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PubMedDate not supplied

Infection control practices of Rhode Island dental hygienists and certified dental assistants.

PURPOSE: Limited studies document the infection control practices of dental hygienists and dental assistants even though both groups play a vital role in the prevention of disease transmission in the dental office. The purpose of this study was to survey Rhode Island registered dental hygienists and certified dental assistants to (1) determine their current infection control practices; (2) to document attendance at an infection control course; and (3) to identify the need for additional infection control education. METHODS: In October of 1993 a fixed-response survey was mailed to a random sample of 267 registered dental hygienists (RDHs) and 260 certified dental assistants (CDAs) in Rhode Island. Data were analyzed using descriptive statistics, cross-tabulations, and the chi-square statistic. RESULTS: Responses were received from 171 RDHs and 153 CDAs for adjusted response rates of 64% and 59%, respectively. Most responding RDHs and CDAs were wearing gloves but substantially fewer were utilizing one of the two acceptable combinations of personal protective barriers. Other procedures that were not always practiced by a substantial number of respondents included the use of disposable barriers, following recommended handwashing protocol, utilizing appropriate procedures for disinfection and sterilization of dental instruments and handpieces, updating medical histories, and biological monitoring of sterilization equipment. Although the majority of both groups reported having attended an infection control course within the past year, having written infection control protocols in place, and being satisfied or very satisfied with the level of infection control, many recommended procedures were not practiced routinely. CONCLUSIONS: These findings indicate that lack of compliance with infection control guidelines is multifactorial. Even though there is a need for continuing infection control education for dental hygienists and certified dental assistants, education alone is not the answer.

Chi-Square Distribution↗
PubMed2004

Nonmelanoma skin cancer mortality (1988-2000): the Rhode Island follow-back study.

OBJECTIVES: To estimate (1) the magnitude of and the components and factors associated with nonmelanoma skin cancer (NMSC) mortality and (2) the proportion of deaths misclassified as NMSC. DESIGN: Population-based follow-back study. SETTING AND PATIENTS: All Rhode Island residents whose deaths between 1988 and 2000 were attributed to NMSC. MAIN OUTCOME MEASURES: Distribution of diagnoses, verification of the causes of death, and characterization of associated factors. RESULTS: The proportion of misclassified deaths was significantly higher for nongenital NMSC (57%) than for genital NMSC (18%; P<.001). Most of the deaths misclassified as nongenital NMSC were caused by squamous cell carcinoma of mucosal surfaces. The age-adjusted NMSC mortality rate was 0.91 (per 100 000 persons per year), of which almost half (0.45) were due to genital carcinoma. Nonmelanoma skin cancer mortality increased sharply with age. The mortality rate from nongenital NMSC in men was more than twice that in women, but for genital NMSC this ratio was reversed. Skin cancers originating on the ear were responsible for more than a quarter of all deaths caused by nongenital NMSC. No cases of NMSC mortality occurred in organ transplant recipients. Many individuals had comorbid psychiatric conditions or evidence of unreasonable delay in seeking medical care for their lesions. CONCLUSIONS: Misclassifying the cause of death as nongenital NMSC accounts for a large source of error on death certificates in Rhode Island. Overall, nongenital squamous cell carcinoma and basal cell carcinoma death rates have declined, and mortality due to genital carcinoma was about half of total NMSC deaths. The dermatology community should emphasize prevention of mortality from genital skin cancer, while continuing to stress the importance of reducing excessive exposure to UV light and prompt treatment of NMSC.

Adolescent↗
PubMed1996

The evaluation of symptomatic carotid artery disease. A survey of specialty practices in Rhode Island.

