Screening For Medical Conditions Research Articles

Patients Attitudes' Toward Chairside Medical Screening in a Dental Setting

Objective: To assess patient’s attitudes toward chairside medical screening in a dental setting. Material and Methods: In this descriptive-analytic study, subjects referring to the dental school, dental offices, and clinics of Kerman were evaluated. Each subject filled a questionnaire containing demographic data, patient's attitude towards the performance of examination and the medical status of the subjects. The questionnaire consisted of seven main questions and the subjects were asked to rate them from very important (score 5) to not important at all (score 1). Wilcoxon and Mann-Whitney tests and t-test were used. Friedman's nonparametric analysis of variance was used to compare response items within each question. Results: Screening for medical conditions by dentists was important for most of the participants, and it was important for them to be monitored for their medical condition by the dentists. The majority of patients had the will to be screened for each medical condition by the dentists. Male subjects stated skillfulness and professionality (88.4%) as the most important characteristics of the dentist and compassion as the least important one (56.2%). Female subjects stated knowledge of the dentists (96.3%) as the most essential characteristic and compassion as the least important one (85.8%). The will to undertake screening tests was higher in elder subjects. Conclusion: Dental patients have a positive attitude for medical conditions screening. Screening for medical conditions in a dental setting is a new approach, which might be an important contributor to disease control in the general population.

Dentists\u2019 attitudes towards chairside medical conditions screening in a dental setting in Saudi Arabia: an exploratory cross-sectional Study

BackgroundScreening for medical conditions (MCs) of public health importance is a first step in disease prevention and control. Prior studies in the United States found oral health care providers (OHCPS) embrace screening for increased risk of medical conditions in the dental setting. Our objectives were to assess Saudi Arabian (SA) dentist’s attitudes, willingness and perceived barriers towards implementing screening for MCs into their dental practices.MethodsA self-administered, 5-point Likert Scale (1 = very important/willing to 5 = very unimportant/unwilling) questionnaire was given to a convenience sample of 190 practicing dentists. Friedman nonparametric analysis of variance was used to compare responses within each question.ResultsOf the 143 responding dentists the mean age was 31 years; 102 (71%) were men. The majority felt it was important for a dentist to screen for cardiovascular disease (98.6%), hypertension (97.9%), diabetes (97.9%), human immunodeficiency virus (HIV) (97.9%), and hepatitis C virus (98.6%). Respondents were willing to refer a patient to a physician (97.9%); send samples to an outside laboratory (96.1%); conduct screening that yields immediate results (96.2%); and discuss results immediately with the patient (93.7%). Respondents were willing to measure/collect blood pressure (67.2%); weight and height (63.7%); and finger stick blood (54.6%). The whole responding dentists (100%) reported time as an important barrier. Respondents were significantly more willing to refer a patient for consultation than send samples to an outside laboratory (mean ranks: 2.32, 2.81, P < 0.001); significantly more willing to measure blood pressure than take oral fluids for salivary diagnostics (mean ranks 2.22, 2.75, p = 0.003). Insurance was significantly (P < 0.05) less important barrier than time, cost, patients’ willingness or liability (mean ranks 3.56, 2.63, 3.00, 2.79, 3.02, respectively).ConclusionsThe majority of dentists in this study reported positive attitudes towards and willingness to perform medical screenings in their practice. Time was an important factor.

Patients' attitudes toward screening for medical conditions in a dental clinic at the Lagos State University Teaching Hospital, Ikeja

BACKGROUND: Early identification of people at increased risk of disease who could benefit from prompt intervention can prevent the onset or control the severity of the disease. This study investigated the knowledge and perceived barriers of dental patients toward screening for medical conditions within a dental setting. MATERIALS AND METHODS: Consenting participants (n = 500) who presented in the Dental Department of Lagos State University Teaching Hospital were recruited using a simple random sampling method. An interviewer-administered questionnaire was used to obtain sociodemographic information as well as the respondents' knowledge, attitudes, and perceived barriers regarding screening for medical conditions by a dentist. Data entry and analysis were done using SPSS version 19 and P RESULTS: Majority of respondents were aged CONCLUSION: The study participants had a positive predisposition toward screening for medical conditions in the dental clinic even though they had concerns about payment and extra time spent for screening. Opportunistic screening for medical conditions is recommended for consenting high-risk patients identified during dental visits. Adequate budgetary allocation to the National Health Insurance Scheme should also be made to address the financial constraints that patients have.

