Mercury hygiene and biomedical waste management practices among dental health-care personnel in public hospitals in Lagos State, Nigeria

BACKGROUND

Indiscriminate disposal of hospital wastes including mercury/amalgam wastes pose a serious threat to life and environment. There is a growing concern about biomedical waste (BMW) management among health care workers, however there are limited reports on BMW management by dental personnel in developing countries.

OBJECTIVES

This study investigated the level of knowledge of BMW, observance of proper mercury hygiene and BMW management practice among public dental personnel in Lagos State, Nigeria.

METHODS

A cross-sectional study regarding BMW management across public hospitals in Lagos State, Nigeria was conducted following institutional ethics committee approval. A self-administered questionnaire was utilized to obtain data from different facilities selected by purposive and simple random sampling techniques as applicable. The questionnaires were distributed among 437 respondents by convenience sampling. The resulting data were statistically tested using Chi-square and G-test with p-value < 0.05 indicating significant level.

RESULTS

Amongst 437 respondents, majority were females (62.5%) and the highest proportion fell within the age range of 25-34 years (44.4%). Only 17.2% of the respondents had good knowledge of BMW management/legislation and 4.1% had good BMW practice. Less than half (49.4%) of respondents disposed mercury-contaminated materials inside the trash and majority (92.2%) did not observe proper mercury hygiene. Significantly better mercury hygiene practices were observed in secondary facilities (p=0.040).

CONCLUSION

A minor proportion of public dental personnel had good knowledge and practice of proper mercury hygiene and BMW management. This shows there is an urgent need for training of health personnel on proper BMW handling and disposal in developing countries like Nigeria.

Psychological Distress and Post-Traumatic Symptomatology Among Dental Healthcare Workers in Russia: Results of a Pilot Study

The spread of SARS-CoV-2 infection has increased the risk of mental health problems, including post-traumatic stress disorders (PTSD), and healthcare workers (HCWs) are at greater risk than other occupational groups. This observational cross-sectional study aimed to explore the symptoms of depression, anxiety, and PTSD among dental HCWs in Russia during the coronavirus disease 2019 (COVID-19) pandemic. The survey was carried out among 128 dental HCWs from three dental clinics of Ekaterinburg, Russia. The mean age of the sample was 38.6 years. Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale-21 (DASS-21); PTSD was assessed using the PTSD Symptom Scale-Self-Report (PSS-SR); subjective distress was assessed using the Impact of Event Scale-Revised (IES-R). The results indicated that 20.3-24.2% HCWs had mild to extremely severe symptoms of psychological distress, and 7.1-29.7% had clinical symptoms of PTSD. No differences between females and males were revealed. HCWs working directly with patients had significantly higher levels of PTSD symptoms and the risk of PTSD development compared to those working indirectly, whereas older HCWs had significantly higher levels of both psychological distress and PTSD symptoms compared to younger HCWs. Thus, dental HCWs are at high risk for psychological distress and PTSD symptoms during the COVID-19 pandemic.

Analysis of anxiety-related factors amongst frontline dental staff during the COVID-19 pandemic in Yichang, China

BACKGROUND

Dental staff were characterized with the tolerance of enduring stress and they are at a high risk to respiratory infectious disease. This study compared the anxiety level of the frontline dental staff (FDS) to the general public in Yichang during the coronavirus disease of 2019 (COVID-19) pandemic and examined potential explanatory factors to the differences.

METHODS

Two online questionnaires were used separately to collect data from FDS and the general public. The Chinese version of Beck Anxiety Inventory (BAI) was included for the assessment of anxiety. Firstly, a Chi-square test was conducted to compare the anxiety state between these two groups. Then, a bivariate analysis using Cramer's V and Eta squared was conducted to find the potential factors. Lastly, a binary logistic regression was performed to examine the association between potential factors and the anxiety state of FDS.

RESULTS

In general, FDS were 4.342 (95% CI: 2.427-7.768) times more likely to suffer from anxiety disorders than the general public. The bivariate analysis showed that age, Level Three Protective Measures (PM-3), conflicts with patients and/or colleagues were moderately associated with the anxiety state of FDS. But the knowledge of COVID-19, the treatment to suspected or confirmed cases both had a weak association with the anxiety among FDS. Conversely, workload, the exposure to potential infectious substance and conducting aerosol generated performance were not significantly related to the anxiety of FDS. As the model indicated, an elder age and PM-3 protective measures could lower the anxiety state of FDS, whereas the conflict with patients or/and colleagues would worsen it.

