Assessment of Knowledge Among the Physicians Regarding Dental Screening Prior to Chemotherapy and Radiotherapy

ABSTRACT Objective: To evaluate the physicians' knowledge regarding the referral for dental screening prior to chemotherapy and radiotherapy. Material and Methods: We conducted a cross-sectional study using simple random sampling among 468 physicians from various specialties with diverse experience levels from different regions in Saudi Arabia. A self-reporting questionnaire was distributed among the physicians, which consisted of questions assessing the physicians' knowledge about oral health and complications in patients prior to chemotherapy and radiotherapy. Statistical analysis was done after the data was collected employing SPSS, and p<0.05 was taken as significant. Results: Residents were more as expected (39.3%), followed by specialists (2.31%). The majority had a practice experience for more than five years (67.8%).The scores for the knowledge assessment showed that 51.3%, nearly half of the participants, had lower scores. The scores were statistically significant (p<0.05). Conclusion: General physicians and specialists should be aware of the dental complications and associated diseases in patients with malignancies and those undergoing chemo and radiotherapy. It is proposed that more awareness should be raised among physicians to rectify this lapse.

A South African perspective on community psychology practice competencies.

The appropriateness of the paradigm underlying competency frameworks and their specific application in the list of definitions developed by a Task Group of Society for Community Research and Action (SCRA) for US community psychologists need further consideration. This paper considers the technicist and behavioural roots of some of these concepts, illustrating tensions when applying them to community psychology. It then proposes a competency perspective from the global South. Drawing from focus group discussions with, and written reflections from, postgraduate Master's students in training as clinical and counselling psychologists, this paper builds inductively from the recorded data. Following a template analysis of the material, four integrating themes were evident. The distinctive nature of community psychology is highlighted through the themes: relational foundations, activity evolution, self-management and the awareness and influences of processes. Proposals for an alternative framework ("RASP") are based on its emergence from the applications of learning to practice, emphasising community-based principles. The importance of reflection as the basis for the learning is highlighted. The imperatives to foreground social justice and to enable reflexive thinking on action are discussed, along with concepts based on Humanist and Social Constructivist paradigms, to lead to more interactive and inclusive processes in work on competencies.

Assessment of the compliance with minimum acceptable technical parameters proposed by PI-RADS v2 guidelines in multiparametric prostate MRI acquisition in tertiary referral hospitals in the Republic of Turkey.

PURPOSE: Although the clinical use of multiparametric prostate magnetic resonance imaging (mpMRI) is increasing, the adherence to parameters for mpMRI, which had been described in the Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) for an optimum image acquisition is unknown. In this paper, we aimed to determine the compliance with the minimum acceptable technical parameters for prostate mpMRI defined by PI-RADS v2 in tertiary care centers in Turkey. METHODS: We sent a survey to all radiology departments of tertiary referral hospitals in Turkey (n=120) to evaluate their adherence to PI-RADS v2 technical specifications. Statistical analysis was performed using chi-square, Fisher exact, ANOVA, and the Student t tests. The cutoff values for image acquisition times were also determined with receiver operating characteristics (ROC) analysis. P values <0.05 were considered statistically significant. RESULTS: One hundred and eleven clinics responded to our survey (response rate, 92.5%). Prostate MRI was reported to be performed in 61 centers, of which 26 (42.6%) used 3 T (Tesla) scanner while 35 (57.4%) used 1.5 T. The adherence to slice thickness, in-plane phase and frequency resolutions on T2-weighted imaging were 68.9%, 41%, and 9.8%, respectively. The adherence to the same parameters on diffusion-weighted imaging (DWI) were higher compared with T2-weighted imaging (85.2%, 62.3%, and 78.7%, respectively). In comparative analysis, the adherence to slice thickness, field of view (FOV) and in-plane phase resolution on T2-weighted imaging were higher for 3 T compared with 1.5 T scanners (P = 0.004, P = 0.041, and P = 0.001, respectively). T2-weighted imaging acquisition time was significantly longer for the centers that adhered to FOV (P = 0.034) and in-plane T2-weighted imaging phase resolution (P = 0.028). The DWI scan time was significantly longer when they adhered to DWI-FOV (P = 0.014) and b value ≥1400 s/mm2 (P = 0.008). The calculated cutoff of scan times were 220 s in T2-weighted imaging and 312 s in DWI to ensure the compliance with voxel sizes and b value criteria. CONCLUSION: The tertiary referral centers in Turkey did not meet majority of the technical specifications of PI-RADS v2 during prostate MRI acquisition. Awareness to the minimum acceptable technical parameters of mpMRI should be increased to potentially improve the quality of prostate cancer imaging.

