The Future of Artificial Intelligence in Sports Medicine and Return to Play.

Artificial intelligence (AI) has shown tremendous growth over the last decade, with the more recent development of clinical applications in health care. The ability of AI to synthesize large amounts of complex data automatically allows health care providers to access previously unavailable metrics and thus enhance and personalize patient care. These innovations include AI-assisted diagnostic tools, prediction models for each treatment pathway, and various tools for workflow optimization. The extension of AI into sports medicine is still early, but numerous AI-driven algorithms, devices, and research initiatives have delved into predicting and preventing athlete injury, aiding in injury assessment, optimizing recovery plans, monitoring rehabilitation progress, and predicting return to play.

Cream skimming and discrimination in access to medical care: A field experiment.

This study measures the differences in access to healthcare for female patients in France in three medical specialties (dentistry, gynecology and psychiatry) according to two criteria: the African ethnicity of the patient and the benefit of having means-tested health insurance coverage. To this purpose, we conducted a nationally representative field experiment on more than 1500 physicians. We do not find substantial discrimination against the patient of African origin. However, the results indicate that patients with means-tested health insurance coverage are less likely to get an appointment. Differentiating between two types of coverage, we show that the lesser-known coverage (ACS) is more penalized than the other (CMU-C) as poor knowledge of the program increases the physician's expectation of additional administrative tasks and is an important element to explain cream-skimming. We also find that, for physicians who are free to set their fees, the opportunity cost of accepting a means-tested patient increases the penalty. Finally, the results suggest that enrollment in OPTAM, the controlled pricing practice option that incentivizes physicians to accept means-tested patients, reduces cream-skimming.

Implementation of virtual OSCE in health professions education: A systematic review.

INTRODUCTION: The Objective Structured Clinical Examination (OSCE) has been widely used in health professions education since the 1970s. The global disruption caused by the COVID-19 pandemic restricted in-person assessments and medical educators globally sought alternative means to assess and certify students and trainees to meet the acute demand for health-care workers. One such solution was through virtual OSCE (vOSCE), which modified traditional in-person OSCE using videoconference platforms. This meta-ethnography sought to synthesise qualitative literature on candidates' and assessors' experiences of vOSCE to evaluate whether it may have a role in future assessment practices. METHODS: In June 2022, we systematically searched PsycINFO, Medline and ERIC for peer-reviewed qualitative and mixed-methods articles that described candidates' and assessors' experiences of virtual OSCE in health professions education. Of 1069 articles identified, 17 were synthesised using meta-ethnography. RESULTS: The final synthesis represented 1190 candidates and assessors from faculties of medicine, dentistry, nursing, pharmacy and osteopathy. We developed our findings into four key concepts. 'Strengthening confidence in a virtual environment' highlighted attempts to overcome and mitigate concerns associated with transitioning from in-person to virtual assessment. 'Understanding the scope of use as an assessment' reflected on the suitability of vOSCE in assessing various skills. 'Refining operational processes' emphasised the technical challenges of implementing vOSCE and impacts on accessibility and resources. 'Envisioning its future role' considered the applicability of vOSCE in the climate of rapid development in telehealth. CONCLUSION: This meta-ethnography highlighted that although vOSCE was primarily considered a temporary and crisis response, candidates and assessors recognised positive, as well as negative, consequences of the transition towards them. Moving forward, medical education policymakers should carefully consider the extent to which elements of vOSCE could be incorporated into assessment systems, particularly in light of the rise of telehealth in clinical practice.

Integration of Gross Anatomy, Histology, and Pathology in a Pre-matriculation Curriculum: A Triple-Discipline Approach.

In recent years, many schools have cut back on their teaching and laboratory hours, and courses in the anatomical sciences are more integrated into the horizontal and longitudinal curriculums. Traditionally, teaching in anatomical science classes consists of lectures and laboratory sessions. Usually, gross anatomy and histology are the two main courses in pre-matriculation programs. The summer pre-matriculation program at the University of Mississippi Medical Center (UMMC) was designed to better prepare students for success in their first year of medicine and dentistry. The course provided these students with an opportunity to study gross anatomy and histology ahead of time and develop their learning skills for the coming academic year. Historically, gross anatomy and histology courses have been taught separately with a different emphasis. We have designed a new approach to implement gross anatomy, histology, and pathology-all three disciplines-in a single lecture in the organ section of the histology course. This triple-discipline (triple lecture) approach allows three professors in anatomy, histology, and pathology to work together in a two-and-a-half-hour review lecture. This approach allows students to develop their critical thinking skills and better prepares them to transfer basic anatomic knowledge into their future clinical practice. Students indicated this was their first experience with the triple-discipline approach, and they remarked that it helped them integrate anatomy and histology as well as demonstrate the clinical importance of the structures and organs. This approach can be used at different stages of medical education and helps faculty and students better integrate various disciplines and is more suitable in the modern curriculum. A similar approach was used in our fourth year course in medical histology.

