External Cervical Resorption Detected by Cone Beam Computed Tomography on an Immature, Unerupted Maxillary Second Premolar.

Root resorption is a commonly recognized risk of orthodontic treatment and can range from minimal changes at the apex to aggressive and extensive erosion of tooth structure. The following report is aimed at presenting a rare case of idiopathic aggressive preeruptive root resorption in a maxillary second premolar of a young child prior to orthodontic force. During phase I orthodontic treatment, the maxillary premolar required surgical exposure with a bracket and chain to assist in its eruption. Before the exposure, a cone beam computed tomography (CBCT) was captured to aid in localizing the premolar and its relationship to vital structures. In addition to identifying relevant anatomy, the image also revealed an incidental finding of extensive external cervical root resorption. The risks, benefits, prognosis, and alternatives of continuing with surgical exposure of the affected premolar were presented to the guardian. The informed and consented decision was made to continue with the exposure and subsequent orthodontic treatment to align the tooth in the arch. Upon eruption to the occlusal plane, the tooth was amenable to endodontic pulp vitality testing, Endo Ice, and a follow-up CBCT. It was determined that there was advanced aggressive progression of the resorptive process. The Patel Classification 3Cd/Class 4 Heithersay ECR diagnosis and a poor prognosis ultimately resulted in the extraction of the tooth. Management of this case highlights a number of important clinical features including the rarity of advanced preeruptive idiopathic external cervical root resorption, a multidisciplinary approach (orthodontic, endodontic, and surgical) to diagnose and manage the ECR, and the importance of prescribing and acquisition of appropriate imaging to aid in the early diagnosis of the entity. This case report will add to the body of knowledge of a rare incidence of advanced ECR on a young patient with a nontraumatized, unerupted maxillary second premolar.

Leadership, Teamwork, and Collaboration: The Lived Experience of Conducting Multisite Research Focused on Quality and Safety Education for Nurses Competencies in Academia.

AIM: The aim of this study was to explore facilitators and barriers to conducting a multisite national study in nursing academia unsupported by grant funding. BACKGROUND: Scholarship focused on the Quality and Safety Education for Nurses (QSEN) competencies stimulates opportunities for research and collaboration among nurse educators and clinicians. Twelve members of the QSEN Academic Task Force collaborated on a multisite study of the effectiveness of a QSEN teaching strategy and published the findings. METHOD: A descriptive phenomenological reflective approach using Kim's critical reflective inquiry model was used to explore the lived experiences of the original study investigators. Data were analyzed using Colaizzi's phenomenological reduction. RESULTS: Findings revealed seven facilitators and one overarching barrier to conducting academic research projects of this scope. CONCLUSION: Participants found that strong leadership, a commitment to teamwork and collaboration, and a shared interest were critical to conducting a successful national study across academic settings.

Nursing Students' Perceptions of Just Culture in Nursing Programs: A Multisite Study.

BACKGROUND: While just culture is embraced in the clinical setting, just culture has not been systematically incorporated into nursing education. PURPOSE: The purpose of this study was to assess prelicensure nursing student perceptions of just culture in academia. METHODS: Following a quantitative, descriptive design, the Just Culture Assessment Tool for Nursing Education (JCAT-NE) was used to measure just culture across multiple (N = 15) nursing programs. RESULTS: The majority of JCAT-NE respondents (78%) reported their program has a safety reporting system, 15.4% had involvement in a safety-related event, and 12% submitted an error report. The JCAT-NE mean total score was 127.4 (SD, 23.6), with a statistically significant total score decline as students progressed from the beginning (133.6 [SD, 20.52]) to the middle (129.77 [SD, 23.6]) and end (122.2 [SD, 25.43]) of their programs (χ[2] = 25.09, P < .001). CONCLUSIONS: The results from this study are a call to action for nursing education to emphasize the tenets of just culture, error reporting, and quality improvement.

Constructive Feedback Teaching Strategy: A Multisite Study of Its Effectiveness.

AIM: The study purpose was to describe students' perceptions of feedback after participating in a teaching strategy designed to foster a view of feedback as an opportunity for improvement. BACKGROUND: Although delivering and receiving constructive feedback are essential to the role of the professional nurse, feedback has been identified as a trigger for incivility in academia and practice. METHOD: Twelve nurse educators from the Quality and Safety Education for Nurses Academic Task Force, located at nine schools of nursing across the nation, implemented a presentation about giving and receiving constructive feedback in junior and senior courses. RESULTS: Five hundred twenty-three students submitted a total of 985 posts or essays in response to viewing the presentation; seven themes were identified. CONCLUSION: Viewing this teaching strategy enabled nursing students to develop an awareness of the opportunity that constructive feedback presents for professional development, self-improvement, teamwork and collaboration, and patient safety.

Office managers' forum.

This article is a summary of the key elements presented during the conference held as part of the Practice Management and Development course sponsored by the Multi-Specialty Foundation in Las Vegas, Nevada in 2009. This article represents an amalgam of perspectives from practices across the United States. The Office Managers' Forum brought together the office managers and surgeons from practices across the United States as panelists. The panelists answered a multitude of practice management questions that included wide-ranging topics such as accounting and financing, staff well being, working with a spouse, hiring and firing, staff meetings, accreditation, motivation, and problems and perks specifically associated with a facial plastic surgery practice.

Alteration in prehospital drug concentration after thermal exposure.

OBJECTIVE: The aim of the study was to determine the remaining concentration of 23 commonly carried emergency medical services medications used in the United States after they have experienced thermal extremes that have been documented in the prehospital environment for a period of 1 month. METHODS: Pharmaceuticals were thermally cycled (-6 degrees C and 54 degrees C) every 12 hours and then assayed by high-performance liquid chromatography. RESULTS: Eight (35%) of 23 prehospital pharmaceuticals revealed ending concentrations of less than 90% with strong correlation to thermal exposure time. These included lidocaine, diltiazem, dopamine, nitroglycerin, ipratropium, succinylcholine, haloperidol, and naloxone. CONCLUSION: A decrease in concentration was found to be statistically significant in 8 (35%) of 23 commonly carried emergency medical services pharmaceuticals. These results provide new information and perspective regarding stability of emergency drugs in the prehospital environment by evaluating a broad range of pharmaceuticals as well as by using thermal exposure points that have been documented in the United States.