CONCLUSIONS

During the COVID-19 pandemic, FDS were more likely to suffer from anxiety disorders than the general public. An elder age, sufficient personal protective measures and good relationships with colleagues and patients would help them to maintain good mental health.

The opinions and attitudes of dental school academic staff towards oral healthcare education for older adults

The term 'oral health care for older adults' has various interpretations, and its meaning is not clear among dental school academic staff. Additionally, there are no theoretical or practical stand-alone courses on oral health care for older adults in Japanese dental schools. To improve oral health care education, we investigated the opinions and attitudes toward oral health care education for older adults among academic staff in dental schools. Data were collected in seven dental schools from May to September 2013 via an online questionnaire survey. Five-hundred-fifty-eight academics (428 male, 130 female) participated (response rate 57%). The average number of years since they had completed a university degree was 20.2 (SD 10.2) years. The majority (Over 90%) of participants perceived that oral health care should be provided in nursing facilities, hospitals, and at home. Its treatments and instructions should include, not only methods of keeping good oral hygiene, but also improvement of oral function such as swallowing training and salivary glands massage. The majority (84.2%) suggested oral health care education should be combined as a one-credit, stand-alone course. Findings indicate that dental academics have an understanding the need for a course in oral health care for older adults. Participants supported the need for further development of education in oral health care for older adults' in Japan, as a separate course on its own right. However there were some different views about content by teaching field. The need for a national core program for teaching oral health care education was suggested.

Quality management and job related factors predicting satisfaction of dental clinic staff in Estonia

OBJECTIVE

The aim of the study was to explore the role of managerial style, work environment factors and burnout in determining job satisfaction during the implementation of quality improvement activities in a dental clinic.

METHOD

Quantitative research was carried out using a prestructured anonymous questionnaire to survey 302 respondents in Kaarli Dental Clinic, Estonia. Dental clinic staff assessed job satisfaction, managerial style, work stress and burnout levels through the implementation period of ISO 9000 quality management system in 2003 and annually during 2006-2009. Binary logistic regression was used to explain the impact of satisfaction with management and work organisation, knowledge about managerial activities, work environment and psychosocial stress and burnout on job satisfaction.

RESULTS

The response rate limits were between 60% and 89.6%. Job satisfaction increased significantly from 2003 to 2006 and the percentage of very satisfied staff increased from 17 to 38 (p<0.01) over this period. In 2007, the proportion of very satisfied people dropped to 21% before increasing again in 2008-2009 (from 24% to 35%). Binary logistic regression analysis resulted in a model that included five groups of factors: managerial support, information about results achieved and progress to goals, work organisation and working environment, as well as factors related to career, security and planning. The average scores of emotional exhaustion showed significant decrease, correlating negatively with job satisfaction (p<0.05).

CONCLUSION

The implementation of quality improvement activities in the Kaarli Dental Clinic has improved the work environment by decreasing burnout symptoms and increased job satisfaction in staff.

Behaviour management of an anxious child

Children with dental anxiety may refuse treatment, which can lead to dental emergencies. Behavior management is an essential skill and should be acquired by all members of a dental team treating children. Dental surgery staff should be relaxed, welcoming and friendly. Make the child the centre of attention and smile. Use age-appropriate language and avoid the use of jargon. Decide who will talk to the child and when, as he/she may only be able to listen to one person at a time. Avoid non-dental conversations with colleagues during procedures.

Attitudes towards establishing a daily supervised school-based toothbrushing programme--determined by Q-sort methodology

OBJECTIVES

This study used Q-sort methodology to determine the views of staff involved in a national school-based daily toothbrushing programme.

METHODS

Q-methodology is a mixed-method approach in which participants are asked to sort a collection of statements according to degree of agreement with them. Factor analysis identified subgroups of like-minded participants and revealed areas of consensus and disagreement. 24 Community Dental Service staff managing or delivering the toothbrushing programme were asked to rank 49 statements derived from previous qualitative interviews.