Virtual Reality for Upper Limb Rehabilitation in Patients With Obstetric Brachial Palsy: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Obstetric brachial palsy (OBP) is a pathology caused by complications during childbirth because of cervical spine elongation, affecting the motor and sensory innervation of the upper limbs. The most common lesion occurs on the C5 and C6 nerve branches, known as Erb-Duchenne palsy. The least common lesion is when all nerve roots are affected (C5-T1), which has the worst prognosis. Virtual reality (VR) is commonly used in neurological rehabilitation for the evaluation and treatment of physical deficits. OBJECTIVE: This systematic review aims to assess the efficacy of VR in the rehabilitation of upper limb function in patients with OBP. METHODS: A search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines in several scientific databases-PubMed, Web of Science, PEDro, Cochrane, MEDLINE, Scopus, and CINAHL-without language or date restrictions and including articles published up to April 2023. The inclusion criteria were established according to the population, intervention, comparison, outcome, and study (PICOS) design framework: children aged <18 years diagnosed with OBP, VR therapy used in addition to conventional therapy or isolated, VR therapy compared with conventional therapy, outcomes related to OBP rehabilitation therapy, and randomized controlled trials (RCTs). The PEDro scale was used to assess the methodological quality of the RCTs, and the Cochrane Collaboration tool was used to assess the risk of bias. The Review Manager statistical software (version 5.4; The Cochrane Collaboration) was used to conduct the meta-analysis. The results were synthesized through information extraction and presented in tables and forest plots. RESULTS: In total, 5 RCTs were included in this systematic review, with 3 (60%) providing information for the meta-analysis. A total of 138 participants were analyzed. All the studies used semi-immersive or nonimmersive VR systems. The statistical analysis showed no favorable results for all outcomes except for the hand-to-mouth subtest of the Mallet scoring system (functional activity; standardized mean difference -0.97, 95% CI -1.67 to -0.27; P=.007). CONCLUSIONS: The evidence for the use of VR therapy for upper limb rehabilitation outcomes in patients with OBP was insufficient to support its efficacy and strongly recommend its use. Nevertheless, scientific literature supports the use of VR technologies for rehabilitation as it provides several advantages, such as enhancing the patient's motivation, providing direct feedback, and focusing the patient's attention during the intervention. Thus, the use of VR for upper limb rehabilitation in patients with OBP is still in its first stages. Small sample sizes; limited long-term analysis; lack of testing of different doses; and absence of International Classification of Functioning, Disability, and Health-related outcomes were present in the included RCTs, so further research is needed to fully understand the potential of VR technologies as a therapeutic approach for patients with OBP. TRIAL REGISTRATION: PROSPERO CRD42022314264; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=314264.

Editing the editors: Aims and priorities of health professions education journals.

PURPOSE: Although health professions education (HPE) scholarship has flourished in recent decades, the influence of HPE journals has received little attention. This study examines the editorial policies and priorities of leading HPE journals. METHODS: Fourteen HPE journals with the highest impact factors were reviewed for their editorial aims, scope, intended readership, and priority topic areas. Text from journal websites was coded using thematic analysis. RESULTS: 10/14 HPE journals included in this study were linked to regional or national education societies. Two focussed predominantly on medicine, one on dentistry, one on nursing, one on nutrition, and the remaining nine on general HPE. Although journals differed in their projected aims and proposed readerships, four overarching editorial themes were identified: (1) methodological and theoretical rigor; (2) impact on practice; (3) global relevance; (4) advancing knowledge. CONCLUSIONS: Leading HPE journals share a number of priority areas and principles, implying some cohesion and consensus amongst the HPE scholarly community. These journals prioritise impact at the level of individual practitioners. Given the importance of policy level change in the development and reform of HPE around the world, the relative lack of focus on policy impact in HPE journals is worthy of further exploration.

Disruptions to in-person medical visits across the United States during the COVID-19 pandemic: evolving disparities by medical specialty and socio-economic status.

