Orientações da COREMU SMS SP como estratégia de comunicação efetiva nos programas de Residência em Saúde

Orientações da COREMU SMS SP como estratégia de comunicação efetiva nos programas de Residência em Saúde. 2º Congresso Mineiro de Enfermagem ( 2ª CMENF).

Boas-vindas | COREMU

Vídeo apresenta a residência multiprofissional, normas institucionais e traz orientações dos programas de residências, entre outras informações.

Evaluation of the aesthetics and clinical findings in patients with missing maxillary lateral incisors treated with a 10-year interval.

INTRODUCTION: The most common treatment approaches for patients missing maxillary lateral incisors are implant replacement (IT) and orthodontic space closure (SC). Treatment techniques change and improve over time, and it is of interest to know if improvements differ between the methods. AIM: To compare the aesthetic outcome and other clinical findings in patients with one or two missing maxillary lateral incisors who were treated with a 10-year difference in time, with either orthodontic space closure or implant replacement. MATERIAL AND METHODS: A total of 88 patients were included in the study. Forty-four patients treated between 2011 and 2018 were included as the latter cohort (LC). The LC was compared to the early cohort (EC; n = 44), treated between 2001 and 2008. A total of 132 teeth was analysed: 62 teeth in the EC (28 teeth in IT cases and 34 teeth in SC cases) and 70 teeth in the LC (34 teeth in IT cases and 36 teeth in SC cases). Long-term clinical and aesthetic outcomes were evaluated. RESULTS: An improvement over time was found in crown length, BoP, papilla, the inclination of incisors, and overall appearance in IT cases and in crown colour and overbite in SC cases. A deterioration over time was found in crown length and BoP among the SC cases. CONCLUSION: Among the IT cases, an improvement in outcomes was noted over time. When comparing SC cases the colour of the crown and overbite had improved, while crown length and BoP had deteriorated over time.

Uncovering a pseudoscience: an analysis of 'biological dentistry' Instagram posts.

OBJECTIVE: This infodemiology study aimed to analyze characteristics of English-language Instagram posts on 'Biological Dentistry'. MATERIALS AND METHODS: Using CrowdTangle, we analyzed 500 'Biological Dentistry' posts published on Instagram from May 2017 to May 2022. Two researchers assessed each post for facticity, motivation, author's profile, sentiment, and interaction metrics. Statistical analysis was employed to compare interaction metrics between dichotomized categories of posts' characteristics and determine predictors of misinformation and user engagement. RESULTS: Over half of the posts (58.4%) were from health-related authors, and a considerable number contained misinformation (68.2%) or were financially motivated (52%). Sentiment was mostly negative or neutral (59.8%). Misinformation was associated with financial motivation (OR = 2.12) and health-related authors (OR = 5.56), while non-health-related authors' posts associated with higher engagement (OR = 1.98). Reliable content, non-health-related authorship, and positive sentiment were associated with increased user interaction. CONCLUSION: Misinformation about 'Biological Dentistry' on Instagram is mainly spread by financially incentivized health-related authors. Yet, non-health-related authors' posts resonate more with audiences, highlighting a nuanced relationship between content facticity, authorship, and engagement.

A comparative study of the use of digital technology in the anterior smile experience.

OBJECTIVES: this study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations. METHODS: Sixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index. RESULTS: Based on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction. CONCLUSION: Digitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

Program Director Attitudes Toward Acceptance of Pediatric Dentistry Entrustable Professional Activities (EPAs).

Purpose: To acquire comments on pediatric dentistry entrustable professional activities (EPAs) from pediatric dentistry residency program directors (PDs). Methods: An electronic survey invited PDs to evaluate 16 previously developed EPAs on whether they were critical to patient safety, resident education, or both. PDs were asked to evaluate a fully developed EPA to assess structure and clarity and describe barriers to EPA. Descriptive statistics were completed. Results: Forty-one of 103 PDs completed the entire survey. Eighty-five percent (36 of 42) of PDs believed EPAs are critical to pediatric dentistry education, and 81 percent (34 of 42) believed EPAs are critical to patient safety. Eighty-one percent of PDs would likely use EPAs when available. Seventy-five percent (31 of 41) of PDs reported that they have had a resident who would have benefited from a longer duration of training. Conclusions: The majority of pediatric dentistry residency program director participants surveyed reported that entrustable professional activities are critical to patient safety and resident education. EPAs may be a valuable option for assessing residents' readiness for graduation.

