RESUMO
The aim of this study was to analyze information about advanced education programs in prosthodontics (AEPPs) collected in American Dental Association (ADA) surveys on advanced dental education from 2006-07 to 2016-17. Data recorded included number of AEPPs and information on program directors, applicants, and enrollees in AEPPs. The results showed that, from 2006 to 2016, there was an increase in the number of AEPPs and enrollment of prosthodontic residents, and the number of applicants per program more than doubled. Despite these increases, steps are needed to increase the number of underrepresented minority residents in prosthodontics. Also, a periodic survey of prosthodontic residents to identify their goals, experiences during training, and career plans could benefit the specialty by providing more insight into the future prosthodontic workforce.
Assuntos
Educação de Pós-Graduação em Odontologia/estatística & dados numéricos , Educação em Odontologia , Avaliação de Programas e Projetos de Saúde , Prostodontia/educação , Prostodontia/estatística & dados numéricos , Atitude do Pessoal de Saúde , Odontólogos , Educação em Odontologia/economia , Educação em Odontologia/estatística & dados numéricos , Humanos , Saúde Bucal/educação , Avaliação de Programas e Projetos de Saúde/economia , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Estudos Retrospectivos , Faculdades de Odontologia , Inquéritos e Questionários , Estados UnidosRESUMO
Over recent decades, numerous clinical advances and policy changes have affected outcomes for candidates of kidney transplantation in the United States. We examined the national Scientific Registry for Transplant Recipients for adult (18+) solitary kidney transplant candidates placed on the waiting list for primary listing from 2001 to 2015. We evaluated rates of mortality, transplantation, and waitlist removal. Among 340 115 candidates there were significant declines in mortality (52 deaths/1000 patient years in 2001-04 vs 38 deaths/1000 patient years in 2012-15) and transplant rates (304 transplants/1000 patient years in 2001-04 vs 212 transplants/1000 patient years in 2012-15) and increases in waitlist removals (15 removals/1000 patient years in 2001-04 vs 25/1000 patient years in 2012-15) within the first year after listing. At 5 years an estimated 37% of candidates listed in 2012-15 were alive without transplant as compared to 22% in 2001-04. Declines in mortality over time were significantly more pronounced among African Americans, candidates with longer dialysis duration, and those with diabetes (P < .001). Cumulatively, results indicate dramatic changes in prognoses for adult kidney transplant candidates, likely impacted by selection criteria, donor availability, regulatory oversight, and clinical care. These trends are important considerations for prospective policy development and research, clinical and patient decision-making, and evaluating the impact on access to care.
Assuntos
Transplante de Rim/mortalidade , Mortalidade/tendências , Seleção de Pacientes , Alocação de Recursos , Transplantados/estatística & dados numéricos , Listas de Espera/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Transplante de Rim/legislação & jurisprudência , Masculino , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Estados Unidos , Adulto JovemRESUMO
STATEMENT OF PROBLEM: The longevity of silicone facial prostheses is short, and published data concerning this type of rehabilitation are limited. PURPOSE: The purpose of this retrospective study was to identify predictive variables for prosthetic failure and to highlight the results that can be expected after treatment with silicone facial prostheses. MATERIAL AND METHODS: After institutional approval, patient records from a single Brazilian institution for the time period 2004 to 2015 were assessed. A standardized form was used to collect patient data. Frailty survival modeling (simple random effects survival model) was used to test whether age, sex, type of prosthesis, source of defect, number of implants, and type of retention have a direct impact on the prosthetic failure rate (α=.05). RESULTS: Auricular prostheses were the most frequently fabricated prostheses. Eighty-four prostheses were fabricated during the follow-up period. The overall survival rate for facial prostheses was 34.5%. Color alteration was the most common reason for new prostheses (27.38%). The implant success rate was 98.18%. The number of implants approached statistical significance (P=.06) with a reduced risk of failure when the patient had 2 implants compared with patients with zero implants and patients with more than 2 implants. CONCLUSIONS: Patients should be recalled frequently so that retouches can be performed, avoiding the repeated fabrication of new prostheses. Well-designed studies are necessary to identify more relevant complications and factors that lead to prosthetic failure.
Assuntos
Face/cirurgia , Complicações Pós-Operatórias/epidemiologia , Próteses e Implantes , Crânio/cirurgia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Falha de Prótese , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: Oral health has a significant effect on health, and for women, poor oral health can lead to poor birth outcomes and can affect their child's health. Nursing interventions to improve the oral health of at-risk women have the potential to increase maternal and child systemic and oral health. The identification of women at a high risk for poor oral health is a necessary to develop and evaluate these interventions. DESIGN AND SAMPLE: This study examined the factors related to dental insurance and dental service use for women of childbearing age in the United States. A secondary analysis of the 2003-2004 National Health and Nutrition Examination Survey was completed to examine the predisposing, enabling, and need variables associated with dental insurance status and dental service use in a representative random sample of 1,071 women. RESULTS: The results showed that over 40% of women had no dental insurance. Women with less education, lower income, and dental need were significantly less likely to have dental insurance. Dental utilization by the uninsured was low and a racial/ethnic disparity was noted. CONCLUSION: A lack of dental insurance and dental service utilization is a significant concern. Nurses working with low-income women should educate the population about oral health and advocate for policies to increase dental insurance coverage.
Assuntos
Assistência Odontológica/estatística & dados numéricos , Seguro Odontológico/estatística & dados numéricos , Adolescente , Adulto , Assistência Odontológica/enfermagem , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Inquéritos Nutricionais , Estados Unidos , Saúde da Mulher , Adulto JovemRESUMO
For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.
Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Disparidades em Assistência à Saúde , Classe Social , Adolescente , Adulto , Serviços de Saúde Bucal/economia , Etnicidade/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Cobertura do Seguro/estatística & dados numéricos , Modelos Logísticos , Análise Multivariada , Ohio , Saúde Bucal , Fatores Socioeconômicos , Adulto JovemRESUMO
The purpose of this study was to explore perceptions of the roles and responsibilities of dental education in serving the public good, and the extent to which they are being met, from the vantage point of leaders at the university and state level. Five questions were developed to gather views on dental education's success in meeting the expectations and needs of the public. Fifty-one interviews were conducted with leaders at seven institutions and with public officials in six states. Overall, dental education was perceived as fulfilling its public purpose in promoting oral health, providing access to care, and conducting relevant research. However, significant areas for improvement were noted including better communication of accomplishments to key stakeholders, graduating a more socially aware, culturally sensitive, and community-oriented dental practitioner, and being a committed partner with other community leaders in improving access to care for all citizens. Current programs aimed at addressing these gaps (e.g., Pipeline, Profession, and Practice program) are discussed. Dental education can address these perceptions only by producing graduates who desire to fulfill their obligations to society and serve the public good.