Awareness of forensic dentistry among dental professionals in western Saudi Arabia: A knowledge, attitude, and practice-based cross-sectional study.

The aim of the study is to assess the knowledge, attitude, practice, and self-reported record for a list of items that are useful to forensic dentistry (FD) among dental professionals from the western region of Saudi Arabia. This cross-sectional survey was conducted among 406 dental health professionals. A pre-validated questionnaire written in Google Forms was used as a study tool. The questionnaire contained 4 parts: 1 - demographics; 2 - knowledge about FD; 3 - the attitudes; 4 - assessing dental record maintenance. Statistical data were analyzed using Pearson chi-square (χ2). The degree distribution amongst 406 respondents was: 64 bachelors; 162 masters; 180 Doctor of Philosophy (PhDs). 52% of respondents agreed that dentists should have enough knowledge about FD. Yet, 90.4% did not receive any training. All qualifications were aware of FD with no significant difference between groups (P = .06). According to degree, a significant difference between the 3 groups (P = .004), where a bachelor degree showed the least desire in testimony in court for FD evidence (50%) compared to master and PhD degrees (80%, 75%, respectively). Almost 56% of consultants reported that it is not primarily for the dentist to have a good knowledge of FD, while all other qualifications agreed to the opposite (66%). 55.4% of general dentists, 73% of residents, and 94% of consultants believed that FD is an accurate, sensitive, and reliable method in the identification of unknown victims or criminals. Our study revealed that there is a lack of knowledge, attitude, and practice among undergraduates and general dental practitioners. However, this scenario can be upgraded by the inclusion of FD in the dental curriculum in Saudi Arabia.

Guidelines to support newly qualified professional nurses for effective clinical practice.

BACKGROUND:  Transitioning to a professional role is difficult for newly qualified professional nurses. Given the challenges that these nurses experience during the transition to practice, support is essential for them to become efficient, safe, confident, and competent in their professional roles. OBJECTIVES:  The purpose of this study was to explore the transition experiences of newly qualified professional nurses to develop a preceptorship model. METHOD:  This study employed a qualitative approach to purposively collect data. Concept analyses were conducted applying the steps suggested by Walker and Avant, and the related concepts were classified utilising the survey list of Dickoff, James and Wiedenbach's practice theory. RESULTS:  A preceptorship model for the facilitation of guidance and support in the clinical area for newly qualified professional nurses was developed. The model consists of six components, namely, the clinical environment, the operational manager and preceptor, the newly qualified professional nurse, the preceptorship, the assessment of learning, and the outcome. CONCLUSION:  The study revealed that newly qualified professional nurses face many transition challenges when entering clinical practice. They are thrown far in, experience a reality shock, and are not ready to start performing their professional role. The participants agreed that guidance and support are needed for their independent practice role.Contribution: The preceptorship model for newly qualified professional nurses would be necessary for the transition period within hospitals. This preceptorship model may be implemented by nursing education institutions as part of their curriculum to prepare pre-qualifying students for the professional role.

Supportive periodontal care in dental practice: Part 1 - the importance and implications for general dental practitioners.

Supportive periodontal care is an essential component of maintaining the outcome of periodontal treatment. It is essential to ensure cost benefit to both patients and the health services where millions are spent on treating patients with periodontal disease. The dentist must be able to recognise the crucial and important role they play in providing supportive care and therapy to periodontally compromised patients, either independently or as part of a wider dental team, over and above the various challenges they may experience in the provision of such care in general dental practice. The timely intervention with treatment or referral during this phase will help reduce the risk of tooth loss and adverse consequences to the dentist and their team by way of litigation. The aim of this paper is to provide an update on the delivery of supportive periodontal care in general dental practice with a particular reference to the role of the dentist.

What is occlusion? Part 2.

Some dentists choose to ignore the subject of occlusion, while others propose a set of doctrinal rules. It is of little wonder therefore that it can become a source of confusion and even controversy. This series of two papers aims, firstly, to answer the very simple question of 'what is occlusion?'. It will put occlusion into the context of the articulatory system because that is the bio-mechanical environment where the majority of dentists do their work. The concept of jaw relation will also be discussed but within the context of this locomotive system. Ideal occlusion will be described but only after answering the question: for whom or what might an occlusion be considered ideal? Although, in the book of which this is the first chapter, he presents what has worked for him during many years as a general dental practitioner, university lecturer and specialist in restorative dentistry, he has tried not to be didactic because he feels that, in a profession, there are no right answers, only the right questions.

