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Journal of the Advanced Practitioner in... 2018Lung cancer screening with low-dose computed tomography of the chest is now a service covered by the Centers for Medicare and Medicaid Services and most private... (Review)
Review
Lung cancer screening with low-dose computed tomography of the chest is now a service covered by the Centers for Medicare and Medicaid Services and most private insurers. However, providers may experience many barriers that could prevent them from offering lung cancer screening to eligible patients. Advanced practitioners are uniquely positioned to provide lung cancer screening within a formal screening program. Our nurse practitioner-led lung cancer screening program was developed to address these barriers, and to provide evidence-based access to care for a high-risk patient population.
PubMed: 31086688
DOI: No ID Found -
Preventing Chronic Disease Jul 2023A public health practitioner's mission is to protect and promote the health of all people in all communities. Components of being successful in that mission include...
A public health practitioner's mission is to protect and promote the health of all people in all communities. Components of being successful in that mission include understanding who is at risk of negative outcomes, identifying effective actions to promote and protect health, and communicating information accordingly. Information must be scientifically rigorous, provide appropriate contextualizing information, and refer to and visually represent people through words and images in respectful ways. Public health communication objectives include that the audience accepts, understands, and acts on the information to protect and promote health. This article describes the impetus for, development of, and public health applications and implications of principles to guide communication efforts. CDC's Health Equity Guiding Principles for Inclusive Communication is a web-based resource published in August 2021 that offers - but does not mandate - guidance and recommendations for public health practice. The resource can help public health practitioners and their partners consider social inequities and diversity, think more inclusively about the people they serve, and adapt to the cultural, linguistic, environmental, and historical situation of each population or audience of focus. Users are encouraged to have conversations about the Guiding Principles as they plan and develop communication products and strategies in collaboration with communities and partners and build a shared vocabulary consistent with how communities and groups of focus see and understand themselves, because words matter. As the public health field renews its focus on shifting the paradigm toward equity, a language and narrative shift is a vital intervention.
Topics: Humans; United States; Health Communication; Public Health; Health Promotion; Public Health Practice; Centers for Disease Control and Prevention, U.S.
PubMed: 37410939
DOI: 10.5888/pcd20.230061 -
Journal of the American Dental... Jan 2021An important step in integrating dental and medical care is improving understanding of the frequency and characteristics of dental practitioners who conduct health risk...
Dental practitioners' use of health risk assessments for a variety of health conditions: Results from the South Atlantic region of The National Dental Practice-Based Research Network.
BACKGROUND
An important step in integrating dental and medical care is improving understanding of the frequency and characteristics of dental practitioners who conduct health risk assessments (HRAs).
METHODS
From September 2017 through July 2018, active dentist and hygienist members of the South Atlantic region of The National Dental Practice-Based Research Network (N = 870) were invited to participate in a survey evaluating their HRA practices (screening, measuring, discussing, referring patients) for 6 health conditions (obesity, hypertension, sexual activities, diabetes, alcohol use, tobacco use). For each health condition, the authors used ordinal logistic regression to measure the associations among the practitioner's HRA practices and the practitioner's characteristics, barriers, and practice characteristics.
RESULTS
Most of the 475 responding practitioners (≥ 72%) reported they at least occasionally complete 1 or more HRA steps for the health conditions except sexual activities. Most practitioners screened (that is, asked about) and gave referral information to affected patients for diabetes (56%) and hypertension (63%). Factors associated with each increased HRA practice for 2 or more outcomes were non-Hispanic white compared with Hispanic practitioner (cumulative odds ratio [COR] obesity, 0.4; 95% confidence interval [CI], 0.2 to 0.8; and COR diabetes, 0.3; 95% CI 0.2 to 0.8), male compared with female practitioner (COR tobacco, 0.3; 95% CI, 0.2 to 0.7; and COR hypertension, 0.4; 95% CI 0.2 to 0.8), and practitioner discomfort (COR, obesity and alcohol use, 0.7; 95% CI, 0.6 to 0.9; and COR, sexual activities 0.6; 95% CI 0.5 to 0.8).
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Dental practitioners are conducting HRA practices for multiple conditions. Interventions should focus on reducing practitioner discomfort and target non-Hispanic white, male practitioners.
