical interpretation of genomic variation and emphasized the need for collaborative and transparent reporting of genomic variation.

A qualitative analysis of novice and expert mental performance consultants’ professional philosophies

Professional philosophy has received increased attention as a topic of research and applied interest. A professional philosophy is believed to develop during the early years of consulting and evolve as a function of experience, advanced education and training, reflective practice, and supervision. To systematically investigate this proposed transition, this study sought to analyze novice and expert mental performance consultants’ (MPCs) professional philosophies using Poczwardowski et al.’s hierarchical structure of professional philosophy as a guiding framework. Additionally, this study aimed to explore perceptions of how a professional philosophy might improve consultant effectiveness. Eighteen participants (9 novice MPCs, 9 expert MPCs) were interviewed about the various components of their professional philosophy. Findings revealed key similarities and differences between the types of philosophies that novice and expert MPCs adopted in their practice. Novice and expert consultants exuded their values in the relationships with their clients, however, experts modeled their values through their behaviors. Although both groups used their chosen theoretical paradigm to guide their work with clients, expert MPCs specifically mentioned using this to aid their case conceptualization. Benefits of understanding one’s unique philosophy to provide sport psychology services were also highlighted by both groups. Findings help to further highlight the importance of developing a consulting philosophy as a novice consultant. Furthermore, understanding one’s philosophical approach to practice could be important for ensuring seasoned consultants are providing effective services to clients. Lay summary: Professional philosophy is a fundamental driving force of mental performance service delivery and represents a valuable asset for both junior and senior practitioners. Professional philosophy is characterized by the purpose, values, beliefs, and ideals underlying one’s consulting approach and underpins the decisions regarding which theories, principles, interventions and techniques to utilize in practice to facilitate change. Based on the nuances observed when comparing philosophies of novice and expert mental performance consultants, practitioners of all levels can benefit from periodically reflecting upon their consulting philosophy to continuously hone their craft and improve their competence and efficacy. IMPLICATIONS FOR PRACTICE Novice mental performance consultants should look to develop a philosophy in line with their values and beliefs at an early stage in their career. Expert consultants should continue to be aware of their own philosophy and recognize the importance of how it contributes to an effective and coherent delivery of service.

Radiolucent Lesions of the Jaws: An Attempted Demonstration of the Use of Co-Word Analysis to List Main Similar Pathologies.

(1) Background: Many radiolucent jaw lesions exist, and they often show a radiographic resemblance, rendering diagnosis a challenging act. Closely related lesions should be frequently mentioned together in the academic literature, which might be helpful for junior practitioners in determining their differential diagnosis. The usefulness of bibliometric analysis in this respect has yet to be demonstrated. (2) Methods: This study evaluated academic publications on radiolucent jaw lesions, as indexed by the Web of Science Core Collection database. The mentions of radiolucent jaw lesions were extracted from the complete bibliographic records of the publications, and co-word analyses were conducted with the aid of VOSviewer. (3) Results: Based on 1897 papers, visualization maps were synthesized to evaluate co-occurrences of the radiolucent jaw lesions. Ameloblastoma was frequently mentioned together with odontogenic keratocyst, dentigerous cyst, and radicular cyst. Osseous dysplasia was co-mentioned with osteomyelitis, ossifying fibroma, odontoma, fibrous dysplasia, and apical periodontitis. (4) Conclusions: The co-word analysis, a form of bibliometric analysis, could demonstrate a relatedness of radiolucent jaw lesions that could be considered at differential diagnosis.

Multiparametric CT-based assessment of pretracheal anatomical relationships for safe tracheotomy: A long-forgotten issue revisited

ObjectivesTo assess the anatomical relationships and variations in the pretracheal space and to guide tracheotomy procedures in a safe manner with image-based evidence. Materials and methodsA retrospective study was conducted on unirradiated patients requiring elective tracheotomies. Preoperative contrast-enhanced CT (CECT)/CT venography (CTV) was applied for an anatomical evaluation of the pretracheal region. Vascular morphologies were compared for three vessels: the anterior jugular vein (AJV), the innominate artery (IA) and the inferior thyroid vascular plexus (ITVP). The relationships between the thyroid isthmus and the 2nd–4th tracheal rings were also analyzed. ResultsA total of 120 patients were identified, most of whom (n = 110, 91.7%) had head and neck squamous cell carcinomas. Patients with recognizable AJVs (n = 118) were divided into 3 groups: single-branch (n = 11, 9.2%), double-branch (n = 105, 87.5%), and multibranch (n = 2, 1.7%). In addition, IAs were categorized as low-bifurcation (n = 51, 42.5%), high-bifurcation (n = 40, 33.3%), platform (n = 27, 22.5%) and variant types (n = 2, 1.7%). Within the platform types, high-lying IAs (n = 15, 8.3%) might have interfered with the standard tracheal incisions due to possible IA-tracheal overlay. This interference was also related to the height of intraoperative tracheal incisions (rn = 0.364, P = 0.001). Within ITVPs, independent-trunk types were found in 71 cases (59.2%), while common-trunk types were found in 45 (37.5%). In addition, a low thyroid isthmus (suprasternal-isthmus distance <3 cm) was found in 83 cases (69.2%). ConclusionsCT image-based evidence can prepare junior practitioners with important pretracheal anatomical information, thereby facilitating safer tracheotomy procedures. Our results shed light on vascular relationships for emergent tracheotomy.