Exploring Volunteer Pharmacists' Experiences in Responding to 2023 Türkiye Earthquakes: A Qualitative Phenomenological Study.

OBJECTIVE: Pharmacists are vital in disaster response efforts, dispensing essential medications, managing pharmacy services, consulting, and educating survivors regarding their medications. Their contributions, however, are often underrepresented in scientific literature. This study aimed to explore the experiences of pharmacists who provided pharmacy services to meet the pharmaceutical needs of the survivors after 2 major earthquakes in Türkiye in 2023. METHODS: This study adopted a phenomenological approach. Data were collected using semi-structured interviews. Purposive sampling was used to invite pharmacists who provided pharmacy services to survivors. Interview transcripts were analyzed following an inductive, reflexive thematic analysis. RESULTS: In total, 15 pharmacists were interviewed. Four main overarching themes "response to the earthquake," "preparedness for the earthquake," "experiences during service delivery," and "mental and physical experiences" were developed. CONCLUSIONS: From participants' experiences, it is essential to expand the clinical responsibilities of pharmacists and train them in providing wound care, administering immunization, and prescribing. Pharmacists should be integrated as essential members of disaster health teams. International health organizations, nongovernmental organizations, and governments are encouraged to work collaboratively and develop disaster management plans including pharmacists in early responders. This might help mitigate the deficiencies and overcome challenges in health-care systems to provide effective patient-centered care by health professionals and respond effectively to disasters.

Impact of pharmaceutical care for asthma patients on health-related outcomes: An umbrella review.

Recent systematic reviews suggest that pharmacists' interventions in asthma patients have a positive impact on health-related outcomes. Nevertheless, the association is not well established, and the role of clinical pharmacists is poorly represented. The aim of this overview of systematic reviews is to identify published systematic reviews assessing the impact of pharmacists' interventions on health-related outcomes measured in asthma patients. PubMed, Embase, Scopus, and Cochrane Library were searched from inception to December 2022. Systematic reviews of all study designs and settings were included. Methodological quality was assessed using AMSTAR 2. Two investigators performed study selection, quality assessment and data collection independently. Nine systematic reviews met the inclusion criteria. Methodological quality was rated as high in one, low in two, and critically low in six. Reviews included 51 primary studies reporting mainly quality of life, asthma control, lung capacity, and therapeutic adherence. Only four studies were carried out in a hospital setting and only two reviews stated the inclusion of severe asthma patients. The quality of the systematic reviews was generally low, and this was the major limitation of this overview of systematic reviews. However, solid evidence supports that pharmaceutical care improves health-related outcomes in asthma patients.

The role of Lesotho community pharmacists in preventing and controlling cardiovascular diseases: The perceived facilitators and barriers.

BACKGROUND: Cardiovascular diseases are a leading cause of mortality globally. The impact of cardiovascular diseases can be minimized by addressing modifiable risk factors at primary health care level. Community pharmacists are well-positioned to identify patients at risk of cardiovascular diseases for early detection and initiation of treatment. However, the role of Lesotho community pharmacists in preventing and controlling cardiovascular diseases is not well understood. The purpose of this study was to explore the Lesotho community pharmacists' role in preventing and controlling cardiovascular diseases. METHODS: The methodological reporting of this study was guided by the consolidated criteria for reporting qualitative studies. A list of registered community pharmacists was obtained from the Ministry of Health. Pharmacists were selected based on their close proximity to the researcher and invited to participate. Semi-structured interviews were conducted until data saturation was reached. The interviews were audio-recorded, transcribed verbatim, and analysed thematically. RESULTS: Five themes were identified namely: 1) Current roles 2) Future role 3) Facilitators, 4) Barriers, and 5) Community pharmacists' perceptions of their roles. Generally, community pharmacists were involved in medication counselling, health promotion, and referral of patients. Lack of support from government, patients' lack of adherence, poor interprofessional relationship, and lack of clear community pharmacy practice guidelines were identified as barriers. Despite the challenges, community pharmacists are motivated by patients' gratitude for their services. CONCLUSIONS: Lesotho community pharmacists can potentially improve cardiovascular diseases' health outcomes at primary healthcare level through early detection of CVD risk factors, and health promotion.

The Role of Chief Medical officers in making Public Health Overview Documents in Norwegian Municipalities. A qualitative Study.