Topics: Delivery of Health Care; Dental Hygienists; Dentists; Female; Humans; Male; Professional Role; Risk Assessment
PubMed: 33276954
DOI: 10.1016/j.adaj.2020.09.003 -
Omega May 2018Sexuality and intimacy, including contact, tenderness, and love, are important at every life stage. Intimate expression is especially vital at the end of life, when... (Review)
Review
Sexuality and intimacy, including contact, tenderness, and love, are important at every life stage. Intimate expression is especially vital at the end of life, when relationships with loved ones are time limited. Unfortunately, care providers often ignore the potential need for sexual expression, especially at the end of life. In this article, we consider current research on sexuality and end-of-life care and situate these two fields in an ecological framework. We explore how end-of-life sexuality and intimacy can be supported by practitioners in multiple nested contexts and provide suggestions for theoretically-driven interventions. We also provide reflexive considerations for practitioners.
Topics: Female; Humans; Interpersonal Relations; Male; Palliative Care; Sexual Partners; Sexuality; Terminal Care
PubMed: 29285977
DOI: 10.1177/0030222817696540 -
Nederlands Tijdschrift Voor Geneeskunde 2016An increasing number of prevention programmes are being introduced in primary and secondary care. Patients seldom doubt the usefulness of these programmes, but doctors... (Review)
Review
An increasing number of prevention programmes are being introduced in primary and secondary care. Patients seldom doubt the usefulness of these programmes, but doctors more frequently do. Primary care programmes for prevention of depression require a high level of effort, but are not very effective: the incidence of new depressive episodes is relatively low, and there is a high percentage of drop-outs from intervention programmes. We need to look critically at the ever increasing expansion of screening and prevention activities in the general practitioner's (GP's) practice, because the fuller the GP's agenda the less time there is for the patient's personal story.
Topics: Depression; General Practitioners; Humans; Primary Health Care
PubMed: 27531250
DOI: No ID Found -
Journal of the American Dental... Dec 2023Local anesthesia is an essential component of dentistry, but there is limited quantifiable understanding of what techniques and local anesthetic solutions are used by...
BACKGROUND
Local anesthesia is an essential component of dentistry, but there is limited quantifiable understanding of what techniques and local anesthetic solutions are used by practicing dentists. Use of the local anesthetic articaine has been highly debated in dentistry regarding its efficacy and risks for paresthesia. The aims of this study were to expand the knowledge of local anesthesia practices of dentists in the United States through a large-scale survey and associate potential influencing factors regarding articaine use specifically.
METHODS
The 23-item survey was sent to 10,340 practicing dentists in the United States, gathering demographic data and local anesthesia approaches and concerns. Statistical analysis consisted of descriptive, bivariate, and multivariate logistic regression analyses.
RESULTS
A total of 1,128 dentists completed the survey. Previous experience with articaine was reported by 97.6% of respondents, with 3.3% no longer using articaine. Sixty percent of respondents indicated using articaine for most local anesthetic injections administered. Multivariable regression analysis found those reporting to use articaine for all local anesthetic injections involving vasoconstrictors were more likely to be male (odds ratio, 1.59; P = .002) or general dentists (odds ratio, 1.63; P < .001).
CONCLUSIONS
Articaine has a perceived benefit to practitioners as most respondents reported using articaine as their primary local anesthetic. A practitioner's sex and type were found to affect the profile of use of articaine.
PRACTICAL IMPLICATIONS
Assembling evidenced-based local anesthesia practices would be beneficial to ensure US practitioners are more standardized in administering local anesthetics, particularly articaine, in the safest and most efficacious way.
Topics: Male; Humans; United States; Female; Carticaine; Anesthetics, Local; Anesthesia, Dental; Anesthesia, Local; Surveys and Questionnaires; Lidocaine; Double-Blind Method
PubMed: 37777935
DOI: 10.1016/j.adaj.2023.08.005 -
Journal of Music Therapy Aug 2021Although there is empirical support for patient-preferred live music (PPLM) in addressing affective states and pain for adults in medical settings, there is a lack of...