Severe, symptomatic carotid artery disease is most often diagnosed by conventional cerebral angiography. Noninvasive tests are commonly used to identify candidates for angiography and endarterectomy. The purpose of this study, a mail and telephone survey of academic and community neurologists, neurosurgeons, and vascular surgeons in Rhode Island in 1994, was to determine which noninvasive tests physicians used to evaluate these patients and how the test results were used to select patients for angiography. One hundred (86%) of a possible 116 responses were collected. Seventy-six percent of physicians chose carotid duplex ultrasound as the first diagnostic test, a percentage significantly higher than that for any other test (p < 0.0001). Fourteen percent chose angiography without a prior screening test; 3% chose magnetic resonance angiography (MRA) prior to angiography, 6% chose carotid duplex ultrasound plus MRA prior to angiography, and 1% chose MRA without angiography. The specific noninvasive test results required for angiography referral were surprisingly variable, both within and across the three physician specialties. Vascular surgeons and neurosurgeons were more likely to choose angiography without prior screening tests than were neurologists. In conclusion, the majority of specialty physicians in the state of Rhode Island chose carotid ultrasound as the screening test of choice for the evaluation of a potential endarterectomy candidate. Few responding physicians chose MRA in combination with carotid duplex ultrasound prior to angiography, or MRA prior to angiography or MRA alone. Awareness of the actual practice patterns of specialists may lead to programs of education for physicians to improve practice and patient outcome through more refined use of diagnostic tests prior to angiography or endarterectomy.

Carotid Artery Diseases↗
PubMed2005

Depositional history of organic contaminants in Narragansett Bay, Rhode Island, USA.

Sediment cores were taken at three locations in Narragansett Bay, Rhode Island, USA in 1997 and analyzed for a variety of organic contaminants including polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), chlordanes, linear alkyl benzenes (LABs), benzotriazoles (BZTs) and dichlorodiphenyltrichloroethanes (DDTs) and metabolites. The distributions of these chemicals at Apponaug Cove and in the Seekonk River indicate that there was a disturbance in the depositional environment relative to cores collected at these locations in 1986 demonstrating the potential for buried contaminants to be remobilized in the environment even after a period of burial. Sharp breaks in the concentration of several organic markers with known dates of introduction were successfully used to determine the sedimentation rate at Quonset Point. Both the Quonset Point and Seekonk River cores had subsurface maximums for DDTs, PCBs, PAHs and BZTs, which are consistent with expected inputs to the environment. The Apponaug Cove core showed an increase of most contaminants at the surface indicating a recent event in which more contaminated sediments were deposited at that location.

Environmental Monitoring↗
PubMed1997

Census tract analysis of lead exposure in Rhode Island children.

There has been increasing interest in a targeted approach to the screening and prevention of lead exposure in children. Targeted screening requires an understanding of variation in lead exposure in individual children or by region. In order to better understand variation by region, we studied Rhode Island lead poisoning screening data, examining average lead exposure to children living in 136 Providence County census tracts (CTs). The study population included 17,956 children aged 59 months and under, who were screened between May 1, 1992, and April 30, 1993. We evaluated the relationship between the percentage of children with blood lead > or = 10 micrograms/dL (pe10) and sociodemographic and housing characteristics, derived from United States 1990 Census data, of these CTs. CT descriptors included population density, percentage of households receiving public assistance income, median per capita income, percentage of households female headed, percentage of houses owner occupied, percentage of houses built before 1950, percentage of houses vacant, percentage of population Black, percentage of recent immigrants, and intraurban mobility. On average, 109 children were screened in each census tract; mean screening rate was 44%. There was wide variation in average lead exposure among census tracts, with pe10 ranging from 3 to 60% of screened children (mean 27%). Individual census variables explained between 24 and 67% of the variance in pe10 among CTs. A multiple regression model including percentage screened, percentage of households receiving public assistance, percentage of houses built before 1950, In (percentage of houses vacant), and percentage of recent immigrants explained 83% of variance in pe10. The percentage of houses built before 1950, a variable which models the presence of lead paint in old houses, displayed the largest adjusted effect on pe10 over the range observed for that variable in RI CTs. The percentage of houses vacant was also a highly significant and robust predictor; we suggest that vacancy is an ecological marker for the deterioration of leadbased paint, with higher vacancy neighborhoods containing houses in poorer condition. In Rhode Island, census tracts with high vacancy rates also have high rates of recent immigration, making immigrant groups vulnerable to lead exposure. Small-areas analysis may be useful in directing resources to high risk areas, explaining the sociocultural forces which produce such exposure and analyzing the effects of housing policy over time in states with high screening penetration.

Child, Preschool↗
PubMed1979

Interactive computer supported tumor registry in the state of Rhode Island.