AIMS: To investigate how Chief Medical Officers experience their role in the municipalities´ work with making the public health overview documents, demanded by the Norwegian Public Health Act from 2012. METHODS: A qualitative study with semi-structured focus group interviews with 21 Chief Medical Officers from 20 different municipalities in Norway. The interviews were conducted in 2017. The data were analyzed thematically. RESULTS: The Chief Medical Officers were mainly positive to participating in making public health overview documents. They took on roles as leaders of the work, medical advisors, data collectors towards local GPs and listening post to other sectors. Organizational factors like too small positions and a lack of tradition to involve the CMO in public health work were experienced as barriers to their involvement. The collaboration with the public health coordinators was said to be rewarding, and the intersectoral process involved employees from other sectors in a new way in public health. Although there were some positive experiences, several CMOs considered the use and impact of the public health overview document as limited. CONCLUSION: There was a large variation in the amount and the type of involvement the Chief Medical Officers had in making the public health overview documents in Norwegian municipalities. More research is needed to understand if this has any consequences for the quality of public health work in the municipalities and whether it is a sign of a changing role of the Chief Medical Officers.

Non-dispensing pharmacists integrated into general practices as a new interprofessional model: a qualitative evaluation of general practitioners' experiences and views.

BACKGROUND: A new interprofessional model incorporating non-dispensing pharmacists in general practice teams can improve the quality of pharmaceutical care. However, results of the model are dependent on the context. Understanding when, why and how the model works may increase chances of successful broader implementation in other general practices. Earlier theories suggested that the results of the model are achieved by bringing pharmacotherapeutic knowledge into general practices. This mechanism may not be enough for successful implementation of the model. We wanted to understand better how establishing new interprofessional models in existing healthcare organisations takes place. METHODS: An interview study, with a realist informed evaluation was conducted. This qualitative study was part of the Pharmacotherapy Optimisation through Integration of a Non-dispensing pharmacist in primary care Teams (POINT) project. We invited the general practitioners of the 9 general practices who (had) worked closely with a non-dispensing pharmacist for an interview. Interview data were analysed through discussions about the coding with the research team where themes were developed over time. RESULTS: We interviewed 2 general practitioners in each general practice (18 interviews in total). In a context where general practitioners acknowledge the need for improvement and are willing to work with a non-dispensing pharmacist as a new team member, the following mechanisms are triggered. Non-dispensing pharmacists add new knowledge to current general practice. Through everyday talk (discursive actions) both general practitioners and non-dispensing pharmacists evolve in what they consider appropriate, legitimate and imaginable in their work situations. They align their professional identities. CONCLUSIONS: Not only the addition of new knowledge of non-dispensing pharmacist to the general practice team is crucial for the success of this interprofessional healthcare model, but also alignment of the general practitioners' and non-dispensing pharmacists' professional identities. This is essentially different from traditional pharmaceutical care models, in which pharmacists and GPs work in separate organisations. To induce the process of identity alignment, general practitioners need to acknowledge the need to improve the quality of pharmaceutical care interprofessionally. By acknowledging the aspect of interprofessionality, both general practitioners and non-dispensing pharmacists will explore and reflect on what they consider appropriate, legitimate and imaginable in carrying out their professional roles. TRIAL REGISTRATION: The POINT project was pre-registered in The Netherlands National Trial Register, with Trial registration number NTR-4389.

Exploring the pharmacists' role in optimising antithrombotic therapy in primary care: a qualitative study.

OBJECTIVE: In antithrombotic therapy, the balance between efficacy and safety is delicate, which makes it challenging for healthcare professionals, including pharmacists, to optimise therapy. Pharmacists may play an important role in optimising antithrombotic therapy, but especially in primary care, this role has not been elucidated. Here, we study how community pharmacists (pharmacists in primary care) perceive their current and future role in antithrombotic therapy. DESIGN: We conducted a qualitative study using semi-structured interviews. The interview protocol and subsequent analysis were based on the Theoretical Domains Framework, and the findings were interpreted with the Capability Opportunity Motivation - Behaviour System. SETTING AND PARTICIPANTS: The interview participants were community pharmacists, located across the Netherlands, from the Utrecht Pharmacy Practice network for Education and Research. RESULTS: We interviewed 16 community pharmacists between February and August 2021 and identified several major themes which were important for the pharmacist's role in antithrombotic therapy. Pharmacists felt responsible for the outcome of antithrombotic treatment and intended to invest in their role in antithrombotic therapy. Pharmacists did, however, experience barriers to their role in antithrombotic therapy, like a lack of access to clinical information such as the indication of antithrombotic treatment and a lack of specific knowledge on this treatment. CONCLUSION: Community pharmacists perceive a role for themselves in antithrombotic therapy. To fulfil this role, several preconditions must be met.