Occupational Noise Exposure in the Pediatric Dental Setting.

Purpose: To evaluate the noise levels recorded in a hospital-based pediatric dental clinic and evaluate the occupational exposure personnel have to potentially hazardous levels of noise. Methods: A SoundAdvisor™ Sound Level Meter Model 831C was used to gather 19 days of background sound data (equivalent continuous sound levels, measured as LAeq) in the open bay, quiet room, sedation suite, and operating room settings. A Spartan™ Wireless Noise Dosimeter Model 730 (Larson Davis) was utilized to capture data about personal noise exposure of pediatric dental residents over 81 clinic sessions. Personal noise exposure was compared to the Occupational Safety and Health Administration (OSHA) stand- ard. Results: Background A-weighted sound pressure level was significantly less for the open bay than in the operating room, quiet room, and oral sedation setting (P<0.05), while the operating room was significantly less than the oral sedation setting (P=0.038). Personal LAeq was significantly less for the open bay than the quiet room (P=0.007) and oral sedation settings (P=0.007). There was a significantly larger percentage of time above 80 dBA captured in the oral sedation suite compared to the open bay (P=0.010) or operating room (P=0.023). Conclusions: Daily occupational noise exposure did not exceed the thresholds set forth by OSHA. Sedation and quiet room treatment settings were noted to be the loudest pediatric dental clinical environments.

Accuracy of Parent-Reported Allergies and Medications in Pediatric Dentistry.

Purpose: To measure the accuracy of parent-reported allergies and medication usage by comparing parental reports during dental con- sultations to medical reports from their child's primary care physician. Methods: A retrospective chart review was performed for 862 eligible patients 17 years and younger seen in the Department of Pediatric Dentistry at Franciscan Children's, Boston, Mass., USA, and who were required to obtain medical clearance prior to initiating dental treatment with sedation or general anesthesia. Allergies were categorized into three groups: food, environmental, and drug allergies. Allergies in each category reported by the parents were compared to the physician-reported allergies to assess for accuracy. Medications reported by the parents were also compared to the total number of medications reported by the physician and categorized as a full, partial, or non-match. Results: The sensitivity of parental identification for drug, food, and environmental allergies was 50.9 percent, 48.1 percent, and 18.8 percent, respectively. Of the 245 patients taking prescription medications, 53.1 percent of parents were unable to identify any of their child's medications, 22.9 percent of parents were partially able to identify their child's medications, and only 24.1 percent of parents were able to identify their child's medications fully. Among parents of children who take one or more medications as reported by their physician, the average reporting accuracy was 34.7 percent. Conclusion: Utilizing interprofessional collaboration is warranted in identifying accurate reports of patient allergies and medication usage in the pediatric population to prevent adverse reactions and improve the overall quality of dental care.

The feedback dilemma in medical education: insights from medical residents' perspectives.

BACKGROUND: Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training. METHODS: This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents. RESULTS: The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting. CONCLUSIONS: Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care.

How different attributes are weighted in professionals' decision-making in Pediatric Dentistry-a protocol for guiding discrete choice experiment focused on shortening the evidence-based practice implementation for dental care.

BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .

Clinical application principles and new developments of zirconia crown.

Zirconia crown has been widely used in the field of prosthodontics. Traditional zirconia exhibits excellent mechanical properties but lacks translucency. The introduction of transparent zirconia significantly enhances its aesthetic performance. In clinical applications, factors affecting the aesthetic results of full zirconia crown should be comprehensively considered, and the most suitable restoration should be chosen. Additionally, clinicians need to design appropriate tooth preparation dimensions and methods based on an individual patient's actual situation. During the clinical bonding process of zirconia, proper surface treatment of the tooth and restoration is essential. The selection of suitable adhesives is crucial for achieving optimal bonding strength and aesthetics.

Simulation Improves Emergency Medicine Residents' Clinical Performance of Aorta Point-of-Care Ultrasound.

