What factors influence the use of contracts in the context of NHS dental practice? A systematic review of theory and logic model.
Ontology highlight
ABSTRACT:
SUBMITTER: Harris R
PROVIDER: S-EPMC4008934 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundLogic models are becoming an increasingly common feature of systematic reviews, as is the use of programme theory more generally in systematic reviewing. Logic models offer a framework to help reviewers to 'think' conceptually at various points during the review, and can be a useful tool in defining study inclusion and exclusion criteria, guiding the search strategy, identifying relevant outcomes, identifying mediating and moderating factors, and communicating review findings.Methods and findingsIn this paper we critique the use of logic models in systematic reviews and protocols drawn from two databases representing reviews of health interventions and international development interventions. Programme theory featured only in a minority of the reviews and protocols included. Despite drawing from different disciplinary traditions, reviews and protocols from both sources shared several limitations in their use of logic models and theories of change, and these were used almost unanimously to solely depict pictorially the way in which the intervention worked. Logic models and theories of change were consequently rarely used to communicate the findings of the review.ConclusionsLogic models have the potential to be an aid integral throughout the systematic reviewing process. The absence of good practice around their use and development may be one reason for the apparent limited utility of logic models in many existing systematic reviews. These concerns are addressed in the second half of this paper, where we offer a set of principles in the use of logic models and an example of how we constructed a logic model for a review of school-based asthma interventions.
| S-EPMC4648510 | biostudies-literature
Project description:Background:Transitioning from theoretical medicine to clinical practice is both an important and difficult process in dental education. Thus, there is an urgent need for teaching methods that can improve the ability of dental students to integrate dental theory with clinical practice. Methods:First, we conducted training for problem-based learning based on real clinical cases for dental students. The students were then assigned to dentist/patient roles to rehearse and perform simulated clinical scenarios. Finally, questionnaires, clinical patient care scores, and performance assessments were utilized to evaluate and compare the effectiveness of this training with that of traditional teaching methods. Results:Students' abilities to treat and communicate with patients markedly improved after using this reformed teaching method. Among the 30 enrolled students, 29 liked the method, found it time-efficient, and believed that it could help enhance their problem-solving confidence and interest in prosthodontics. They also believed that this teaching method could help them gain a good understanding of related theoretical material, generally thought that the reformed teaching method was more valuable than the traditional approach, and would like to introduce it to others. Conclusion:After the reformed teaching method was implemented, the students not only achieved better scholastically, but also demonstrated greater accuracy in diagnosing the conditions of patients and formulating treatment plans. They were also more frequently acknowledged by patients, indicating that this method is effective for dental students.
| S-EPMC7008813 | biostudies-literature
Project description:In France, veterinarians can both prescribe and deliver veterinary medicines, which is a questionable situation from the perspective of antimicrobial use (AMU) reduction to avoid antimicrobial resistance (AMR). This situation places veterinarians in direct commercial relationships with the pharmaceutical industry as purchase contracts are signed between veterinarians and pharmaceutical companies. The aim of the present work is to analyse the relationships between veterinarians and pharmaceutical firms in the oligopoly market context of French veterinary medicine to determine whether the prescription behaviour of practitioners can be biased by joint prescription and delivery. Therefore, we develop an analysis based on principal-agent theory. Contracts between pharmaceutical companies and veterinarians during the 2008-2014 period were analysed based on 382 contracts related to 47 drugs belonging to eight main pharmaceutical firms (2320 observations). The price per unit after rebate of each drug and contract was calculated. The descriptive analysis demonstrated high disparity among the contracts across pharmaceutical firms with regard to the provisions of the contracts and how they are presented. Then, linear regression was used to explain the price per unit after rebate based on the explanatory variables, which included the yearly purchase objective, year, type of drug and type of rebate. The decrease in price per unit after rebate for each extra €1000 purchase objective per drug category was established to be €0.061 per 100 kg body weight for anticoccidiosis treatments, €0.029 per 100 kg body weight for anti-inflammatories, €0.0125 per 100 kg body weight and €0.0845 per animal for antiparasitics, and €0.031 per animal for intramammary antimicrobials. Applying agency theory reveals that veterinarians can be considered agents in the case of monopolistic situations involving pharmaceutical firms; otherwise, veterinarians are considered principals (oligopolistic situations in which at least several medicines have similar indications). The present study does not provide evidence suggesting that joint prescription and delivery may introduce any potential prescription bias linked to conflicts of interest under the market conditions during the 2008-2014 period.
