-
British Dental Journal Jun 2024This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little...
This case presents clinical techniques and materials that may be applied in the management of internal tunnelling root resorption, a rare condition which has little published literature.A 25-year-old woman was referred to a specialist centre by her general dental practitioner following an incidental finding of a radiographic radiolucency, suggestive of root resorption associated with tooth 21. A provisional diagnosis of external cervical resorption was made, and following cone beam computed tomography (CBCT), a definitive diagnosis of internal tunnelling root resorption given. Non-surgical endodontic treatment was completed using continuous wave compaction with a calcium-silicate based sealer. No further intervention has been required.A summary of the histology, aetiology, prevalence, diagnosis, management and prognosis of internal tunnelling root resorption is provided. The benefits of CBCT for diagnosing and managing internal tunnelling resorption defects and using continuous wave compaction with a calcium-silicate based sealer, compared to cold obturation techniques, are discussed.
Topics: Humans; Root Resorption; Female; Adult; Incisor; Cone-Beam Computed Tomography; Root Canal Filling Materials; Silicates; Calcium Compounds; Maxilla; Root Canal Therapy
PubMed: 38942857
DOI: 10.1038/s41415-024-7504-7 -
Evidence-based Nursing Jun 2024
PubMed: 38942467
DOI: 10.1136/ebnurs-2023-103888 -
BMJ Military Health Jun 2024Soldiers must achieve high-level mission-preparedness to endure extended periods of physical and cognitive activity, with unpredictable recovery, in all environments.... (Review)
Review
Soldiers must achieve high-level mission-preparedness to endure extended periods of physical and cognitive activity, with unpredictable recovery, in all environments. Nutrition provides the foundation for health and performance. Militaries have not maximised the strategic and financial value that considering nutrition as a military capability could deliver. A whole system approach to military nutrition, based on the prepare-perform-recover human capability cycle phases, is presented. Trainee nutrition requirements, through to very-high-readiness forces undertaking arduous roles at reach, must be specifically addressed. Promoting military performance diets in the prepare phase, through practitioner-supported nutrition education and food provision, will ensure mission readiness and mitigate ill health. Delivering nutrition in field settings in the perform phase-through smaller/lighter, nutritionally optimised rations and smart packaging technologies-will improve utility and minimise waste. Strategic dietary supplement use can provide a mission performance-enhancing adjunct to a food-first philosophy. Impact value chain analysis of military nutrition capability investments could support cost-benefit measurement.
PubMed: 38942432
DOI: 10.1136/military-2024-002738 -
Journal of Psychosomatic Research Jun 2024Identifying whether experienced symptom burden in individuals with medical predisposition indicates somatic symptom disorder (SSD) is challenging, given the high overlap...
OBJECTIVE
Identifying whether experienced symptom burden in individuals with medical predisposition indicates somatic symptom disorder (SSD) is challenging, given the high overlap in the phenomenology of symptoms within this group. This study aimed to enhance understanding SSD in individuals at risk for heart failure.
SUBJECTS AND METHODS
Cross-sectional data from the Hamburg City Health Study was analyzed including randomly selected individuals from the general population of Hamburg, Germany recruited from February 2016 to November 2018. SSD symptoms assessed with the Somatic Symptom Scale-8 and the Somatic Symptom Disorder-12 scale were categorized by applying cluster analysis including 412 individuals having at least 5% risk for heart failure-related hospitalization within the next ten years. Clusters were compared for biomedical and psychological factors using ANOVA and chi-square tests. Linear regressions, adjusting for sociodemographic, biomedical, and psychological factors, explored associations between clusters with general practitioner visits and quality of life.
RESULTS
Three clusters emerged: none (n = 215; 43% female), moderate (n = 151; 48% female), and severe (n = 46; 54% female) SSD symptom burden. The SSS-8 mean sum scores were 3.4 (SD = 2.7) for no, 6.4 (SD = 3.4) for moderate, and 12.4 (SD = 3.7) for severe SSD symptom burden. The SSD-12 mean sum scores were 3.1 (SD = 2.6) for no, 12.2 (SD = 4.2) for moderate, and 23.5 (SD = 6.7) for severe SSD symptom burden. Higher SSD symptom burden correlated with biomedical factors (having diabetes: p = .005 and dyspnea: p ≤ .001) and increased psychological burden (depression severity: p ≤ .001; anxiety severity: p ≤ .001), irrespective of heart failure risk (p = .202). Increased SSD symptoms were associated with more general practitioner visits (β = 0.172; p = .002) and decreased physical quality of life (β = -0.417; p ≤ .001).
