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Biomedical subjects

S L Handelman

Publications and source records attributed to S L Handelman.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

An educational consultative model for general practice training programs.

A behavioral science consultant has been retained by two hospital-based general practice residency (GPR) programs and one advanced program in general dentistry at the University of Rochester, and Eastman Dental Center, NY. This consultant is available throughout the year and serves as an external consultant who knows the programs well, and can be used as a source of information on various existing and potential issues and problems. The model used by the consultant has been inductive and is based on the expressed needs of faculty members, trainees, and directors. A number of issues or problems were identified, including faculty member morale, evaluation of residents' growth, resident and supporting staff relations, curriculum development, cooperation with other departments and institutions, and dealing with patients' anxiety to dental treatment. For each, a specific plan was developed. Various types of experiential techniques were used, including brainstorming, role playing, and taping and feedback. Didactic activities included minicourses and workshops in which standard teaching methods were used, such as lectures, seminar discussions, literature study, and demonstration. The model has evolved, and as each activity has succeeded, more faculty members have sought help from the consultant.

Consultants↗
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Hyposalivatory drug use, whole stimulated salivary flow, and mouth dryness in older, long-term care residents.

Drug-induced hyposalivation has only been anecdotally related to various subjective and objective oral problems. The study described here of 157 residents of a long-term care facility reports data on whole masticatory-stimulated salivary flow rates, use of medications, and perceptions of symptoms associated with hyposalivation, including mouth and eye dryness, tooth sensitivity, chewing satisfaction, and taste and smell acuity. One hundred and twelve residents (71%) were taking one or more drugs that induced hyposalivation. Salivary flow rates were lower in persons who were taking such drugs, and lowest in persons who were taking such drugs for a protracted period. Flow was also lower in females than males, and lower in persons institutionalized for long periods than in persons institutionalized for short periods. Persons who were taking drugs that induce hyposalivation were institutionalized longer, used more medications, had more health problems, were dissatisfied with chewing, and had fewer teeth than persons who were not taking such drugs. Persons who reported having mouth dryness also reported eye dryness and were dissatisfied with their chewing ability. Perceived mouth dryness was not related to salivary flow.

Aged↗
PubMedDate not supplied

Oral yeasts, mucosal health, and drug use in an elderly denture-wearing population.

Drug use among the elderly may be a factor in oral mucosal pathology and the prevalence of oral yeasts. This study was designed to evaluate the relationship between oral yeast, denture-bearing mucosal health and drug use, especially drugs with known hyposalivatory side effects. There was an inverse relationship between denture-bearing mucosal health, and hyposalivatory drug use r = -0.41 P less than 0.04. Use of drugs with a hyposalivatory side effect was related to increased numbers of Candida glabrata but not Candida albicans in saliva and at denture stomatitis and denture sore sites.

Aged↗
PubMedDate not supplied

Effects of hyposalivatory medications on saliva flow rates and dental caries in adults aged 65 and older.

Institutionalized adults aged 65 or older often receive medications that have been associated with decreased saliva flow. Flow rates depressed by hyposalivatory medications are thought to increase susceptibility to dental caries. In this study, a cross-sectional comparison was made of stimulated whole saliva rates and coronal and root caries prevalence in a group of older adults, in a long-term care facility, taking hyposalivatory medications vs. a control group. No significant differences were found between the two groups in masticatory or gustatory stimulated flow rates or in mean decayed coronal or root surfaces.

Aged↗
PubMedDate not supplied

Removal of impacted third molars by oral/maxillofacial surgery and general dentistry residents.

The post-operative symptoms of patients who had undergone third molar extractions by Oral/Maxillofacial Surgery (OMS) residents were compared with those of patients whose extractions were performed by General Dentistry (GD) residents. The OMS group had more extractions per visit and were more likely to use intravenous sedation than the GD-treated group. No significant differences were found when the provider groups were compared by post-operative symptoms such as osteitis, infection, trismus, or paresthesia/dysthesia. The pain relief due to postoperative analgesics during the immediate 12-hour period was higher for patients treated by GD residents. Multiple regression analysis revealed that this difference was due to the number of teeth extracted and the complexity of the surgical procedure, independent of type of provider.

Adolescent↗
PubMedDate not supplied

The growth of postdoctoral general dentistry programs.

From 1972 to 1990, the number of Postdoctoral General Dentistry (PGD) programs increased by 57% and enrollment increased by 57% and enrollment increased by 131% for a total of 118 PGD programs and 1,367 positions. Although there has been some increase in military and Veterans Affairs (VA) programs, the major increase was in civilian programs. From 1972-78, the major impetus for growth was hospital sponsorship of General Practice Residency (GPR) programs. With federal funding of PGD programs, civilian GPR programs continued to be the main source of growth until the accreditation of Advanced Education in General Dentistry (AEGD) programs in 1981. Subsequently, almost all increases were in AEGD programs. Over the 12-year period of federal funding (1978-90), there was an increase of 406 civilian PGD positions to make a total of 925 positions. The increase in enrollment directly attributable to federal funding was 242. The "unmet demand" for PGD programs was estimated to be approximately 300 positions for 1990, from data derived from the Survey of Dental Seniors and the Matching Program. Assuming that the number of PGD positions continues to increase by 35 positions a year, as it has in the past 12 years, the unmet demand would be met in slightly less than 10 years. If, however, a postdoctoral year was mandated for licensure, the increase in the number of positions would be far short of projected need.

Education, Dental, Graduate↗
PubMedDate not supplied

Patient satisfaction in a regular and after-hours dental clinic.

To determine whether financial incentives would have an impact on the quality of care, we compared patient satisfaction in a "regular" daytime postdoctoral general dentistry clinic and an "after-hours" clinic, using a 14-item mail questionnaire to a randomly selected sample of adult patients, stratified by age and gender. The providers in both clinics were identical; however, the method of compensation was different. When residents treated patients in the regular clinic, they were paid a fixed stipend, while the "after-hours" clinic residents' compensation was fee-for-service. The percentage of patients giving very favorable or favorable responses was high in both clinics. However, the response of patients in the "after-hours" clinic was more favorable for total number of visits required for care to be completed, management of pain, and politeness of receptionists. This study demonstrated that the payment of financial incentives to residents did not reduce and may even have enhanced patient satisfaction.

Adult↗