No abstract

No abstract

Severe dental disease has been reported for patients receiving psychiatric treatment. This study compared the oral status of noninstitutionalized adults with chronic mental illness with a similar group without such history, and evaluated relative risk factors, for example, xerostomia, diet, hygiene, and poverty. A sample of 37 subjects with chronic mental illness (CMI) and 29 control subjects without mental illness were assessed for dental, medical and social history; head, neck, and oral soft tissue pathology; salivary flow; DMFS, gingivitis, loss of periodontal attachment, plaque, and calculus. The groups were equivalent in socio-economic level, education, dental history, and home care. All subjects with CMI received psychotropic medications (mean of 3.8 drugs for 10.3 years). The CMI group had significantly higher incidence in the following variables: self-reported dry mouth; consumption of carbonated beverages (P less than .001); mucosal, lip, and tongue lesions (P less than .01); coronal smooth surface caries (P less than .001); severity of plaque (P less than .001) and calculus (P less than .01); and salivary flow (P less than .05). No significant differences were evident in the M and F components of DMFS, in gingivitis or loss of attachment. The results indicate significant increases in risk factors and increased oral pathosis in persons with mental illness who live in community settings compared with a control group that showed dental neglect.

The aim of this study was to elucidate possible relationships between ultrasound indices of follicular blood flow, oocyte recovery and the subsequent production and morphological quality of preimplantation embryos. A total of 27 women with bilateral tubal occlusion, undergoing treatment for infertility by in-vitro fertilization and embryo transfer, contributed data from 29 cycles. Transvaginal ultrasonography with colour Doppler imaging and pulsed Doppler spectral analysis was used to obtain indices of blood flow for each follicle immediately before it was aspirated. The main outcome measures for each follicle were the pulsatility index, peak systolic velocity, recovery or non-recovery of an oocyte and the subsequent production or non-production of an embryo. A total of 126 follicles were studied, 102 oocytes were recovered and 58 embryos (49 at grades I or II) were produced. There were six clinical pregnancies (pregnancy rate 27.3% per embryo transfer, 22.2% per patient). There was a significant correlation (P < 0.0001, chi2 test) between whether or not follicular blood flow was detected and whether or not an oocyte was recovered. The sensitivity of a test based on the presence of detectable blood flow and the subsequent recovery of an oocyte was 74% and the positive predictive value was 93%. The peak systolic velocity (PSV, measured in cm/s, mean +/- SD) in follicles with detectable blood flow was significantly higher in follicles that were associated with the production of a preimplantation embryo (19.7 +/- 10.8) compared with those that were not (9.9 +/- 5.3, P < 0.0001, Student's t-test). There was a 70% chance of producing a grade I or II embryo if the follicular blood velocity was >/=10 cm/s, compared with 14% if the PSV was <10 cm/s, or 18% if no blood flow was detected. We conclude that there is a physiological relationship between follicular blood velocity, oocyte recovery and the production of a high-grade preimplantation embryo, which may form the basis of a useful clinical test.

High-dose calcium is a more potent and better-tolerated hCT stimulator than is pentagastrin. The reference ranges for basal and stimulated hCT established via automated chemiluminescent assay were lower than those reported for other assays.

BackgroundQuality and patient safety (PS) are critical components of medical education. This study reports on the self-reported PS competence of medical students and postgraduate trainees.MethodsThe Health Professional Education in Patient Safety Survey was administered to medical students and postgraduate trainees in January 2012. PS dimension scores were compared across learning settings (classroom and clinical) and year in programme.ResultsSixty-three percent (255/406) of medical students and 32% (141/436) of postgraduate trainees responded. In general, both groups were most confident in their learning of clinical safety skills (eg, hand hygiene) and least confident in learning about sociocultural aspects of safety (eg, understanding human factors). Medical students’ confidence in most aspects of safety improved with years of training. For some of the more intangible dimensions (teamwork and culture), medical students in their final year had lower scores than students in earlier years. Thirty-eight percent of medical students felt they could approach someone engaging in unsafe practice, and the majority of medical students (85%) and postgraduate trainees (78%) agreed it was difficult to question authority.ConclusionsOur results suggest the need to improve the overall content, structure and integration of PS concepts in both classroom and clinical learning environments. Decreased confidence in sociocultural aspects of PS among medical students in the final year of training may indicate that culture in clinical settings negatively affects students’ perceived PS competence. Alternatively, as medical students spend more time in the clinical setting, they may develop a clearer sense of what they do not know.

No abstract

In Our Own Voice (IOOV) is a 90-min anti-stigma program that comprises face-to-face stories of challenges of mental illness and hopes and dreams commensurate with recovery. We pared down IOOV to a 30-min version, using information from two focus groups. In this study, effects of 90- versus 30-min IOOV are contrasted with 30 min of education. Two hundred research participants were randomly assigned to one of these three conditions and completed a measure of stigmatizing perceptions and recollections. People in the education group remembered more negatives than the two IOOV groups. To control for overall response rate, a difference ratio was determined (difference in positive and negative recollection divided by overall recollections). Results showed the two IOOV conditions had significantly better ratios than education. These findings suggest the 30 min version of IOOV is as effective as the 90 min standard.