OBJECTIVES: This study aimed to investigate how people's health-seeking behaviors evolve in the COVID-19 pandemic by community and medical service category. STUDY DESIGN: This is a longitudinal study using mobility data from 19 million mobile devices of visits to all types of health facility locations for all US states. METHODS: We examine the variations in weekly in-person medical visits across county, neighborhood, and specialty levels. Different regression models are used for each level to investigate factors that influence the disparities in medical visits. County-level analysis explores associations between county medical visit patterns, political orientation, and COVID-19 infection rate. Neighborhood-level analysis focuses on neighborhood socio-economic compositions as potential determinants of medical visit levels. Specialty-level analysis compares the evolution of visit disruptions in different specialties. RESULTS: A more left-leaning political orientation and a higher local infection rate were associated with larger decreases in in-person medical visits, and these associations became stronger, moving from the initial period of stay-at-home orders into the post-lockdown period. Initial reactions were strongest for seniors and those of high socio-economic status, but this reversed in post-lockdown period where socio-economically disadvantaged communities stabilized at a lower level of medical visits. Neighborhoods with more female and young people exhibited larger decreases in in-person medical visits throughout the initial and post-lockdown periods. The evolution of disruptions diverges across medical specialties, from only short-term disruption in specialties such as dentistry to increasing disruption, as in cardiology. CONCLUSIONS: Given distinct patterns in visit between communities, medical service categories, and between different periods in the pandemic, policy makers, and providers should concentrate on monitoring patients in disrupted specialties who overlap with the at-risk contexts and socio-economic factors in future health emergencies.

Origins of Maxillofacial Surgery in Mediterranean Medical History.

Maxillofacial and dental surgery has been around for a surprisingly long time. The first evidence of oral dental treatment can be traced back to Northern Italy 13,000 to 14,000 years ago. The first known evidence of dental filling with beeswax dates back to 6500 years ago in a site located in Slovenia. Fixing teeth with gold wires and prostheses and replacing them was performed for millennia in ancient Egypt and Phoenicia as well as in Etruria predating the Roman empire. In 1210, the earliest-known oral surgery group was formed in France leading to rapid advancement of the specialty over the following years with Pierre Fauchard, known as the father of modern dentistry, who turned dentistry from a craft into a profession. Despite diverse populations of various ethnic backgrounds, the Mediterranean civilization is truly one and unique. It was always at the forefront of scientific progress and technologic innovations in all fields of medicine and surgery and in particular in maxillofacial surgery.

Adsorption of Ferritin at Nanofaceted Al2O3 Surfaces.

The influence of nanoscale surface topography on protein adsorption is highly important for numerous applications in medicine and technology. Herein, ferritin adsorption at flat and nanofaceted, single-crystalline Al2O3 surfaces is investigated using atomic force microscopy and X-ray photoelectron spectroscopy. The nanofaceted surfaces are generated by the thermal annealing of Al2O3 wafers at temperatures above 1000 °C, which leads to the formation of faceted saw-tooth-like surface topographies with periodicities of about 160 nm and amplitudes of about 15 nm. Ferritin adsorption at these nanofaceted surfaces is notably suppressed compared to the flat surface at a concentration of 10 mg/mL, which is attributed to lower adsorption affinities of the newly formed facets. Consequently, adsorption is restricted mostly to the pattern grooves, where the proteins can maximize their contact area with the surface. However, this effect depends on the protein concentration, with an inverse trend being observed at 30 mg/mL. Furthermore, different ferritin adsorption behavior is observed at topographically similar nanofacet patterns fabricated at different annealing temperatures and attributed to different step and kink densities. These results demonstrate that while protein adsorption at solid surfaces can be notably affected by nanofacet patterns, fine-tuning protein adsorption in this way requires the precise control of facet properties.

Health sciences undergraduate students academic track records.

BACKGROUND: Academic track record analysis is essential for evaluating the training of students and the structure of higher education study programs, which allows diagnosing and preventing educational lag and school dropout. OBJECTIVE: To analyze the differences in academic track records of UNAM health sciences undergraduate students from generations 2001 to 2016. MATERIAL AND METHODS: Study of real cohorts; graduation and lag rates were calculated. ANOVA was used to contrast the graduation rates between campuses by undergraduate program and time. To identify critical periods, survival functions were used with Kaplan-Meier's method. RESULTS: The lowest percentages of lag were observed in nursing and medicine students; nursing students had the highest graduation rates, especially at Zaragoza campus; dentistry students had the lowest graduation rates and the highest dropout and lag rates. Women showed higher graduation rates and lower risk of dropout and lag. CONCLUSIONS: Nursing, medicine and psychology undergraduate students at Zaragoza and Iztacala campuses, with modular programs, achieved the highest graduation percentages and the lowest dropout and lag rates.