Short-Term Pain Evolution and Treatment Success of Pulpotomy as Irreversible Pulpitis Permanent Treatment: A Non-Randomized Clinical Study.

The objective of this work was to evaluate (1) the short-term evolution of pain and (2) the treatment success of full pulpotomy as permanent treatment of irreversible pulpitis in mature molars. The study consisted of a non-randomized comparison between a test group (n = 44)—full pulpotomy performed by non-specialist junior practitioners, and a control group (n = 40)—root canal treatments performed by specialized endodontists. Short-term pain score (Heft–Parker scale) was recorded pre-operatively, then at 24 h and 7 days post-operatively. Three outcomes were considered for treatment success: radiographic, clinical and global success. For short-term evolution of pain, a non-parametric Wilcoxon test was performed (significance level = 0.05). For treatment success, a Pearson Chi square or Fisher test were performed (significance level = 0.017–Bonferroni correction). There was no significant difference between test and control groups neither regarding short term evolution of pain at each time point, nor regarding clinical (80% and 90%, respectively) or global success (77% and 67%, respectively). However, a significant difference in radiographic success was observed (94% and 69%, respectively). The present work adds to the existing literature to support that pulpotomy as permanent treatment could be considered as an acceptable and conservative treatment option, potentially applied by a larger population of dentists.

Standard Jones and Modified Jones: An Earnings Management Tutorial

ABSTRACT Context: measurement of earnings management usually requires multi-step models for computation. After examining the literature through bibliometrics studies, literature review, and research databases, we found that the Standard Jones model and its subsequent modifications are those that have more prominent use. Much of this research is potentially interesting for business theories related to earnings quality and accounting manipulation; however, it is difficult to be understood by junior researchers and practitioners, because they are not clearly described in the literature or the steps may be easy to confuse. Objective: in this tutorial, we present several key concepts about earnings management and explain, step by step, how to measure it. Method: our tutorial considers measurement using the following models: Standard Jones, Modified Jones, Modified Jones with return on assets (ROA), and Modified Jones using Cash Flows and Accruals Reversals. Conclusions: our main contribution with this tutorial is to provide a step-by-step guide for future studies, so that they can be more comparable with each other when using measurement methods of earnings management.

Wrist fracture management and the role of surgical care practitioner through the patient's journey.

The presentation of this case study involves an exploration of the patient's journey in detail after having a traumatic wrist fracture, which is recognised as one of the most common fractures encountered daily in emergency services by junior doctors and practitioners. However, this article not only analyses the medical guidance for this type of case, but also the importance of the surgical care practitioner role in trauma and orthopaedics. All practitioners attending patients in emergency services are required to develop a good knowledge of anatomy, physiology, patient's examination technique, classifications and consequently being aware of the possible surgical options for treatment of the fracture. They will also need to fully understand the legal implications of consent to ensure safe practice.

Role and educational implications of cognitive surgical skills

Surgical skills have traditionally been classified as technical and non-technical skills. Technical skills—also called psychomotor skills—constitute a core component of surgical skills. They have been the focus of surgical skill...

Professionalization of Public Health in Nepal

Background: The need for a professionalized and highly skilled public health workforce is essential to improving and protecting the health of populations, especially in Nepal. This study aimed to explore: (i) the current trends in public health in Nepal and (ii) the opportunities and barriers to the professionalization of the sector.&#x0D; Methods: We employed an exploratory qualitative research design and used a combination of semi-structured interviews with senior public health professionals and a small focus group discussion with more recently qualified public health practitioners in Nepal. A total of nine professional stakeholders were interviewed and five junior practitioners joined the focus group discussion. Data was collected via Skype due to COVID-19 restrictions. Thematic analysis was used to analyze the data.&#x0D; Results: Four core themes emerged from the research: understanding the public health approach; health priorities; federalization and the impact on public health practice; professionalization and workforce development.&#x0D; Conclusions: Political federalization and more recently COVID-19 have impacted the development, capacity, and employment of this often-neglected workforce. Public health graduates with their broad-ranging knowledge and skills are often overlooked in the health sector. This is related to a general lack of understanding of what public health is and what public health practitioners do amongst politicians and the general public.