Elucidating the biophysical processes responsible for the chromatic attributes of peripheral cyanosis.

The purple or blue coloration of hands and feet, known as peripheral cyanosis, can represent one of the initial signs of potentially life threatening medical conditions. Consequently, procedures aimed at its early detection and interpretation can help health-care professionals to select the appropriate treatment for these conditions. The effectiveness of such procedures, in turn, depends on the correct assessment of the biophysical processes responsible for eliciting this abnormal skin appearance. However, despite the diverse body of existing clinical research involving cyanosis, the interplay between physiological changes and the optical phenomena leading to cyanotic responses remains not fully understood. In this paper, we methodically examine this interplay through controlled in silico experiments. Among other relevant aspects, the results of our experiments demonstrate that Rayleigh scattering, a light attenuation phenomenon overlooked by previous studies on peripheral cyanosis, plays a pivotal role in the manifestation of cyanotic chromatic attributes. We believe that the insights derived from our experiments can contribute to the development of more effective protocols for the screening of medical conditions associated with peripheral cyanosis etiology.

Assessment of Dental Providers’ Knowledge, Behavior and Attitude towards Incorporating Chairside Screening for Medical Conditions: A Pilot Study

Objective: Emerging evidence-based information supports incorporation of point-of-care screening of individuals at-risk for undiagnosed medical conditions in dental settings. In this study, dental provider’s knowledgeability, attitude and behavior regarding chairside medical screening was assessed across nine federally qualified health center (FQHC)-operationalized dental centers integrated into a large Midwestern US healthcare organization to establish receptivity among regional dental providers. Further, this pilot effort informed the study design and survey tool for conducting a larger statewide study. Methods: Knowledgeability surrounding point-of-care screening, was piloted via a multiple-choice survey targeting 100 regional FQHC dental providers (dentists and dental hygienists) utilizing SurveyMonkey®. The survey captured provider demographics, medical knowledgeability, attitudes, and current practice patterns with conduct of chairside medical screening. Chi-square analysis compared responses based on the respondent’s gender, year of graduation and clinical role. Results: A 26% response rate was achieved. The 26 responding dental providers reported screening for hypertension, diabetes mellitus, prediabetes, obesity, chronic kidney disease, human papilloma virus, hepatitis, human immunodeficiency virus and adverse events of chemotherapy and radiotherapy, with a frequency of 88%, 37%, 8%, 42%, 21%, 29%, 25%, 25% and 37% respectively. Willingness to incorporate chairside screening into clinical practice that yielded immediate results was indicated by 57% of respondents. The most important factors associated with engagement of medical screening included time investment (92%), patient willingness (88%), liability (84%), insurance coverage (56%) and cost (52%). Conclusions: Overall, this pilot study indicated that dental providers’ attitude relative to chairside screening for medical conditions was favorable. While respondents indicated willingness to collect oral fluids for salivary diagnostics and blood pressure and height/ weight measurements, lack of willingness to utilize finger-stick approaches for assessing glycemic status was identified. A statewide study is currently being planned to establish a comprehensive understanding of barriers impeding adoption of chairside screening for medical conditions in a dental setting.

Health care reform brings new opportunities

Health care reform brings new opportunities

Persistent shoulder pain: possible visceral or systemic sources

Background: Several case studies and expert commentaries have been published relating to visceral and systemic sources of persistent shoulder pain; yet, as the evidence presented here suggests, more published work is needed. No systematic reviews have been published to date, likely because this problem is not conducive to randomized control trial investigations.Objectives: This narrative presents a review of the literature of various serious medical conditions that may present as persistent shoulder pain. As physical therapists (PTs) are managing patients with multiple complicated health issues, the PT must be proficient in performing a thorough history and review of systems in order to refer the patient if indicated.Major Findings: In addition to being proficient in examining the shoulder for neuromusculoskeletal (NMS) conditions, it is important that PTs are competent in the screening procedures that may alert the PT of the need for prompt medical referral. Signs and symptoms that present as an NMS shoulder problem can have visceral origins in the thoracic and abdominal cavities and/or systemic manifestations related to the presence of cancers, diabetes, autoimmune diseases, or infectious diseases. Key points to remember when screening for medical conditions are summarized and outlined.Conclusions: The cases presented demonstrate why it is important that PTs are responsible for screening for medical pathology. Physical therapists may be the first medical team members to examine patients due to their role as primary health care providers.