RESULTS

Varimax rotation produced a three-factor solution with five/six participants loading significantly into each group. Groups divided largely according to staff role: Factor 1, mainly support workers (assistants with no oral-health background); Factor 2, managers; and factor 3, oral health educators (dental nurses with teaching qualifications). As staff new to the area of oral-health, the views of support workers were of particular interest. Unlike others, this group saw Designed to Smile as a unique health promotion scheme and wanted to involve as many children as possible, regardless of oral-disease risk. Managers' perceptions of issues affecting the establishment of the programme differed from those staff in day-to-day contact with the 515 schools in which the toothbrushing took place.

CONCLUSIONS

This study used a long established but little used technique to ascertain the commonality of views of staff These data may be of value not only in managing the current programme, but for anyone who may be considering developing such a toothbrushing scheme.

Facing a moral dilemma--introducing a dental care insurance within the public dental service

Through the reform entitled "Dental care insurance-dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvård).This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic.The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.

Assessing health workers knowledge on the determinants of health: a study in Enugu Nigeria

BACKGROUND

Different social economic and personal factors have been touted as determining a person's health. This encompasses a person's living environment, economic status, genetic makeup, physical attributes and not just access to health services. It is important that health workers recognize that a person's socio-economic environment can have an adverse effect on the health status ofthe individual so as to capture this aspect in their choice of intervention.

METHODS

The study was carried out in two tertiary institutions in Enugu state selected purposively because they housed a dental clinic. It was a descriptive cross sectional study consisting of 87 participants which represented all the dental taff available during the study period. The participants were interviewed with a structured questionnaire used to elicit the knowledge of health workers on health determinants.

RESULTS

When individual factors were considered, a greater percentage of health workers, believed that safe drinking water (98.9%), where a person lives (96.6%) and a balanced diet, affect health more than availability of health services (59.8%) or the ability of the health care system to meet the needs of the people (55.2%). However when ranking the magnitude of the contribution of the various determinants of health the majority (37.9%) considered a good health care system the most important contributory factor to determining health of a community while social environment (14.9%) was the least.

CONCLUSION

The ranking of good healthcare system over social environment points to the emphasis being laid on curative instead of preventive management of diseases, which have been entrenched in our health workers. Considerations should therefore be made for public health institutions to dwell more on health promotion and education activites on the importance of the social determinatants on health.

Quality management and work environment in Swedish oral and maxillofacial surgery

This thesis attempts to describe the opinion of the work with quality, quality management, and work environment among the employees at Oral and Maxillofacial Surgery (OMFS) clinics in Sweden.

THIS THESIS AIMED TO

Analyse if the OMFS clinics in Sweden actively work with quality development and if so which systems they use. Explore the opinion of the employees about quality work. Describe how the employees of OMFS clinics in Sweden perceive good work, i.e., their image of the dimensions that the profession should contain to be really good work. Investigate whether there is a discrepancy between ideal and reality for this group. Describe how the employees of OMFS clinics in Sweden perceive their health. Analyse how work environment influenced attitudes to and knowledge of quality among employees of OMFS clinics in Sweden. The study was based on self-report questionnaires which in 2003 were sent to all OMFS clinics in Sweden. The response rate was 86%. Only at two clinics did all the respondents agree on their system. Surgeons rated intellectually stimulating work as most important, and the hazard-free work environment as least important. The nurses rated stimulating fellowship as most important, and the opportunity for career advancement as least important. The percentage unit differences between the ideal and the reality were largest for the item the work provides opportunities to have an influence on important decisions. There were significant differences between maxillofacial. surgeons and dental nurses and assistant nurses as to muscle- and joint trouble. The differences were also significant between men and women both as to muscle- and joint troubles and somatic trouble. Only work environment was significant for attitude towards quality work. Profession, gender, clinic size, and a factor for hard demand had significant associations to quality management system used or not.

IN CONCLUSION

More than half of the respondents stated that they worked with a quality system. The dental nurses and assistant nurses had a much more positive view on the potential of quality work as a means to improve their work than had the maxillo-facial surgeons. For a majority of the dental nurses the working situation concerning the physical environment was more important than for the maxillo-facial surgeons. The employees emphasized free, influential, and intellectually stimulating work, but the dissonance between ideal and reality was rather wide concerning good work. OMFS employees are feeling unhealthy, but no worse than other high-risk-groups in human service working and better than female general practice dentists. The women of OMFS employees feel worse than the men.