A new interactive computerized tumor registry has been established for the state of Rhode Island. The registry is implemented with new data base software which features a pagination scheme with rapid retrieval of non-coded variable data. The types of data stored are discussed as well as the computer system and methods of data entry storage and retrieval.

Computers↗
PubMed1987

Cause-specific mortality among Rhode Island jewelry workers.

Cause-specific mortality patterns among Rhode Island jewelry manufacturing workers, as identified on death certificates from 1968 to 1978, were examined using the proportionate mortality ratio (PMR) method. Among males, elevated PMRs were observed for nonmalignant kidney disease (PMR = 163; Observed deaths [Obs] = 19; p less than or equal to .05), liver cancer (PMR = 297; Obs = 6; p less than or equal to .05), drug dependence (PMR = 379; Obs = 5; p less than or equal to .05), and accidental poisonings (PMR = 274; Obs = 8; p less than or equal to .05). All but one of the deaths from accidental poisonings involved drugs or drugs and alcohol. Among females, elevated PMRs were observed for stomach cancer (PMR = 174; Obs = 20; p less than or equal to .01), peptic ulcer (PMR = 235; Obs = 8; p less than or equal to .05), diseases of the skin and subcutaneous tissue (PMR = 383; Obs = 5; p less than or equal to .05), and drug dependence (PMR = 674; Obs = 3; p less than or equal to .05). Exposure to known renal toxins (heavy metals and solvents) used in the jewelry industry may account for the excess deaths from kidney disease. The elevated PMR for liver cancer may be due to exposure to solvents (trichloroethylene, perchloroethylene, carbon tetrachloride) that cause liver cancer in animals. The elevated PMRs for drug dependence and accidental poisonings may be due to the socioeconomic status of jewelry workers, or to the interaction between solvents used in jewelry manufacturing and drugs, or drugs and alcohol. Because of the lack of information about the specific occupational exposures of the decedents, this should be viewed as an exploratory investigation requiring further follow-up.

Cause of Death↗
PubMed1998

The development and structural confirmation of the Rhode Island Stress and Coping Inventory.

A new measure, the Rhode Island Stress and Coping Inventory (RISCI), was developed to examine perceived stress and coping independent of specific stress situations. An adult sample (N = 466) was randomly divided into equal halves for developmental and confirmatory instrument development. Initial instrument development used principal components analysis, item analysis, and a measure of internal consistency (Coefficient alpha). Confirmatory factor analysis (CFA) was employed on the confirmatory sample to examine the structure of the refined item set. Several CFA fit indices indicated excellent fit for a model that represents perceived stress and coping as two moderately correlated dimensions. Validity analyses found strong relationships in the expected directions for both RISCI subscales with the 5-item Mental Health Inventory. Further validity analyses supported the utility of the RISCI in applied research with smokers and confirmed past research findings that successful quitters experience less perceived stress and cope better than relapsers.

Adaptation, Psychological↗
PubMed2004

Perceptions of breast and cervical cancer risk and screening among Dominicans and Puerto Ricans in Rhode Island.

This study explored perceptions of cancer, risk, and screening among Dominicans and Puerto Ricans in Rhode Island. Qualitative interviews were conducted with a community-based sample of 147 adults. Perceived risks for breast cancer were predominantly associated with carelessness about health care, trauma to the breast, and breastfeeding. Cervical cancer risks were mostly attributed to carelessness about health care and sexual behaviors. A strong sense of fatalism and embarrassment coexisted with positive beliefs about check-ups and screening. Participants cited confianza (trust, confidence) in their doctor, and their doctor's provision of information and explanations, as important factors in decreasing embarrassment and increasing their likelihood of getting screened. While familiarity with mammography and Pap testing was great among participants, many did not practice sustained, regular screening, and held misconceptions about tests and screening guidelines. Respondents' perceptions of having sufficient information often did not correspond to their having the accurate information necessary to promote informed screening decisions.

Adult↗
PubMed1984

Hereditary retinal degeneration in the Rhode Island Red chicken. I. Histology and ERG.