| S-EPMC7916326 | biostudies-literature
Project description:Tobacco use and oral sex (OS) are important risk factors for oral and oropharyngeal Human papillomavirus (HPV) infection. Little is known about the prevalence of OS practice in South Africa. This study aimed to determine the prevalence of OS practice and tobacco use in a South African patient population. This cross-sectional study used a structured questionnaire to collect socio-demographic characteristics, tobacco use, betel nut use and OS practice data from consenting adults (≥18 years; n = 850). Oral sex practices were recorded for patients 18-45 years-old (n = 514). Data analysis included chi-square and multiple logistic regression analyses. Of the study population, 55.2% (n = 468) were female, 88% (n = 748) self-identified as black Africans and 45.1% (n = 383) were unemployed. Furthermore, 19.7% (n = 167), 6.4% (n = 54) and 2.1% (n = 18) were current smokers, snuff users and betel nut users, respectively. Out of the 514 who answered the questionnaire in relation to OS, 22.8% (n = 115) reported to practice it. Oral sex practice in the age group 18-45 years was most common among the self-identified white participants (41.9%); and among tobacco users than among non-tobacco users (30.9% vs. 20.5%; p = 0.022). A multivariable-adjusted regression model showed that white South Africans were more likely to use tobacco than black Africans (OR = 5.25; 95% CI = 2.21-12.47). The practice of OS was more likely among those 18-35 years-old (OR = 1.67; 95% CI = 1.01-2.74), but had no significant association with tobacco use (OR = 1.06; 95% CI = 0.62-1.83). The observed age and ethnic differences in both risk behaviours suggest a need for targeted population intervention in order to reduce the risk for oral HPV infection.
| S-EPMC6415827 | biostudies-literature
Project description:BackgroundThe current study explored the perspectives of preparedness for dental practice from a range of relevant stakeholders (i.e., educators, employers, final-year students, graduates, practitioners, and professional associations) using an anonymous online survey in which participants described either their preparedness for practice, or the preparedness of graduates they have encountered, across six domains.ResultsA total of 120 participants completed the survey. Participants were from several Australian states and territories; regional, rural, and urban locations; and working in the public and private sector. Students and new graduates generally felt prepared for activities in all the identified domains. Stakeholders reported consistently that the knowledge of dental profession graduates was at the required level to enter practice in Australia in a safe way. Activities involving the knowledge of clinical entrepreneurship and financial solvency were the dimensions where students and graduates felt least prepared (e.g., explaining fees, negotiating finances). In the domains involving clinical and technical competencies, students and new graduates self-assessed as less prepared around managing dental trauma and medical emergencies. On the other hand, activities around social and community orientation, and to a lesser extent professional attitudes and ethical judgements, were the dimensions where students and graduates felt the most prepared.ConclusionsPresent findings indicate that there appear to be good standards of preparedness for practice for graduate dental professionals. This exploratory study provides insights into the nature of preparedness for Australian dental professionals and provides a basis for targeting education and professional development to address areas of need.
| S-EPMC9385413 | biostudies-literature
Project description:BackgroundDespite evidence-based guidelines advocating for the provision of oral health care throughout pregnancy, dentists remain hesitant to provide dental treatment for pregnant women. However, little is known about attitudes toward treating pregnant women among dental school faculty, who may transmit their attitudes and treatment preferences to their students.MethodsWe collected cross-sectional survey data at the New York University College of Dentistry, which produces 10% of all US dentists and is the largest US dental school, to understand faculty attitudes and knowledge regarding providing dental treatment to pregnant women. This study was part of an educational effort to improve dental care access by pregnant women and to examine what factors influence willingness to treat pregnant patients among dental faculty members.ResultsWe found that concerns about professional liability outweighed inadequate knowledge regarding treatment of pregnant patients in determining dental faculty's willingness to treat pregnant women.ConclusionsEducational interventions delivered to dental faculty regarding current dental treatment guidelines for pregnant women may not be sufficient to increase faculty's provision of dental care to women during pregnancy. Future work to design effective interventions to increase dental treatment of pregnant women among dental faculty should address liability concerns.Knowledge transfer statementInterventions addressing dental clinician and faculty knowledge about dental treatment for pregnant women may be insufficient to increase dental treatment among pregnant women. Instead, policy makers should consider designing, implementing, and evaluating interventions addressing malpractice and liability concerns.