ANTECEDENTES: El análisis de las trayectorias académicas es fundamental para evaluar la formación de los estudiantes y la estructura de los programas de estudio de educación superior, lo que permite diagnosticar y prevenir el rezago y abandono escolar. OBJETIVO: Analizar las diferencias en las trayectorias académicas de los estudiantes de las licenciaturas en ciencias de la salud de la UNAM de las generaciones 2001 a 2016. MATERIAL Y MÉTODOS: Estudio de cohortes reales; se calcularon tasas de egreso y rezago. Se realizó ANOVA para contrastar el egreso entre planteles por carrera y tiempo. Para identificar los períodos críticos se utilizaron funciones de supervivencia con el método de Kaplan-Meier. RESULTADOS: En las licenciaturas en enfermería y medicina se observaron los menores porcentajes de rezago; enfermería presentó los mayores porcentajes de egreso, sobre todo en la Facultad de Estudios Superiores Zaragoza; odontología mostró los menores índices de egreso y mayores índices de abandono y rezago. Las mujeres mostraron mayor egreso y menor riesgo de abandono y rezago. CONCLUSIONES: Los estudiantes de las licenciaturas en enfermería, medicina y psicología de las facultades de estudios superiores Zaragoza e Iztacala, con programas modulares, alcanzaron los mayores porcentajes de egreso y menores índices de abandono y rezago.

PHYSICAL HEALTH OF STUDENTS AND DIGITALIZATION OF HIGHER MEDICAL EDUCATION: RISK FACTORS.

OBJECTIVE: The aim: To study the dynamics of gadget use by higher education students of the Bogomolets National Medical University and to assess technological impact on the physical health of students. PATIENTS AND METHODS: Materials and methods: To accomplish the tasks set using theoretical and experimental methods of scientific research: systematic analysis, comparison and generalization of the bibliosemantic method, questionnaires, and interviews with students. Quantitative data collected during the survey of students studying in the «Dentistry¼, «Pediatrics¼, «Medicine¼, «Pharmacy, Industrial Pharmacy¼, «Physical Therapy, Occupational Therapy¼, and «Medical Psychology¼ specialties were processed using the MedCalc statistical software, and there was carried out comparative analysis afterwards. RESULTS: Results: During the quarantine and martial law, medical university students were forced to study distantly or in a mixed format using various gadgets and computers. It is obvious that the physical condition of a person is affected by the duration of their use of various devices. In this paper, therefore, the risks and the researched dynamics of gadget use by higher education students of the Bogomolets National Medical University were identified. Thus, the technological impact on the physical health of students was also defined. Moreover, the data based on the results of height and weigh calculation of higher education students, which used to diagnose types of obesity by anthropometric indicators, were also collected. CONCLUSION: Conclusions: According to the results of the research, it was established that the students of the Bogomolets National Medical University spent a significant part of their study time sitting in the classroom or at the computer (40 hours weekly average). We found that in the process of distance learning, prolonged sitting at a PC or other gadget (as well as general sedentary lifestyle) has affected the female higher education students majoring in 222 «Medicine¼ course their body mass index. The time spent using gadgets both in the educational and non-formal education (self-education) processes has increased significantly. We attribute this fact to the emergence of a significant number of online educational resources in the public domain, the growing number of webinars, trainings, and master classes conducted by both domestic and foreign experts online.

Aesthetic rehabilitation for anterior teeth of dental fluorosis with direct composite veneers.

Intrinsic discoloration can be formed due to many reasons, and by clinical evaluation and history from the patient, the exact cause of the discoloration can be known and one of the reasons that can make the intrinsic discoloration is the high level of fluoride intake. Two siblings had come to the Department of Restorative Dentistry clinics; they had the same compliance which is severe dental fluorosis, caries, and malocclusion of their teeth. What is interesting and worrying is that some patients with severe dental fluorosis show higher levels of caries, which can be explained as the enamel becoming porous with severe fluorosis. The possible treatment options were discussed with the patients. According to their financial concern and their desire to get their teeth done as soon as possible, the use of direct composite veneer for the treatment of anterior teeth was decided. Long-term clinical trials are required to assess the efficacy of various treatment options for fluorosis of different severity.