Strauss et al. Respond

We appreciate the response to our article regarding the proportion and characteristics of patients who saw a dentist but not a primary care health provider in 2008. Like Greenberg and Glick, we also performed an earlier analysis using National Health and Nutrition Examination Survey (NHANES) data. We determined the proportion of individuals at increased risk of having diabetes, but who were unaware of that increased risk.1 We found that 93% of US persons over 20 years of age, undiagnosed with diabetes but with moderate or severe periodontal disease, have risk factors indicating the importance of diabetes screening. We determined that 50% of those persons had seen a dentist in the past year and could have been screened for diabetes in the dental office. We appreciate Greenberg and Glick’s analysis regarding the potential use of the dental visit to identify males at increased risk for developing a severe cardiovascular event.2 Like their subsequent analyses demonstrating dental provider and patient willingness to participate in patient screening for medical conditions in the dental office,3,4 our research has shown the willingness of dentists and patients to be screened for diabetes.5 This is especially the case if screening involves the use of oral blood from at-risk patients with periodontal disease. In our article, we report results of a preliminary assessment of the extent to which a dental practice could serve as a site of opportunity to identify a variety of systemic health disorders for patients of all ages. Medical Expenditure Panel Survey (MEPS) data were very useful because they enabled explicit inclusion in our analysis of specific types of primary care health providers (physicians, nurses, nurse practitioners, physician assistants, physical therapists, optometrists, and chiropractors) who saw patients on an outpatient basis in an office, hospital outpatient department, or hospital emergency room.6 Using interactive MEPSnet query tools,7 the analyses were straightforward, enabling researchers who have limited familiarity with complex survey analysis software to conduct other salient analyses. Our finding that 19.5 million people with diverse sociodemographic characteristics only visited a dental practice in 2008 suggests that the potential value of disease screening by dentists cuts across all strata of the US population. Like Greenberg and Glick, we welcome the potential collaboration between oral and systemic health practitioners and researchers that may be stimulated by discussion of our findings. Such a collaboration can serve to improve patients’ health, even as it reduces long-term health care costs resulting from unnecessary delay in disease identification.

Patients' attitudes toward screening for medical conditions in a dental setting

Previous studies demonstrated the efficacy of chairside medical screening by dentists to identify patients who are at increased risk for developing cardiovascular-associated events and the favorable attitude of dentists toward chairside medical screening. This study assessed patient attitudes toward chairside medical screening in a dental setting. A self-administered questionnaire of eight five-point response scale questions was given to a convenience sample of adult patients attending an inner-city dental school clinic and two private practice settings. Wilcoxon-Mann-Whitney tests and t-tests were used to compare responses between study groups. Friedman nonparametric analysis of variance was used to compare response items within each question. Regardless of setting, the majority of respondents was willing to have a dentist conduct screening for heart disease, high blood pressure, diabetes, human immunodeficiency virus infection, and hepatitis infection (55-90 percent); discuss results immediately (79 percent and 89 percent); provide oral fluids, finger-stick blood, blood pressure measurements, and height and weight (60-94 percent); and pay up to $20 (50-67 percent). Respondents reported that their opinion of the dentist would improve regarding the dentist's professionalism, knowledge, competence, and compassion (48-77 percent). The fact that the test was not done by a physician was ranked as the least important potential barrier. While all respondents expressed a favorable attitude toward chairside screening, the mean score was significantly lower among clinic patients across most questions/items. The priority rankings within an item were similar for both groups. Acceptance by patients of chairside medical screening in a dental setting is a critical element for successful implementation of this strategy.

Preventing the Unpredicted: Managing Violence Risk in Mental Health Care

Preventing the Unpredicted: Managing Violence Risk in Mental Health Care