| S-EPMC9630723 | biostudies-literature
Project description:Rationale for the studyReal-time polymerase chain reaction (PCR) for respiratory viruses is more sensitive, yet more expensive, than conventionally used direct immunofluorescence (DIF). We determined the impact of real-time PCR, additional to DIF, on antibiotic prescription in ventilated children with lower respiratory tract infection (LRTI) at admission to the pediatric intensive care unit (PICU).MethodsFirst, a multicenter survey study was performed. Subsequently, in a prospective study, children (≤ 5 years) with LRTI were tested at admission by DIF and PCR. Positive DIF results were reported at the end of the first working day. PICU physicians reported antibiotic treatment on the second working day. After informing them of the PCR result antibiotic treatment was reevaluated.ResultsThe multicenter survey study (94 respondents) showed that PCR decreased antibiotic use (P < 0.001). In the prospective study 38 children were included, of which 19 (50%) were DIF positive. Of the 19 DIF negative patients 12 (63%) were treated with antibiotics before revealing the PCR result; the PCR test was positive in 9 out of 12. Revealing PCR results did not alter antibiotic treatment. In 7 DIF negative patients antibiotics not given, the PCR test was positive.ConclusionIn contrast to their responses to the survey study, in real-life PICU physicians did not let their antibiotic prescription be influenced by respiratory real-time PCR in children ventilated for LRTI.
| S-EPMC7167622 | biostudies-literature
Project description:Purpose: Patient-reported outcome measures (PROMs) have the potential to enhance the quality of health care but, as a result of suboptimal implementation, it is unclear whether they fulfil this role in physiotherapy practice. This cross-sectional study aimed to identify the factors influencing PROM use in Dutch private physiotherapy practices. Method: A total of 444 physiotherapists completed a self-assessment questionnaire and uploaded the data from their electronic health record (EHR) systems to the national registry of outcome data. Univariate and multivariate ordinal logistic and linear regression analysis were used to identify the factors associated with self-reported PROM use and PROM use registered in the EHR systems, which were derived from the self-assessment questionnaire and from the data in the national registry, respectively. Five categories with nine independent variables were selected as potential factors for regression analysis. The similarity between self-reported and registered PROM use was verified. Results: On the basis of self-report and EHR report, we found that 21.6% and 29.8% of participants, respectively, used PROMs with more than 80% of their patients, and we identified the factors associated with PROM use. Conclusions: The factors associated with PROM use are EHR systems that support PROM use and more knowledge about PROM use. These findings can guide future strategies to enhance the use of PROMs in physiotherapy practice.
| S-EPMC8330984 | biostudies-literature
Project description:ObjectivesThe adoption of electronic dental records (EDRs) is less extensively studied than electronic medical records (EMRs) in Saudi Arabia. Therefore, a multivariate analysis was conducted to calculate the adoption of EDRs and determine the practice characteristics that influence adoption.MethodsAn online survey was conducted with 220 dental practices in Jeddah from August to December 2021. The questionnaire contained 10 items that measured the adoption of EDRs and identified the region, district, practice characteristics, and practice size. A regression analysis was used to ascertain the relationships between EDR adoption and the predictor variables.ResultsAbout 93% of the dental practices, we surveyed in Jeddah had adopted EDRs. Public dental practices and large practices were associated with higher rates of adoption (respectively, 97.0%, p = 0.016; 97.8%, p = 0.009). The logistic regression model showed statistically significant results regarding practice characteristics, practice size, and the acceptance of insurance patients. EDR adoption was 89% less likely for private dental practices, 99% less likely for smaller dental practices (≥2 dentists), and 98% less likely in dental practices that did not treat patients with insurance.ConclusionsOur study sample showed a high rate of EDR adoption. Among the participants, public practices, large practices, and practices that treat patients with insurance were the most positively inclined toward EDR adoption.
| S-EPMC10440202 | biostudies-literature
Project description: Not available
| S-EPMC2817341 | biostudies-literature