Purpose: Using point-of-care ultrasound (POCUS) to diagnose abdominal aortic aneurysm (AAA) is an essential skill in emergency medicine (EM). While simulation-based POCUS education is commonly used, the translation to performance in the emergency department (ED) is unknown. We investigated whether adding case-based simulation to an EM residency curriculum was associated with changes in the quantity and quality of aorta POCUS performed by residents in the ED. Methods: A case-based simulation was introduced to resident didactics at our academic, Level I trauma center. A case of undifferentiated abdominal pain was presented, which required examination of an ultrasound phantom to diagnose an AAA, with a hands-on didactic. We compared the quantity, quality, and descriptive analyses of aorta POCUS performed in the ED during the four months before and after the simulation. Results: For participating residents (17/32), there was an 86% increase in total studies and an 80% increase in clinical studies. On an opportunity-adjusted, per-resident basis, there was no significant difference in median total scans per 100 shifts (4.4 [interquartile range (IQR) 0-15.8 vs 8.3 [IQR] 3.3-23.6, P = 0.21) or average total quality scores (3.2 ± 0.6 vs 3.2 ± 0.5, P = 0.92). The total number of limited or inadequate studies decreased (43% vs 19%, P = 0.02), and the proportion of scans submitted by interns increased (7% vs 54%, P = < .001). Conclusion: After simulation training, aorta POCUS was performed more frequently, and ED interns contributed a higher proportion of scans. While there was no improvement in quantity or quality scores on a per-resident basis, there were significantly fewer incomplete or limited scans.

Classified diagnosis and treatment scheme of oral cosmetic restoration based on aesthetic analysis (part â ¡): Chinese aesthetic connotation and analysis scheme.

At present, the commonly used clinical protocols of oral cosmetic restoration are mostly based on the oral aesthetic indexes proposed by Western developed countries (referred to as Western aesthetics), which are different from the oral aesthetic indexes unique to Chinese people (referred to as Chinese aesthetics). In the design of restoration schemes and the evaluation of restoration effects, these differences have a large or small effect on the doctor-patient-technology triad. Improper handling could directly weaken the cooperation efficiency of the three parties, reduce patient satisfaction, and even lead to medical disputes in serious cases. From doing a good job of oral cosmetic restoration in China, the connotative characteristics of Chinese oral aesthetics are introduced in this paper, and the value of oral aesthetic analysis in diagnosis and treatment is discussed. The process and method of aesthetic analysis and assessment through the modified Chinese psychosocial impact of dental aesthetics questionnaire and the evaluation ruler of the expected value of oral cosmetic restoration are further introduced in detail.

The phenomenological approach in dentistry - a narrative review.

PURPOSE: Phenomenology is a branch of philosophy that focuses on human lived experience. Illness including dental diseases can affect this living experience. Within the dental literature, there is very little reported on the use of phenomenology compared to other healthcare sciences. Hence, the aim was to review the literature and provide an overview of various applications of phenomenology in dental research. METHODS: This study was a narrative review using literature in the last 10 years identified by web-based search on PubMed and Scopus using keywords. A total of 33 articles that were closely related to the field and application in dentistry were included. The methodology, main results, and future research recommendations, if applicable, were extracted and reviewed. RESULTS: The authors in this study had identified several areas such as orofacial pain and pain control research, dental anxiety, dental education, oral healthcare perceptions and access, living with dental diseases and dental treatment experience in which the phenomenological method was used to gain an in-depth understanding of the topic. CONCLUSIONS: There are several advantages of using the phenomenological research method, such as the small sample size needed, the diverse and unique perspective that can be obtained and the ability to improve current understanding, especially from the first-person perspective.

Graduate medical education success coaching for residents and fellows: a single-institution real-world experience.

While coaching has been employed as a success strategy in many areas such as athletics and business for decades, its use is relatively new in the medical field despite evidence of its benefits. Implementation and engagement regarding coaching in graduate medical education (GME) for residents and fellows is particularly scarce. We report our three-year experience of a GME success coaching program that aims to help trainees reach their full potential by addressing various areas of medical knowledge, clinical skills, efficiency, interpersonal skills and communication, professionalism, and mental health and well-being. The majority of participants (87%) were identified by themselves, their program director, and/or the GME coaches to have more than one area of need. The majority (79%) of referrals were identified by the coaches to have additional needs to the reasons for referral. We provide a framework for implementation of a GME coaching program and propose that coaching in GME may provide an additional safe environment for learners to reveal areas of concerns or difficulty that otherwise would not be disclosed and/or addressed.