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Biomedical subjects

D W Chambers

Publications and source records attributed to D W Chambers.

At least 55 records · Page 3Linked to original sources
PubMed1998

Ethics summit I: assembling the ethical community.

Ethics Summit I was a unique gathering of organizations representing all of oral health care, convened by the American College of Dentists, for the purpose of seeking a common ethical ground. The background of the conference and its logistics are described here. Four themes were discussed: the role of ethics codes, conflicting values, responding to unethical behavior, and organizations as ethical agents. The conference was grounded in the unusual assumptions that the participants did not have to have a common profile of values to engage in ethical discussion and that individual behavior is not the only level at which ethical discussion must take place. Finally, we did not begin with an assumption that one group could define an ethical code that all others might subscribe to. One strong consensus that emerged was the desirability of creating an alliance of all concerned with oral health care to continue such conversations.

Dentistry↗
PubMed1998

Tacit knowledge.

Dentistry is different from most professions and many of the current trends in American business because of its heavy dependence of tacit knowledge--the know-how that defies capture in explicit form. Many of the issues facing the profession today result from attempts to make oral health care more explicit so that it can be managed by those outside the profession. This is unlikely to proceed much farther than it has already. However, dentistry must still find ways of communicating the value of its services in explicit ways that the public will understand.

Clinical Competence↗
PubMed1998

How the Japanese work.

The Japanese do not work harder or even use different approaches so much as they aim for a different result--one that balances process and results and extends the definition of quality beyond the product itself to include cost and convenience to the customer as well. Ten methods of the Japanese kaizen culture of work are presented with applications and contrasts to American dentistry.

Cost-Benefit Analysis↗
PubMed1997

Comparison of mRAST and CAP with skin end point titration for Alternaria tenuis and dermatophagoides pteronyssinus.

There has been a recent explosion of new in vitro tests for the diagnosis of allergies. At present there is no general agreement on which type of in vitro test is best. Recently our hospital switched in vitro testing from the modified radioallergosorbent system (mRAST) to the Pharmacia CAP system (CAP). While changing in vitro testing techniques, 47 patients were tested with both the mRAST and CAP tests. Comparisons were made between the mRAST and CAP results of Alternaria tenuis and Dermatophagoides pteronyssinus allergens. These results were then compared with the results of patients who also underwent intradermal skin testing based on end point titration techniques.

Allergens↗
PubMed1997

Long-term outcome analysis of functional endoscopic sinus surgery: correlation of symptoms with endoscopic examination findings and potential prognostic variables.

One hundred eighty-two patients were evaluated after functional endoscopic sinus surgery. The goal was to establish whether any anatomical finding correlated with symptoms and to find any historical predictors of symptomatic failure. Of all physical findings reviewed, only scarring of middle meatal antrostomy and scarring of the ethmoids approached significance in predicting poor outcome. Surprisingly, of the historical factors reviewed, only gastroesophageal reflux disease was statistically significant as a predictor of poor symptomatic outcome.

Adult↗
PubMed1997

Bonafauxverity.

Explore the source record for details and available documents.

Dental Care↗
PubMed1997

Analyzing the sources of unreliability in fixed prosthodontics mock board examinations.

Mock board examinations in fixed prosthodontics were submitted to generalizability analysis in order to determine which sources of unwanted variance of measurement contribute to grade decisions and whether this lack of reliability is of practical significance. Students completed approximately three fixed prosthodontics test cases during their final year of clinic, and each case was scored by two faculty members. Of the subsamples of students where two test cases (trials) per student were graded by the same two raters, the subsamples with the highest and the lowest inter-rater reliability coefficients were chosen. Typical generalizability coefficients (reliability considering both raters and trials as sources of error) are much lower than the inter-rater reliability estimate, and the standard error of measurement is 80 percent of a grade interval on a five-point scale. In all analyses, the largest source of variance was the student-by-trial interaction, accounting for about 80 percent of the standard error of measurement or one-half a grade on a five-point scale. Even in the subsample with lowest inter-rater reliability, rater, rater-by-student interaction, and rater-by-trial interaction made no contribution to measurement error. Nor did students show evidence of improving over time. There is no possible improvement through the use of rater calibration or additional raters that would equal the improvement made by using two test cases rather than one. The concept of gradient of generalizability is introduced, and implications for initial licensure examinations are discussed.

Analysis of Variance↗
PubMed1997

Competition.

Our ambivalence toward competition can be traced to an unspoken preference for certain types of competition which give us an advantage over the types we value less. Four types are defined (a) pure (same rules, same objectives), (b) collaborative (same rules, shared objective), (c) market share (different rules, same objectives), and (d) market growth (different rules, value added orientation). The defining characteristics of the four types of competition are respectively: needing a referee, arguing over the spoils, differentiation and substitutability, and customer focus. Dentistry has features of all four types of competition, thus making it difficult to have a meaningful discussion or frame a coherent policy on this topic.

Competitive Behavior↗
PubMed1997

Long-term follow-up of aviators after functional endoscopic sinus surgery for sinus barotrauma.

Prior to endonasal endoscopic advances for the treatment of sinus disease, surgical results for aviators with recurrent sinus barotrauma (RSB) were inconsistent. Between 1988 and 1992, 54 aviators, who were permanently or temporarily grounded, underwent functional endoscopic sinus (FES) surgery in an attempt to return them to active flying status. Follow-up in the immediate postoperative period revealed that 98% of these aviators returned to active flight duty. A questionnaire was mailed to each of these aviators to compare their preoperative and long-term postoperative symptoms and determine their current flying status. Long-term follow-up time ranged from 20 to 72 mo with average of 48 mo. Of the aviators who responded to the survey, 92% have continued their flying duties and do not report difficulties with RSB. We conclude that FES surgery is effective in the short- and long-term management RSB in aviators.

Aerospace Medicine↗