Public Awareness on Perio-systemic Interplay: A Cross-Sectional Survey in South India.

BACKGROUND: The oral cavity has been referred to as "the gateway to overall health." It is also said to be the meeting point of medicine and dentistry. AIMS: Our study sought to determine the extent to which the public was aware of the connection between oral/periodontal conditions and general health. SETTINGS AND DESIGN: The observational cross-sectional study's questionnaire was sectioned into oral health awareness, systemic influence on oral health, and personal oral health assessment. MATERIALS AND METHODS: A total of 994 responses were recorded and a Chi-square test was performed to uncover the relationships using SPSS version 22.0. According to responses, 70% of the population on average comprehended the responses to the majority of the oral health awareness-related questions. RESULTS: It has been noticed that only 30% of the general public was aware of the prevalent health issues like diabetes, hypertension, and malnutrition's impact on dental health. However, more than 60% had confidence in their oral health and gave a rating of at least 5. CONCLUSION: The study indicates that a good number of the population was prioritizing their oral health. However, there exists a definitive need to improve oral health awareness thereby ameliorating the overall health of an individual.

[Dental rehabilitation in a young patient with glycogen storage disease type 1B]. / Dentale rehabilitatie bij jonge patiënt met glycogeenstapelingsziekte type 1B.

A young woman, known to have glycogen storage disease type 1B (GSD1B) presents with severe periodontitis. GDS1B causes decreased hepatic and renal glucose production and in many cases neutropenia and neutrophil dysfunction leading to recurrent infections. It was decided to treat the patient by extraction of the most affected teeth and retention of the remaining teeth through periodontal treatment, both with antibiotic prophylaxis. After a follow-up period of 1.5 years, during which there was no visible improvement, it was decided to do a full dental extraction and fabricate complete dentures. Due to subsequent bone resorption in both jaws, the dentures were not functional. After consulting the internist and the oral and maxillofacial surgeon, the decision was then made to place dental implants in both the upper and lower jaw for implant-supported prosthetics. After successful treatment and an osseointegration period, the prosthetics were placed. 1 year after placement, there is a stable implantological situation, without pockets or apparent bone loss. The start of SGLT2 medication may have played a significant role in this.

Brief History of Oral and Maxillofacial Pathology in Colombia: Milestones and Current State.

Oral and maxillofacial pathology, the branch of dentistry concerning clinical and histopathological diagnosis of pathologies of the oral and maxillofacial region, started to develop in Colombia in the mid- 19th century. Since 1950s, dedicated dental clinicians from different dental schools played an important role in its inception and subsequent development. The first significant wave of progress occurred in the 1970s with the appearance of the first formally trained oral pathologists. It was sometime in the late 1980s and early 1990s that dentists Ines Velez and Benjamin Herazo had separate initiatives and created the first oral pathology postgraduate programs in Bogotá. It was in the late 80's and early 90's that dentists Ines Velez and Benjamin Herazo had their own initiatives and created the first oral pathology postgraduate programs in the city of Bogotá. A concomitant of their achievements was the establishment of the first on-site oral pathology biopsies units and registers at Colegio Odontãlogico Colombiano, Pontificia Universidad Javeriana and Escuela Colombiana de Medicina dental schools. The programs have trained many dentists in the field over the years and two of them remain active and fully accredited. The past and present contributions and leaderships of some academic figures and graduates have allowed a steady evolution of the specialty nationwide. Currently, the ability to manage and overcome educational and professional challenges is necessary to advance the growth of this specialty in this country.

John Greenwood's sidenotes on a 1778 John Hunter text at The New York Academy of Medicine.

John Greenwood (1760-1819) was George Washington's preferred dentist. He practiced in New York and made at least one of eight sets of dentures Washington wore (currently in the collection of the New York Academy of Medicine (NYAM). We know very little about John Greenwood's (JG) formal education, except that he came from a famous family of dentists. He inherited from his father, Isaac Greenwood, one important book of the time, John Hunter's 1778 treatise, A Natural History of the Human Teeth. That copy was donated to the New York Academy of Medicine by descendants of John Greenwood. Recently, we became aware of extensive marginalia that John Greenwood wrote in this book. The present article describes John Greenwood's opinion on a variety of dental subjects such as the causes and mechanisms of tooth destruction and gum disease and the presence of microscopic annamalcula that were thought to be connected to poor oral hygiene. Although John Greenwood was self-educated, his observations are surprisingly insightful and at least 37 years ahead of what was described in the contemporary literature.

