COVID-19 Preventive Behaviours in Cameroon: A Six-Month Online National Survey.

Since March 2020, the Cameroonian government implemented nationwide measures to stall COVID-19 transmission. However, little is known about how well these unprecedented measures are being observed as the pandemic evolves. We conducted a six-month online survey to assess the preventive behaviour of Cameroonian adults during the COVID-19 outbreak. A five-point adherence score was constructed based on self-reported observance of the following preventive measures: physical distancing, face mask use, hand hygiene, not touching one's face, and covering the mouth when coughing or sneezing. Predictors of adherence were investigated using ordinal logistic regression models. Of the 7381 responses received from all ten regions, 73.3% were from male respondents and overall mean age was 32.8 ± 10.8 years. Overall mean adherence score was 3.96 ± 1.11 on a scale of 0-5. Mean weekly adherence scores were initially high, but gradually decreased over time accompanied by increasing incidence of COVID-19 during the last study weeks. Predictors for higher adherence included higher age, receiving COVID-19 information from health personnel, and agreeing with the necessity of lockdown measures. Meanwhile, experiencing flu-like symptoms was associated with poor adherence. Continuous observance of preventive measures should be encouraged among Cameroonians in the medium- to long-term to avoid a resurgence in COVID-19 infections.

Wrong tooth extraction: an examination of 'Never Event' data.

The NHS in England has identified several adverse incidents that involve patients, including operations done at the wrong site, as "never" events. We examined published data from the period April 2012 to October 2015 and found that "wrong tooth/teeth removed" is the most common "wrong site" event, and accounted for between 20% and 25% of wrong site surgery never events, and 6% - 9% of all "never" events. All "wrong tooth/teeth removed" events seem to have been reported only by hospitals or Community Trusts. It is important to find out how these events are recorded and to find ways to prevent them.

Leakage evaluation with and without vacuum of two gutta-percha fill techniques.

Two sets of 30 roots were obturated either with lateral condensation or a halothane dip technique. Fifteen roots from each group were immersed in India ink with vacuum and 15 without vacuum. Each root was coated with nail polish and wax, leaving only its apical end open for ink penetration. The roots were cleared and three linear measurements were made: distance of ink penetration coronal to the gutta-percha apical tip; distance from the gutta-percha tip to major foramen; and distance from the major foramen to anatomical apex. The average length of ink penetration coronal to the apical extension of the gutta-percha for the lateral condensation groups combined was 1.33 mm and for the halothane groups combined was 2.15 mm. There was no significant difference between vacuumed and not vacuumed for degree of ink penetration. The gutta-percha of the halothane-dipped groups advanced significantly closer to the foramen than the lateral condensation groups (0.38 mm versus 0.65 mm).

Dental attitudes and behavior related to vertical social mobility by marriage.

Following a dental examination of 5-year-old children, the mothers of 367 of them were interviewed. In 262 cases there was sufficient information relating to the social class of both the mother's husband and her father to enable the relationship between social mobility by marriage and the mother's dental attitudes and behavior to be assessed. The results showed that the views of mothers who moved from one social group to another fell between those of the mothers who were static in each of those two groups. Those mothers who were downward mobile had less favorable attitudes than those who had remained in the higher social group but more favorable than those who had always been in the lower social group. The reverse trend was found in upward mobile mothers. A notable exception to this pattern was the group who moved from social Class III into Class I or II. These mothers exhibited attitudes and behavior which were even more favorable than the static social Class I or II mothers. The similarity of these results to those of others in different fields is discussed.

Multidisciplinary restoration of fused maxillary incisors: a case report.

This case report describes the endodontic, periodontal, and restorative treatment of a maxillary incisor with unusual external and internal anatomy. The right central and lateral incisors had fused, resulting in an oversized unaesthetic central incisor. A small diastema was present between the fused central incisor and the canine. Since overpreparation of the tooth during restoration was anticipated, endodontic therapy was accomplished. Periodontal flap surgery provided an opportunity to reduce the root diameter and narrow the emergence profile of the tooth and to eliminate a plaque-retentive palatogingival groove. A cast post and core rigidly obturated the canal space and provided a preparation on which to fabricate a metal-ceramic restoration simulating the replacement of the right lateral incisor. The final restoration provided significant aesthetic improvement. The learning objective of this article is to familiarize the reader with multidisciplinary restorations.