CONCLUSION
Biomedical factors appear relevant in characterizing individuals at risk for heart failure, while psychological factors affect SSD symptom experience. Understanding SSD symptom diversity and addressing subgroup needs could prove beneficial.
PubMed: 38941711
DOI: 10.1016/j.jpsychores.2024.111848 -
The British Journal of General Practice Jun 2024
PubMed: 38816243
DOI: 10.3399/bjgp24X738429 -
British Dental Journal Jun 2024As temporomandibular disorders (TMDs) become ever more prevalent in both primary and secondary care settings, successful management is increasingly challenging in both...
As temporomandibular disorders (TMDs) become ever more prevalent in both primary and secondary care settings, successful management is increasingly challenging in both sectors. The authors aim to explore the dilemma of TMD management as the patient journeys through from primary to secondary care and offer educational tools to support practitioners in managing this complex patient cohort, as well as outlining alternative solutions for the delivery of TMD management strategies.
Topics: Humans; Temporomandibular Joint Disorders; Primary Health Care; Secondary Care
PubMed: 38942856
DOI: 10.1038/s41415-024-7506-5 -
Contact Lens & Anterior Eye : the... Jun 2024Rigid contact lenses have an important role in contact lens practice. The purpose of this work is to update earlier surveys by describing global trends in rigid lens...
PURPOSE
Rigid contact lenses have an important role in contact lens practice. The purpose of this work is to update earlier surveys by describing global trends in rigid lens fitting between 2000-2023.
METHOD
An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023. Data relating to 342,500 fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of rigid lens fitting, defined as the fitting of any design of a contact lens manufactured in a rigid material.
RESULTS
Overall, rigid lens prescribing increased slightly over time, from 14.2 % of lens fits in 2000 to 15.2 % in 2023 (p < 0.0001). However, post-hoc analysis shows that the change over time is best described as a decline between 2000 and 2012, followed by a steady increase subsequently. There were significant differences in rigid lens prescribing between countries (p < 0.0001). The difference between the percentage of males fitted with rigid lenses, as a proportion of all contact lenses (12.7 %), and females (12.0 %) is significant (p < 0.0001), although not clinically meaningful. Rigid lens wearers are older at fitting than soft lens wearers (38.7 vs 31.3 years, respectively) (p < 0.0001). Analysis of 5,994 rigid lens fits prescribed currently (2019-2023) were categorised as: corneal sphere - 30 %; scleral and corneo-scleral - 28 %; corneal myopia control/orthokeratology - 21 %; and corneal complex (including toric, multifocal and monovision) - 16 %.
CONCLUSION
There has been a slight increase in rigid lens fitting during the second decade of this century. This increase is apparently due to a 'repurposing' of rigid lenses, with the growth of scleral/corneo-scleral and myopia control/orthokeratology lens fits essentially replacing conventional spherical corneal lens fits.
PubMed: 38942659
DOI: 10.1016/j.clae.2024.102255 -
PLOS Global Public Health 2024Patients' experiences in the intensive care unit (ICU) can enhance or impair their subsequent recovery. Improving patient and family experiences on the ICU is an...
Patients' experiences in the intensive care unit (ICU) can enhance or impair their subsequent recovery. Improving patient and family experiences on the ICU is an important part of providing high quality care. There is little evidence to guide how to do this in a South Asian critical care context. This study addresses this gap by exploring the experiences of critically ill patients and their families in ICUs in Bangladesh and India. We elicit suggestions for improvements from patients, families and staff and highlight examples of practices that support person-centred care. This multi-site hospital ethnography was carried out in five ICUs in government hospitals in Bangladesh and India, selected using purposive sampling. Qualitative data were collected using non-participant observation and semi-structured interviews and analysed using reflexive thematic analysis. A total of 108 interviews were conducted with patients, families, and ICU staff. Over 1000 hours of observation were carried out across the five study sites. We identified important mediators of patient and family experience that span many different aspects of care. Factors that promote person-centred care include access to ICU for families, support for family involvement in care delivery, clear communication with patients and families, good symptom management for patients, support for rehabilitation, and measures to address the physical, environmental and financial needs of the family. This study has generated a list of recommendations that can be used by policy makers and practitioners who wish to implement person-centred principles in the ICU.