Adverse jaw outcomes from immune checkpoint inhibitors for head and neck cancer? Case reports.

Radiation treatment plays a mainstream role in the management of head and neck squamous cell carcinomas (HNSCCs). Adverse effects from radiation therapy include osteoradionecrosis of the jaw, and rarely, pathologic fracture. Immune checkpoint inhibitors (ICI) such as pembrolizumab are of growing relevance to the management of metastatic and recurrent HNSCCs. Adverse impacts on bone secondary to medications such as pembrolizumab and nivolumab have been sporadically documented in the literature. The objective of this manuscript is to raise awareness of possible increase in risk for adverse jaw outcomes in patients with HNSCCs exposed to both radiation treatment to the jaws and ICI therapy. This manuscript documents adverse jaw outcomes including osteonecrosis and pathologic fracture of the mandible in two patients receiving pembrolizumab for management of HNSCC who had received prior radiation treatment. A potential link between immunotherapy and adverse jaw outcomes is consistent with the growing understanding of osteoimmunology, investigating the closely interrelated processes in bone remodeling and immune system function, in health and disease. It is important to ascertain if pembrolizumab poses an incremental risk for such outcomes, beyond the risk from prior radiation, for patients managed with radiation treatment and ICI therapy for HNSCC. The general dental practitioner may encounter such patients either in the context of facilitating dental clearance prior to initiation of chemotherapy, or rarely, with poorly explained jaw symptoms and must be alert to the possibility of occurrence of such adverse jaw events to facilitate timely diagnosis and optimal patient management.

The CanMEDS Competency Framework in laboratory medicine: a phenomenographic study exploring how professional roles are applied outside the clinical environment.

Background: The CanMEDS Competency Framework is an internationally recognized model used to outline the proficiencies of a physician. It has predominantly been studied in clinical environments but not all medical specialties take part in direct patient contact. In laboratory medicine, the role of the physician is to promote and enhance patient diagnostics by managing and overseeing the functions of a diagnostic laboratory. Methods: This phenomenographic study explores the lived experiences of biochemistry, microbiology, and pathology residency program directors to better understand how they utilize the CanMEDS competencies. Eight laboratory medicine program directors from across Canada were individually interviewed using a semi-structured interview, and the data was analysed using inductive thematic analysis. Results: The findings show that the current framework is disconnected from the unique context of laboratory medicine with some competencies appearing unrelatable using the current standardized definitions and expectations. Nevertheless, participants considered the framework to be an appropriate blueprint of the competencies necessary for their professional environment, but to make it accessible more autonomy is required to adapt the framework to their needs. Conclusion: Newer renditions of the CanMEDS Competency Framework should better consider the realities of non-clinical disciplines.

Contexte: Le référentiel CanMEDS est un modèle reconnu à l'échelle internationale qui décrit les compétences nécessaires d'un médecin. Cependant, il a été principalement étudié dans des environnements cliniques, mais ce ne sont pas toutes les spécialités médicales qui ont des contacts directs avec les patients. En médecine de laboratoire, le rôle du médecin est de promouvoir et d'améliorer les analyses diagnostiques des patients en supervisant les fonctions d'un laboratoire diagnostic. Méthodes: Cette étude phénoménographique explore les expériences vécues de directeurs de programmes de résidence en biochimie, microbiologie et pathologie afin de mieux comprendre comment leurs programmes de formation utilisent les compétences CanMEDS. Huit directeurs de programme Canadiens en médecine de laboratoire ont participé à une entrevue semi-structurée individuelle et les données recueillies ont été analysées par une analyse thématique inductive. Résultats: Les résultats démontrent que le référentiel actuel est déconnecté de la médecine de laboratoire et que certaines compétences semblent incompatibles en utilisant les définitions normalisées en vigueur. Néanmoins, les participants considèrent que le référentiel est un schéma approprié des compétences nécessaires dans leur environnement professionnel, mais une plus grande autonomie est nécessaire pour l'adapter à leurs besoins. Conclusion: Les prochaines révisions du référentiel de compétences CanMEDS devraient mieux tenir compte des réalités des disciplines non cliniques.