Although there is empirical support for patient-preferred live music (PPLM) in addressing affective states and pain for adults in medical settings, there is a lack of data regarding why PPLM might be effective. Identifying the underlying processes and events of change mechanisms within PPLM has the potential to improve education and clinical training, distinguish music therapy from other music interventions, and augment treatment outcomes for service users. The practitioner's expertise constitutes a component of evidence-based practice and could be used to identify change mechanisms that result in PPLM being effective. Therefore, the purpose of this exploratory interpretivist study was to understand practitioners' perceptions of PPLM change mechanisms for adults in medical settings. I conducted in-depth individual semi-structured interviews with 10 practitioners who had provided protocol-based PPLM in adult medical settings as a component of published research projects. Incorporating member checking and trustworthiness, I used an inductive approach to thematic analysis to analyze data. I identified 3 major themes: Choices within PPLM, Music-based aspects of PPLM, and Positive outcomes resultant of PPLM. These themes were supported by 17 subthemes. The subthemes helped to explain relationships between results and I developed a visual model to conceptualize PPLM change mechanisms. While previous objectivist literature has found PPLM to be an effective intervention for adults in medical settings, the results of the current study provide an evidence-based and practitioner-centric approach to PPLM change mechanisms. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.
Topics: Adult; Emotions; Humans; Music; Music Therapy; Pain; Treatment Outcome
PubMed: 33969416
DOI: 10.1093/jmt/thab006 -
Veterinary Medicine (Auckland, N.Z.) 2015The identification of a "battered pets" syndrome, which put the veterinary profession on a parallel footing with its counterparts in human medicine who respond to... (Review)
Review
The identification of a "battered pets" syndrome, which put the veterinary profession on a parallel footing with its counterparts in human medicine who respond to battered children, women, and elders, expanded the veterinarian's role as an advocate for animals' welfare to include the recognition of, response to, and prevention of animal abuse. Professional policies and legislation in several nations have been amended to define these responsibilities and delineate appropriate responses when animal maltreatment or other forms of family violence are suspected. This article reviews these changes, discusses abuse as a matter of animal welfare and public health, and summarizes research describing animal abuse as a possible indicator and predictor of interpersonal violence. Five steps that helped build human health care's response to child abuse, domestic violence, and elder abuse, and that are analogous to forces in contemporary veterinary practice, are described. It familiarizes practitioners with terminology used in animal cruelty investigations. It describes clinical presentations, client profiles and behaviors, and environmental conditions that may raise a practitioner's index of suspicion of possible animal maltreatment. It reviews protocols that practitioners may employ to respond compassionately and effectively to suspected animal abuse and enhance successful law enforcement investigations and prosecutions. Such responses can unite human and veterinary medicine in a common concern for vulnerable, victimized, and at-risk populations and position veterinarians as an essential part of public health approaches to break the cycles of violence affecting animals and human members of the family and community.
PubMed: 30101120
DOI: 10.2147/VMRR.S87198 -
European Child & Adolescent Psychiatry Sep 2019We aimed to explore the levels of agreement about the diagnoses of Autistic Spectrum Conditions between the referrer, CAMHS practitioner and a research diagnosis, as...
The agreement between the referrer, practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services.
We aimed to explore the levels of agreement about the diagnoses of Autistic Spectrum Conditions between the referrer, CAMHS practitioner and a research diagnosis, as well as the stability of the practitioner's diagnosis over time in a secondary analysis of data from 302 children attending two Child and Adolescent Mental Health Services over two years. Kappa coefficient was used to assess the agreement between the referrer and research diagnosis. Kendall's tau b coefficient was used to assess the agreement between the practitioner and the research diagnosis assigned using the Development and Well-Being Assessment, as well as the agreement between the referrer's indication of presenting problems and the practitioner diagnosis. Diagnostic stability was explored in children with and without a research diagnosis of Autistic Spectrum Condition. There was a moderate level of agreement between the referrer and research diagnosis (Kappa = 0.51) and between practitioner's and research diagnosis (Kendall's tau = 0.60) at baseline, which reduced over the subsequent two years. Agreement between the referrer and practitioner's diagnosis at baseline was fair (Kendall's tau = 0.36).The greatest diagnostic instability occurred among children who practitioners considered to have possible Autistic Spectrum Conditions but who did not meet research diagnostic criteria. Further studies could explore the approaches used by practitioners to reach diagnoses and the impact these may have on diagnostic stability in Autistic Spectrum Conditions. Standardised assessment using a clinically rated diagnostic framework has a potential role as an adjunct to standard clinical care and might be particularly useful where practitioners are uncertain.
Topics: Autistic Disorder; Child; Child, Preschool; Female; Humans; Male; Mental Health Services
PubMed: 30778764
DOI: 10.1007/s00787-019-01290-z