Nurses' knowledge, assessment skills, experience, and confidence in toenail management of elderly people.
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Biomedical subjects
Publications and source records attributed to C Turner.
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OBJECTIVE: To assess the appropriateness of using state-level data on uninsured hospitalizations to estimate the uninsured population. METHODS: The authors used 1992-1996 data on hospitalizations of newborns and of appendectomy and heart attack patients in Florida to estimate the number of people in the state without health insurance coverage. These conditions were selected because they usually require hospitalization and they are common across demographic categories. RESULTS: Adjusted for the gender and ethnic composition of the population, the percentages of uninsured hospitalizations for appendectomies and heart attacks produced estimates of the state's uninsured population 1.6 percentage points lower than those reported for 1996 in the US Census March Current Population Survey. CONCLUSION: Data reported by hospitals to state agencies can be used to monitor trends in health insurance coverage and provides an alternative data source for a state-level analysis of the uninsured population.
Dense annular calcification to the valve attachment is particularly hazardous during mitral valve replacement because of the difficulty of placing sutures and the risk of atrioventricular rupture. We report 11 patients who underwent decalcification of the mitral anulus with the Cavitron Ultrasound Surgical Aspirator (CUSA) during mitral valve replacement. This resulted in a greatly simplified suture placement and prosthetic valve seating as well as enlargement of the annular orifice. Four other patients underwent CUSA debridement of the anterior leaflet of the mitral valve during concomitant aortic valve replacement and CUSA debridement of the aortic anulus. There were no operative deaths or major complications. Ultrasonic debridement is a useful adjunct in the surgical management of the heavily calcified mitral valve.
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The authors describe a patient, aged 10 years 9 months, in whom a mandibular supernumerary premolar developed late and was not diagnosed properly because of the lack of a thorough radiographic examination.
The purpose of this study was to evaluate the pulpal response to four calcium hydroxide preparations in primary teeth. Data indicated the calcium hydroxide-saline paste induced more inflammation and produced a greater zone of mummification than the three commercial preparations studied. Unintentional deep impaction of the medicament or dentinal chips increased inflammation for all categories. All medicaments produced a superficial necrosis (mummification) of the pulp. The greatest degree of mummification was seen with the calcium hydroxide-saline paste. The calcium hydroxide-saline paste produced a thick dentinal bridge, located deeper in the pulp when compared with the commercial agents. Commercial agents produced narrower but sufficiently high-quality dentinal bridges. This study indicates that direct pulp capping of exposures in primary teeth is a viable procedure. The newer commercial agents may be preferred, as they produce minimal inflammation, satisfactory dentinal bridging, and preservation of most of the vital pulp tissue.
Physical contact with patients by health care providers has been found to benefit the patients by reducing their fearful or avoidant reactions. This study tested whether a reassuring touch could be used during a routine pediatric dental examination to reduce children's anxiety and improve their behavior. Thirty-eight children between 3.5 and 10 years of age were randomly assigned to one of two experimental conditions. Children assigned to the touch condition were patted on the upper arm or shoulder on two separate occasions by the dentist during the examination while simultaneously receiving verbal reassurance and descriptions of the upcoming procedures. Children in the no-touch control condition received only the reassuring verbal descriptions without contact. Results indicated that touched children between the ages of 7 and 10 years (but not children aged 3.5 to 7 years) displayed less fidgeting behavior than their no-touch counterparts (P < 0.05). Post-treatment, children who were touched tended to report greater pleasure (P < 0.06) but less dominance (P < 0.10) than children not touched.
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A controversial aspect of pediatric dentistry today is parental presence. A number of authors report an increase in the number of parents who wish to accompany their children throughout the dental appointment. Dentists historically have excluded parents from the treatment area, while pediatricians routinely keep the parent and child together. The purpose of this survey was to determine the frequency that Florida pediatric dentists permit parental presence during children's dental visits and to relate the influence of patient age, dentist's years in practice, procedure type, and practitioner attitudes on parental presence. A high return rate (98.9%) was obtained, and results indicated a significant increase in parental presence in the dental operatory and that further increases in parental presence are expected. Younger children were more likely to be accompanied by a parent for each procedure. Parental presence for examination was more likely than for restorative or extraction. Analysis of variance (ANOVA) indicated that the most frequent attitudes influencing the pediatric dentist's choice to exclude parents were that their presence: wastes time (P < 0.001); disrupts the child (P < 0.05); and makes the dentist uncomfortable (P < 0.05).
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