Exploring the role of community pharmacies as a harm reduction environment for anabolic-androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists.

BACKGROUND: While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers. OBJECTIVE: This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist's regarding AAS harm reduction. METHODS: Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis. RESULTS: While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively. CONCLUSIONS: Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.

Wearing Sports Mouthguards to Prevent Oral and Maxillofacial Trauma.

The theme of the academic annual conferences held by the Chinese Stomatological Association from 2021 to 2023 was "Protecting Natural Teeth to Maintain Oral Health" and coincided with the 24th Winter Olympic Games that took place in Beijing in 2022, and thus prevention of oral and maxillofacial trauma once again attracted the attention of stomatological experts and the public. The incidence of oral and maxillofacial trauma caused by sports is around 25% to 34%1-5, and varies based on the type of sport and other factors, such as age, sex and the skill level of the participants. The risk of oral and maxillofacial trauma is extremely high in high-confrontation and high-speed sports, especially for children and adolescents. Wearing sports mouthguards when participating in sport is an effective way to prevent and reduce the incidence of oral and maxillofacial trauma in such sports, and is the simplest and most practical method of doing so. Sports have developed and gained in popularity significantly in China in recent years, but the awareness and use of sports mouthguards are low. Based on the above background, the Chinese Stomatological Association advocates that athletes and sport participants should wear mouthguards in various confrontational and high-speed sports, and calls on dental practitioners and sports-related organisations to actively support the popularisation and application of sports mouthguards to prevent or alleviate oral and maxillofacial trauma and to raise awareness and increase knowledge of methods to protect natural teeth.

Evaluating Knowledge, Self-Reported Confidence Levels, and Prescription Patterns among Dental Practitioners Regarding Analgesics in Dentistry: A Cross-Sectional Study.

Background and Objectives: Dental pain is a common problem that often leads to unscheduled dental visits and requires a comprehensive understanding of analgesics, including their indications and contraindications. The aim of this study was to investigate dentists' knowledge, self-reported confidence levels, and prescribing patterns of analgesics in dentistry. Materials and Methods: A nationwide cross-sectional online survey was conducted, resulting in 379 responses. Of these, 68.6% were general dentists, and 31.4% were specialists. The collected data included sociodemographic information, levels of knowledge, and prescription patterns. The survey questionnaire explored self-perceived practices, patient information during prescription, and guiding factors. Descriptive statistics and a generalized linear model for regression were used for data analysis. Results: Higher levels of knowledge were observed in specific contexts such as secondary/tertiary healthcare (p = 0.022), specialization in endodontics (p = 0.003), and a higher number of working hours with patients (p = 0.038). Conversely, increased self-confidence was observed among endodontists (p = 0.008), oral surgeons (p = 0.011), and dentists with more than 6 h of patient interaction (p ≤ 0.001). Orthodontists and prosthodontists demonstrated lower knowledge levels, while specialists in family dentistry exhibited lower self-confidence. Self-confidence and knowledge displayed a significant positive correlation (r = 0.039, p < 0.001). The most frequently prescribed medication was ibuprofen (97.9%), primarily for surgical (83.9%) and endodontic procedures (60.9%), with the main indications being pulpal (85.8%), periradicular (57.3%), and postoperative pain (40.1%). Conclusions: This study reveals significant knowledge and confidence gaps among dentists, including limited awareness of the efficacy of nonsteroidal anti-inflammatory drugs for odontogenic pain, a lack of time for effective counseling, and perceived deficits in pharmacology education. To address these issues, targeted educational interventions are recommended to improve analgesic prescribing practice, close knowledge gaps, and increase dentists' confidence in more effective pain management.

Dental transpositions: An update for clinicians.

Transposition of teeth may present to the general dental practitioner and in some circumstances transposed teeth may present with other dental anomalies. Although dental transpositions are rare anomalies, management of transposed teeth can often be complex, requiring multidisciplinary management. It is therefore important for dentists to be familiar with the clinical and radiographic presentation of transpositions and understand the aetiology to aid early diagnosis and appropriate management.Clinical relevance: Dentists are best placed to detect transposed teeth and should be familiar with the clinical and radiographic presentation, aetiology, and classification of transpositions in order to aid early diagnosis and their subsequent management.