Updated hypertension prevalence, awareness, and control rates based on the 2017ACC/AHA high blood pressure guideline.

In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated the Guideline of Prevention, Detection, Evaluation and Management and Management of High Blood Pressure (HBP) in Adults. The purpose of the current study was to evaluate the potential impact of the 2017ACC/AHA HBP guideline on hypertension prevalence, awareness, and control rates. The data were collected from Physical Examination Center of the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 66 977), including demographic information and risk factors of hypertension. The hypertension prevalence, awareness, and control rates of people were evaluated according to the new guideline. Additionally, the factors related to hypertension prevalence were also assessed. According to previous HBP guideline, hypertension prevalence, awareness, and control rate were 30.54%, 44.33%, and 13.04%, respectively. However, when the 2017 ACC/AHA HBP guideline was introduced, the population with hypertension increased from 20 453 to 34 460, the hypertension prevalence rate increased from 30.54% to 51.45%, the awareness rate decreased from 44.33% to 26.31%, and the control rate declined from 13.04% to 2.72%. The most newly diagnosed hypertension patients were from the low-risk population with young age and without the above histories. The 2017ACC/AHA HBP guideline indicated that high hypertension prevalence rate still existed with a substantial increase, while the awareness and control rates were relatively lowered.

Hepatitis B care pathway in Saudi Arabia: Current situation, gaps and actions.

Hepatitis B virus (HBV) infection remains a public health problem worldwide. In this review, we aim to assess the current situation of the HBV care pathway in the Kingdom of Saudi Arabia (KSA), identify gaps/barriers therein, and recommend initiatives to be taken to improve the management of such patients. Towards this end, a literature search was conducted in PubMed and free Internet searches. Interviews with individuals and focus group discussions were held with HBV experts in KSA. Although significant improvements have been made in the past 30 years in KSA in terms of the decline in prevalence (currently estimated to be around 1.3%), the morbidity and mortality related to the disease have not shown a parallel decline. This makes HBV an important public health concern. Furthermore, poor disease awareness, low diagnosis rates, and nonadherence to therapy amplify the disease burden. There are several mandated national screening structures present; however, established protocols for those who test positive and subsequent linkage-to-care are inadequate. In the absence of a virologic cure, a concerted effort should be made to provide safe and effective lifelong treatment. This review provides recommendations to reduce the HBV disease burden in the Saudi population.

COPD-related fatigue: Impact on daily life and treatment opportunities from the patient's perspective.

BACKGROUND: Fatigue is a highly prevalent, challenging and understudied symptom of COPD, which influences the quality of life of patients. This study addresses the patient's perspective on the impact of fatigue on their daily lives and explores possible treatment options to tackle the burden of fatigue. METHODS: Twenty semi-structured interviews were conducted with ten patients hospitalised for a COPD exacerbation and ten outpatients with COPD. Data were transcribed verbatim and coded in an iterative (deductive and inductive) coding process. FINDINGS: Patients perceived severe negative impact of fatigue on their daily lives and emphasized that they were limited in physical, emotional, cognitive and social functioning. These limitations caused a high mental burden which challenged patients' coping resources and making fatigue a symptom difficult to accept. The majority of patients mentioned that they had, to some degree, lost the joy in life or in some cases, even lost the will to live. Patients reported the need for effective treatment and recommended a multidisciplinary approach and blended care, in which an online treatment to improve fatigue management is combined with face-to-face contact with a healthcare professional to increase social support. DISCUSSION: These findings indicate that patients perceive the impact of fatigue on their daily lives to be a key factor in decreasing their quality of life. To increase awareness of fatigue in healthcare professionals and patients and to facilitate early fatigue self-management, a pro-active approach by healthcare professionals might be the best way to realize effective tailored treatment.