The attitude and psychological status of medical staff in China during the COVID-19 outbreak: a cross-sectional survey

BackgroundIn early 2020, the outbreak of coronavirus disease 2019 (COVID-19) in China greatly increased the burden on medical staff. We aimed to investigate the attitudes of medical practitioners towards arranging rotations for medical students during this period of staff shortage and to assess their psychological state. MethodsWe used the self-rating depression scale (SDS) and the self-rating anxiety scale (SAS) to do a psychological assessment of both medical and non-medical staff from 25 centres in different provinces in China. Participants were recruited through hospital departments, online medical-alumni organisations, and open recruitment through online platforms. Participant eligibility criteria for all participants included being older than 18 years and living in China during the survey period, and participant-specific criteria included the following: medical practitioners had to work as a doctor, nurse, or clinical laboratory technician in a medical institution, and work during the COVID-19 outbreak; medical students had to have majored in clinical medicine, nursing, or clinical laboratory diagnosis, and be on an undergraduate internship (phase 1 student) or postgraduate or standardised trainees (phase 2 student), and had to work during the COVID-19 outbreak; non-medical participants had to work in non-medical industries. Medical staff included medical practitioners and medical students. We used WeChat online questionnaires to investigate the attitude of medical practitioners and medical students to arranging for students to be on duty during the epidemic period. The primary outcomes of this study were attitude of medical staff to medical students, depression index (according to the SDS), and anxiety index (according to the SAS). We used descriptive statistics to analyse demographic covariates, SDS scores, and SAS scores, χ2 and Fisher's exact test to compare categorical data, independent t-tests and one-way ANOVA tests to compare numerical data, LSD tests and Tamhane tests to compare significance in multiple groups, Pearson's tests to compare the goodness of fit of numerical data, and Spearman's tests to compare the goodness of fit of two ordinal category data. This study was approved by the medical ethics committee of West China Second University Hospital, Sichuan University (approval number 2020-012). The study was done in accordance with the Declaration of Helsinki and all participants provided informed consent. FindingsWe recruited 506 people (236 medical staff, of which 150 medical practitioners and 86 medical students, and 270 non-medical staff; 130 [26%] men and 376 [74%] women, median age 36 years, IQR 27–45) into our cross-sectional survey. 133 (56%) of 236 medical staff had a positive attitude towards arranging rotations of students on duty, with the most positive being students in phase 2 (34 [68%] of 50 had a positive attitude) and the most negative being senior practitioners (28 [40%] of 70 had a positive attitude). 178 (75%) of 236 medical staff considered students on duty to be high risk, and students in phase 1 (32 [86%] of 37) and senior practitioners (56 [80%] of 70) were particularly worried about this. 160 (68%) of 236 medical staff considered that students who refused to be on duty were excusable, even though some junior practitioners suggested punishing them (17 [22%] of 79). There was no significant difference in SDS and SAS between medical students and medical practitioners, but depression and anxiety was significantly lower than in non-medical staff (SDS 13·69, 95% CI 12·07–15·50, vs SDS 24·20, 21·30–27·11, p=0·0010; SAS 7·54, 5·83–9·46, vs SAS 18·76, 16·22–21·80, p=0·0010). In addition, people with lower education showed a higher index of depression and anxiety than people with higher education (cut-off point for higher education was a bachelor's degree; SDS 14·06, 12·63–15·68, vs SDS 35·03, 30·89–39·09, p=0·0010; SAS 8·52, 6·81–10·34, vs SAS 25·75, 22·41–29·13, p=0·0010). InterpretationNegative psychological states were associated with lower levels of educational attainment, and people with a high education and a medical background could more clearly recognise the development of the epidemic. The more clinically experienced practitioners were, the more worried they were about risks to students. The government should enact permanent bills to guarantee personal safety and accident compensation of students who are willing to go to the front line. FundingNone.

