Building Consensus for a Shared Definition of Adverse Events: A Case Study in the Profession of Dentistry

Comparing perceived heating effect and intensity of therapeutic ultrasound between breast tissue and calf muscle in lactating women: An observational study

OBJECTIVE

Therapeutic ultrasound (TUS) is the most common physiotherapy treatment for inflammatory conditions of the lactating breast. However, effective parameters for treatment are unknown, and based on musculoskeletal evidence. This study's aims were to determine the difference in heat perception (using TUS) between lactating breast and calf muscle tissue and the range of intensities required for heating perception in healthy lactating women.

METHOD

This repeated measures study recruited lactating mothers who exclusively breastfed infants aged 6 months or younger who responded to social media posts and flyers placed in medical offices. TUS was sequentially applied to the breast and calf, starting from 1Wcm2. The intensity at which participants reported first perceived warmth and then most tolerable warmth (or 2.5Wcm2) for the breast and the calf was recorded.

RESULTS

Fifty mothers (mean age, BMI = 31.6 years, 26.5), first perceived warmth at lower intensities in the breast (Z = -3.637,p < 0.001), but there was no difference between locations for most tolerable warmth (Z = -1.165,p = 0.244). Factors associated with higher perception of first warmth were antidepressant use (β = 0.369[95 %CI:0.103-0.635],p = 0.007) and calf location (β = 0.286[95 %CI:0.055-0.516],p = 0.015). Higher body mass index was the only factor associated with higher perception of tolerable warmth (β = 0.024[95 %CI:0.004-0.044],p = 0.017). The range of intensities required to perceive heating in the breast were 1-2.5Wcm2.

CONCLUSIONS

As perception of breast and calf warmth differs, TUS parameters used to treat musculoskeletal conditions may not be appropriate for inflammatory conditions of the lactating breast. Additional studies are needed to determine the tolerability and effectiveness of TUS using different intensities when treating women with ICLB.

Dental patients as partners in promoting quality and safety: a qualitative exploratory study

OBJECTIVE

Active patient involvement in promoting quality and safety is a priority for healthcare. We investigated how dental patients perceive their role as partners in promoting quality and safety across various dental care settings.

METHODS

Focus group sessions were conducted at three dental practice settings: an academic dental center, a community dental clinic, and a large group private practice, from October 2018-July 2019. Patients were recruited through flyers or word-of-mouth invitations. Each session lasted 2.5 h and patients completed a demographic and informational survey at the beginning. Audio recordings were transcribed, and a hybrid thematic analysis was performed by two independent reviewers using Dedoose.

RESULTS

Forty-seven participants took part in eight focus group sessions; 70.2% were females and 38.3% were aged 45-64 years. Results were organized into three major themes: patients' overall perception of dental quality and safety; patients' reaction to an adverse dental event; and patients' role in promoting quality and safety. Dental patients were willing to participate in promoting quality and safety by careful provider selection, shared decision-making, self-advocacy, and providing post-treatment provider evaluations. Their reactions towards adverse dental events varied based on the type of dental practice setting. Some factors that influenced a patient's overall perception of dental quality and safety included provider credentials, communication skills, cleanliness, and durability of dental treatment.

CONCLUSION

The type of dental practice setting affected patients' desire to work as partners in promoting dental quality and safety. Although patients acknowledged having an important role to play in their care, their willingness to participate depended on their relationship with their provider and their perception of provider receptivity to patient feedback.