History of Orthodontics in Brazil - Postgraduate Education.

Orthodontics in Brazil underwent significant transformations in the 1950s when several dentists returned to the country after completing advanced education courses in the specialty abroad. The first two orthodontic associations, in Rio de Janeiro and São Paulo, were constituted in 1955 and 1959. The specialty's first event with characteristics of a professional meeting occurred in São Paulo in 1957, and Postgraduate Orthodontic education became available. This paper aims to describe the central insights of the constitution and evolving of the education of Orthodontics in Brazil.

["The Shakespeare of medicine": works and days of John Hunter (1728-1793)].

John Hunter is rightly ranks with such most famous researchers and physicians as Galen, William Harvey and Andreas Vesalius. His role as the founder of the "experimental surgery" of the New Age and the creator of the famous Hunterian Medical Museum in London is significant for the history of medicine. His contribution into development of dentistry is incontestable. His work "The Natural history of human teeth: an explanation of their structure, use, formation, growth and diseases" (1771) was translated into many languages, but it was never published in Russian. The accuracy of description of the anatomy of teeth, jaws and mouth cavity, the view? contemporary for us, of development of the jaws and their relationship with the masseters, the introduction of such terms as "canines", "incisors" and "anterior molars" into scientific circulation and everyday practice of dentists, the illustrations excellent by their quality and accuracy - all this is John Hunter. His works predetermined path of development of many medical directions, giving food for thought to his followers and disciples. The article reveals the facts of his biography, demonstrates significance of contribution of John Hunter into medicine in his works on anatomy, surgery, natural history of dentistry and stomatology.

[Halitosis. Multidisciplinary approach]. / Khalitoz ­ mezhdistsiplinarnaya problema.

Halitosis is a common complaint among patients. Up to 50% of people worldwide claim to have persistent or intermittent bad breath. Often, bad breath not only disrupts the social life of patients, but is also a symptom of systemic diseases. An important step in the treatment of halitosis is the localization of the source and possible cause of the unpleasant smell. Most often, the problem of halitosis is solved by dentists, because intraoral halitosis accounts for up to 90% of all cases, but doctors of many specialties should deal with the differential diagnosis of its causes. This article considers the main causes of halitosis in patients with diseases of various organ systems.

Contacts with general practitioners, dentists, and medical specialists among nursing home residents: a cross-sectional study in 44 German nursing homes.

BACKGROUND: Nursing home residents have high medical care needs. Their medical care utilization is, however, lower compared to community-dwelling elderly and varies widely among nursing homes. This study quantified the utilization of general practitioners (GPs), dentists, and medical specialists among nursing homes and residents, and investigated whether dentist utilization is associated with individual and nursing home characteristics. METHODS: Forty-four nursing homes invited 2124 residents to participate in a cross-sectional study. For 10 medical specialties, data on contacts in nursing homes, practices, and by telephone in the last 12 months were assessed at individual and nursing home level. The proportion of nursing homes and residents with any form of contact, and the median number and interquartile range (IQR) of contacts among individuals with contact were determined. Using multilevel logistic regression, associations between the probability of individual dental care utilization and sex, age, LTC grade, years of residence, sponsorship, number of nursing home beds, and transport and medical escort services for consultations at a practice were investigated. RESULTS: The proportion of nursing homes with any form of contact with physicians ranged from 100% for GPs, dentists, and urologists to 76.7% for gynecologists and orthopedists. Among the nursing homes, 442 residents participated (20.8% response). The proportion of residents with any contact varied from 97.8% for GPs, 38.5% for neurologists/psychiatrists, and 32.3% for dentists to 3.0% for gynecologists. Only for GPs, neurologists/psychiatrists, dentists, otorhinolaryngologists, urologists, and dermatologists, the proportion was higher for nursing home contacts than for practice and telephone contacts. Among residents with any contact, the median number of contacts was highest for GPs (11.0 [IQR 7.0-16.0]), urologists (4.0 [IQR 2.0-7.0]), and neurologists/psychiatrists (3.0 [IQR 2.0-5.0]). Dentist utilization varied widely among nursing homes (median odds ratio 2.5) and was associated with higher age. CONCLUSIONS: Almost all residents had regular contact to GPs, but only one third had contact with dentists. Lower proportions with contact were found for medical specialists, except for neurologists/psychiatrists. Reasons for the large variations in dental care utilization among nursing homes should be identified. TRIAL REGISTRATION: DRKS00012383 [2017/12/06].