Hereditary blindness in Rhode Island Red chickens was analyzed at various post-hatching stages by light microscopy and electrophysiological recordings. At the time of hatching the retina of affected chicks appeared morphologically normal and identical to that of control, non-affected chicks. Whereas the electroretinographic (ERG) response to light stimulus in normal chicks was near the adult level at the time of hatching, no ERG either under light- or dark-adapted conditions was measurable in affected chicks at any stage examined. Photoreceptor cells of affected animals were seen to undergo degenerative changes after about one week post-hatching. Decrease in number of outer segments, spaces between inner segments and large spaces in the outer nuclear layer were apparent by Day 10. By Day 21, most of the photoreceptor inner segments appeared swollen, and the decrease in number of outer segments and photoreceptor nuclei was noteworthy. By the end of the second month no outer segments were seen and the majority of identifiable inner segments were from cones, a larger proportion than normally present being double cones. By six months, very few photoreceptor inner segments and nuclei remained; most inner segments were deformed and diminutive but usually contained a clearstaining oil droplet characteristic of the principal member of the double cone. In all stages after one week of age, pycnotic nuclei and thinning of inner retinal layers accompanied photoreceptor degeneration. In all specimens examined, degeneration of retinal cells was more pronounced in the superior central retina than in the periphery. Pathological changes were frequently also noted in the pigment epithelium overlying degenerating retina. Because the chick retina is well developed at birth, contains a fovea and a significant cone population and because cones (particularly one specific type) survive rods, we believe that this congenitally-blind chicken may be a useful model for studies on human hereditary retinal degenerations.

Age Factors↗
PubMed2006

Demographic, geographic, and temporal patterns of ambulance runs for suspected opiate overdose in Rhode Island, 1997-20021.

We examine ambulance runs for suspected opiate overdose from 1997 to 2002 using a Rhode Island Department of Health database. Of the 8,763 ambulance runs for overdoses, 18.6% were for suspected opiate overdoses. Most cases were males under age 54. Suspected opiate overdoses were more likely to occur in a private residence, were more frequent on Fridays and Saturdays, and peaked in incidence around 9:00 p.m. The incidence rate of suspected opiate overdose by year was similar. The study results may help identify areas for preventive intervention and demonstrate the limitation of using naloxone as a marker of opiate overdose events.

Adolescent↗
PubMed2002

Public reporting of hospital patient satisfaction: the Rhode Island experience.

This article describes a collaborative process for legislatively mandated public reporting of health care performance in Rhode Island that began with hospital patient satisfaction. The goals of the report were both quality improvement and public accountability. Key features addressed include: the legislative context for public reporting; widespread participation of stakeholders; the structure for decision making; and the use of formative testing with cognitive interviews to get responses of consumers and others about the report readability and comprehensibility. This experience and the lessons learned can guide other States considering public reporting on health care performance.

Adolescent↗
PubMed1991

Malaria in travelers in Rhode Island: a review of 26 cases.

PURPOSE: We reviewed our experience with malaria in two community hospitals in Rhode Island from 1986 to 1990. RESULTS: Twenty-six patients with malaria were identified. Fifteen patients were immigrants who had acquired malaria while visiting their country of origin, particularly West Africa. Fever was present in 67% of cases and gastrointestinal complaints were prominent in 26%. Individuals with a past history of malaria could accurately distinguish current malarial infections from other febrile illnesses. Two patients developed cerebral malaria. Plasmodium falciparum was identified in 77% of the cases. CONCLUSIONS: Malaria is an important diagnosis that United States physicians must consider in the medical evaluation of returning travelers. A significant increase in the number of cases of P. falciparum acquired in East Africa has been reported in recent years. P. falciparum infection must be rapidly diagnosed and treated since delays may result in complications of malaria that may lead to death. Mefloquine is currently recommended by the Centers for Disease Control for prevention of malaria in travelers visiting countries endemic for chloroquine-resistant malaria. This change may alter the epidemiology of malaria in the United States in the future.

Adolescent↗
PubMed1988

Metroliasthes lucida in the eastern wild turkey from Rhode Island.

The cestode, Metroliasthes lucida, is reported for the first time from the eastern wild turkey (Meleagris gallopavo) in Rhode Island, United States; this is the first published record from New England. One of eight birds examined was infected with 10 cestodes.

Animals↗