PubMed: 38941335
DOI: 10.1371/journal.pgph.0003372 -
PloS One 2024Personal care for body organs is a well-known practice of human beings, especially those organs that need regular care to improve function or hygiene. The ear is a...
BACKGROUND
Personal care for body organs is a well-known practice of human beings, especially those organs that need regular care to improve function or hygiene. The ear is a unique sense organ with a specific anatomical shape to perform the function of hearing and balance.
OBJECTIVES
To determine healthcare practitioners' current knowledge, behavior, and attitude regarding ear care.
SUBJECTS AND METHODS
This cross-sectional study was conducted among healthcare practitioners at different hospitals in Najran City, Saudi Arabia, from 25th June to 30th August 2022. A self-administered questionnaire was distributed among healthcare practitioners using an online survey. The questionnaire includes basic demographic characteristics (i.e. gender, speciality, and religion). It assesses the knowledge, behavior, and attitude toward ear care, and the use of mobile headphones and earrings that affect ear health. All statistical data were analyzed using SPSS version 26.
RESULTS
Of the 209 healthcare practitioners involved, 60.8% were females, and 46.9% were physicians. The prevalence of self-ear cleaning was 97.6%. Of them, 33% were cleaning their ears every week. Cotton buds were the most preferred method for self-ear cleaning. The proportion of participants who injured their ears while cleaning was 8.6%. The most common treatment method to relieve ear pain was visiting a doctor (44.4%) and utilizing a painkiller (29.7%). Interestingly, respondents who injured their ears during cleaning and those who experienced wax accumulation were significantly more common among physicians.
CONCLUSION
Self-ear cleaning practices are widely prevalent in this study which could be related to the lack of knowledge about ear care among healthcare practitioners. Physicians who experienced wax accumulation tend to use other methods for self-ear cleaning rather than cotton buds. Further research is needed to determine the knowledge, attitude, and practices of the population who are working in healthcare institutions.
Topics: Humans; Saudi Arabia; Female; Male; Adult; Health Knowledge, Attitudes, Practice; Cross-Sectional Studies; Surveys and Questionnaires; Middle Aged; Health Personnel; Attitude of Health Personnel; Ear
PubMed: 38941273
DOI: 10.1371/journal.pone.0303761 -
Journal of Primary Health Care Jun 2024Introduction Advanced and extended primary health care practice roles have been developed in Aotearoa New Zealand (NZ) for dietetics, nursing, pharmacy, and...
Introduction Advanced and extended primary health care practice roles have been developed in Aotearoa New Zealand (NZ) for dietetics, nursing, pharmacy, and physiotherapy professions. Advanced musculoskeletal physiotherapy roles in primary health care could address escalating health care costs, challenges to workforce sustainability and inefficient primary/secondary care interfaces. Little is known about how stakeholders perceive the recently introduced Advanced Practice Physiotherapist (APP) scope of practice. Aim This study aimed to explore health professionals' perceptions of the APP scope of practice in NZ and how APPs could influence physiotherapy service delivery for people with musculoskeletal conditions in primary health care. Methods Qualitative, face-to-face, semi-structured interviews were conducted with 15 participants including physiotherapists, general practitioners, medical specialists and Accident Compensation Corporation case managers. Inductive interpretive analysis was undertaken. Results Five themes were identified: perceptions of current musculoskeletal management in primary health care; lack of a career pathway; ways in which APPs might facilitate change and what their role would be; characteristics of an APP; and the implementation of the APP role into practice. Discussion Stakeholders were supportive of the APP scope of practice and thought it has the potential to improve patient pathways, health care delivery and health outcomes for those with musculoskeletal conditions. Stakeholders also thought it would fill an important gap in the physiotherapy clinical career pathway. Successful implementation will require assessment of applicants' personal attributes as well as clinical experience and academic qualifications to ensure all stakeholders have confidence to engage with the service, clear communication, active promotion and specific funding.
Topics: Humans; Primary Health Care; New Zealand; Physical Therapists; Qualitative Research; Attitude of Health Personnel; Male; Female; Scope of Practice; Interviews as Topic; Musculoskeletal Diseases; Adult; Professional Role; Middle Aged; Stakeholder Participation
PubMed: 38941257
DOI: 10.1071/HC24029