Preventing wrong tooth extraction: experience in development and implementation of an outpatient safety checklist.

Extraction of the wrong tooth or teeth is a serious and avoidable clinical error causing harm to the patient. All NHS Trusts in England are required to use a surgical safety checklist in operating theatres to prevent incorrect site surgery and ensure safe management of patients. However, the majority of patients have dental extractions and other oral surgical procedures undertaken on an outpatient basis and these patients are also at risk of having an incorrect site surgical procedure such as a wrong tooth extraction. We describe our experience in developing, introducing and refining a surgical safety checklist for outpatient oral surgery along with the key strategic actions needed to ensure effective cultural change and optimum patient safety in the outpatient setting.

Improving patient safety in a UK dental hospital: long-term use of clinical audit.

The improvement of patient safety has been a long-term aim of healthcare organisations and following recent negative events within the UK, the focus on safety has rightly increased. For over twenty years, clinical audit has been the tool most frequently used to measure safety-related aspects of healthcare and when done so correctly, can lead to sustained improvements. This paper explains how clinical audit is used as a safety improvement tool in an English dental hospital and gives several examples of projects that have resulted in long-term improvements in secondary dental care.

Measuring patient safety in a UK dental hospital: development of a dental clinical effectiveness dashboard.

Patient safety is an important marker of quality for any healthcare organisation. In 2008, the British Government white paper entitled High quality care for all, resulting from a review led by Lord Darzi, identified patient safety as a key component of quality and discussed how it might be measured, analysed and acted upon. National and local clinically curated metrics were suggested, which could be displayed via a 'clinical dashboard'. This paper explains the development of a clinical effectiveness dashboard focused on patient safety in an English dental hospital and how it has helped us identify relevant patient safety issues in secondary dental care.

Exposure of hospitality workers to environmental tobacco smoke.

OBJECTIVE: To determine quantitatively the extent of exposure of hospitality workers to environmental tobacco smoke (ETS) exposure during the course of a work shift, and to relate these results to the customer smoking policy of the workplace. SUBJECTS: Three categories of non-smoking workers were recruited: (1) staff from hospitality premises (bars and restaurants) that permitted smoking by customers; (2) staff from smokefree hospitality premises; and (3) government employees in smokefree workplaces. All participants met with a member of the study team before they began work, and again at the end of their shift or work day. At each meeting, participants answered questions from a standardised questionnaire and supplied a saliva sample. MAIN OUTCOME MEASURES: Saliva samples were analysed for cotinine. The difference between the first and second saliva sample cotinine concentrations indicated the degree of exposure to ETS over the course of the work shift. RESULTS: Hospitality workers in premises allowing smoking by customers had significantly greater increases in cotinine than workers in smokefree premises. Workers in hospitality premises with no restrictions on customer smoking were more highly exposed to ETS than workers in premises permitting smoking only in designated areas. CONCLUSIONS: Overall, there was a clear association between within-shift cotinine concentration change and smoking policy. Workers in premises permitting customer smoking reported a higher prevalence of respiratory and irritation symptoms than workers in smokefree workplaces. Concentrations of salivary cotinine found in exposed workers in this study have been associated with substantial involuntary risks for cancer and heart disease.

Volatile N-nitrosamines in urinary catheters.

Levels of volatile N-nitrosamines were measured in 10 brands of latex and 2 brands of silicone catheters using high performance liquid chromatography. The cytotoxicity of catheters from identical batches was determined by measuring the inhibitory effect of catheter extracts on the uptake of 3H-labelled thymidine into L-929 fibroblasts in culture (IC50). The most frequently encountered nitrosamines were N-nitrosodi-n-butylamine and N-nitrosodiethylamine. Total N-nitrosamine levels in excess of 100 ng/g were found in 6 of the 16 catheters tested. When compared with the cytotoxicity of the catheters a significant correlation was found, with increasing nitrosamine content being associated with greater cytotoxicity. In view of the reported toxic and carcinogenic effects of these compounds it is suggested that the nitrosamine content of catheters be routinely monitored and safe regulatory limits be imposed.