Pharmacy and medical students’ competence and confidence with prescribing: A cross-sectional study

IntroductionPrevious research has shown that prescribing competence is weakly correlated with prescribing confidence. This questions whether undergraduate programs adequately prepare students and junior practitioners for safe and rational prescribing. The goal of this project was to investigate whether there are differences in prescribing competence and confidence between fourth year pharmacy and medical students at the University of Alberta. MethodsA cross-sectional design measured prescribing competence using five case scenarios and prescribing confidence with a survey. All fourth-year pharmacy and medical students at the University of Alberta were eligible to participate. Answers to the cases were graded based on therapeutic appropriateness and inclusion of all legal requirements. The confidence survey assessed self-rated confidence of both assessment and prescribing skills. Chi-square tests were used to compare frequencies of prescribing errors and self-rated confidence. The Spearman correlation coefficient was used to explore the correlation between prescribing competence and confidence for both cohorts independently. ResultsThirty-one pharmacy students and 16 medical students (response rate 24% and 10%, respectively) completed the assessment between December 2018 and March 2019. Pharmacy students had significantly more appropriate prescriptions and fewer inappropriate prescriptions than medical students. Both rated themselves as confident or very confident with prescribing, however neither group consistently included all the legal requirements of a prescription. There were no significant correlations between competence and confidence. ConclusionsThere are differences in prescribing competence and confidence between pharmacy and medical students. This assessment identified deficits in prescribing skills that could be targeted by future educational initiatives.

StoryMap(ping) Black Urban Experiences: Toward an Africana DH Subfield Through Research and Pedagogy

In thinking through the meaning of Black Digital Humanities and Africana Studies’ futurity among junior scholars and practitioners, this article presents a meditation on the intersections between Digital Humanities (DH), Africana Studies coursework, and Africana Studies pedagogy. It offers a case study wherein DH was employed in the instruction and assessment activities of an upper division hybrid (i.e., combining traditional face-to-face and online instruction) Africana Studies course at a public university in southern California during the fall semester of the 2018–2019 academic year. The purpose of this experiment was to determine how Africana Studies might go beyond a mere engagement with DH questions, theories, and tools to show how DH coursework that is distinctly “Africana” in nature may be developed more centrally as a subfield of Africana Studies itself. The overarching questions guiding this experiment include the following: What does it mean to engage DH in Africana Studies? How might we teach DH in Africana Studies within the framework of its pedagogical and methodological objectives? How does Africana DH shape both collaborative and creative learning in the classroom?

Retreatment of Root Canals Filled with BioRoot RCS: An In Vitro Experimental Study

IntroductionThe purpose of this study was to compare the speed of removal of root canal filling material and re-establishment of apical patency in root canals filled with a tricalcium silicate–based sealer (BioRoot RCS [BRCS]; Septodont, Saint-Maur-des-Fossés, France) versus a zinc oxide–eugenol sealer (Pulp Canal Sealer [PCS]; Sybron Endo Kerr, Orange, CA) and to analyze the effect of the operator’s experience. MethodsOne hundred twenty root canals of 40 Dentalike dental simulators (Dentsply Sirona, York, PA) were shaped with a WaveOne (Dentsply Sirona) reciprocating file using short 3-mm strokes. Root canals were obturated using a single gutta-percha cone and either BRCS or PCS. Samples treated either with BRCS or PCS were equally dispatched between experienced practitioners and junior practitioners. The time required to remove root filling material and establish apical patency was recorded for each root canal. Samples were compared according to the sealer used and the practitioner’s experience (Mann-Whitney test). ResultsOne hundred fifteen root canals were successfully retreated. No differences in the time required to remove the filling material were observed between the 2 materials for mesiobuccal or distobuccal canals (P > .05). In contrast, the procedure was longer for palatal canals filled with BRCS compared with PCS (79.10 vs 182.45 seconds, P < .01). Experienced practitioners took significantly less time than junior practitioners (P < .05). ConclusionsBRCS can be successfully removed from root canals as quickly as a zinc oxide–eugenol sealer in both mesiobuccal and distobuccal canals but not in palatal ones. The duration of the procedure was affected by the operator’s experience independent of the filling material used or the canal type.

Survey of the necessary competencies and proficiency of safety officers in Thailand.

Competency is important for professionals’ effective performance and career development. However, little is known about the necessary competencies and proficiency in these for Thai safety officers. Therefore, this study aimed to identify the necessary competencies for this group and to compare proficiency in each competency between senior and junior safety officers. A descriptive, cross-sectional study was conducted among 73 safety officers using a self-administered questionnaire. Twenty-five competencies were classified as necessary. Mean proficiency scores were higher for senior safety officers than for more junior safety officers for all examined competencies; however, this difference was not statistically significant for ‘first aid’ or for ‘air sampling and analytical methods’. Regulatory compliance was assessed as the most important competency. Gaps between necessity and proficiency were observed in managing safety programs for the junior group. In both groups, proficiency was lowest in the competency of mental health. The results indicate that Thai safety officers’ training needs may be particularly high for regulatory compliance, managing safety programs, and mental health. Lifelong learning is important for enabling occupational safety and health practitioners to fulfill current requirements in Thailand and elsewhere. Multiple training approaches and a specialist qualification program may encourage competency development, especially for junior practitioners.