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Biomedical subjects

H A Best

Publications and source records attributed to H A Best.

7 recordsLinked to original sources
PubMed2001

Is the current access to health information helping or hindering effective decision-making for dentists and patients? Guidelines for dental practice.

With the introduction of the Internet there has been a growth both in the quantity and accessibility of information to the public concerning health issues. This improved availability of information does not always lead to a more informed public since there is no quality control of information but it can lead to a public that takes a more active role in their own health and thus is involved in shared decision-making. In order to develop a more informed public in the future, systems for quality control of information have been addressed. These systems can range from the present state of uncontrolled information (no quality control) to full-centralised control (censored information). Between these extremes lie two, more appropriate, decentralised filtering approaches--'upstream filtering' (where third parties set quality criteria and evaluate information) and 'downstream filtering' (where data are rated, labelled and weighted according to consumers' criteria). These systems of filtering are discussed along with recommendations for those using the Internet as a source of information. The paper also documents reliable sources of information for the public, highlights the current concepts of shared decision-making, and provides some guidelines for developing an effective decision-making strategy.

Decision Making↗
PubMed2001

Professional development for dentists: patterns and their implications.

BACKGROUND: Approaches to models of professional development for dentists continue to evolve. This study examined the participation and attitudes of dentists in non-formal and informal professional development and continuing dental education. METHODS: Two methodologies were utilised: a self-administered cross-sectional survey of dentists in Victoria, Australia (conducted October to December, 1994), and a review of the records of the Continuing Education Unit of the School of Dental Science at The University of Melbourne for 1995 to 1999. For the cross-sectional survey, the sampling frame was the register of dentists of the Dental Board of Victoria in 1994. RESULTS: From a sample of 616 dentists invited to participate, 396 usable questionnaires were returned (response rate, 66.8 per cent). The valid data indicated that 52.5 per cent of dentists belonged to a study group, 66.5 per cent subscribed to at least one dental journal (other than the Australian Dental Journal), 88.9 per cent discussed dental matters with colleagues regularly, 98.6 per cent personally assessed their own work, 13.3 per cent did not attend continuing education courses and 18.1 per cent did not complete any courses in the year preceding the survey. Participation patterns in continuing education courses were related to socio-demographic characteristics of dentists. Some support was apparent for flexible delivery options for professional development. CONCLUSIONS: Involvement of dentists in Victoria, Australia in professional development activities is high, with complex participation patterns. Whether these patterns adequately address their own and the community's needs for such activities is debatable. Such issues should impact on any regulatory models for professional development for dentists and the development and use of alternative continuing education modalities.

Analysis of Variance↗
PubMed1997

Rapid removal of platelets from plasma utilizing the Hepcheck heparin removal filter.

We investigated whether Hepcheck heparin removal filters could remove residual platelets from platelet-poor plasma (PPP) without compromising samples for lupus anticoagulant (LA) testing. Furthermore we assessed what effect, if any, plasma filtration has on various clotting tests that form the foundation for LA testing. Citrated blood was obtained from 35 normal donors. Two sets of citrated tubes were processed in order to obtain PPP. Citrated blood was also obtained from a single donor to check the actual amounts of platelets removed by the Hepcheck filtration device. One set of PPP samples was filtered using the Hepchek filter device and the other was not processed, i.e. unfiltered. Prothrombin time (PT), activated partial thromboplastin time (APTT), and kaolin clotting time (KCT) were performed on both unfiltered and filtered samples that were tested immediately and after freezing at -70 degrees C for 24 h. Platelet counts on the single donor's citrated plasma were dramatically reduced after filtration. PT and APTT values showed small but statistically significant differences between unfiltered and filtered plasmas whether these were fresh or frozen samples. However, these differences were not clinically significant. KCT data showed statistical and clinical differences between unfiltered and filtered plasmas whether fresh or frozen plasmas were used. In contrast, KCT values were similar if unfiltered, fresh plasmas or filtered, frozen plasmas were used. Coagulation factor assays for factors VIII, IX and X were performed on both sets of PPP samples after freezing to determine if the filtration device affected these levels and would as a result, compromise APTT based lupus testing. Factor IX levels demonstrated a loss of activity following use of the device but no change was observed in factor VIII or factor X. Von Willebrand factor antigen and function as well as multimer structure were not affected by the filtration device in 10 normal donors. Filtering plasmas of two donors with a history of an LA dramatically prolonged clotting times for APTT, Dilute Viper Venom Time, mixing studies, and STACLOT LA tests in comparison with unfiltered plasmas. The data indicate that plasma filtration using the Hepchek device does not adversely affect coagulation testing. Furthermore samples requiring testing for the lupus anticoagulant can be filtered and subsequently frozen and compare favorably with freshly processed samples.

Filtration↗
PubMed1993

Awareness and needs of dental implants by patients in New South Wales.

An exploratory cross-sectional analytical study of patients presenting for prosthodontic treatment to private general dental practices and public hospitals in New South Wales was completed. Significantly more patients attending private dentists had 'heard' of dental implants compared with the hospital group (G2=79.404; df=1; p<0.001) and significantly more of the former patients were aware that dental implant treatment is available in New South Wales (G2=32.823; df=1; p<0.001). Of the patients attending private practice 19.2% felt that it is likely that they may require dental implant treatment in the future and 14.1% of their current treatment requests involved implants. These figures may be considered moderately high whereas the corresponding figures for the patients attending public hospitals were low.

Attitude to Health↗
PubMed1990

Mandibular overdenture treatment. Case report.

Complete mandibular dentures have a significantly lower success rate compared with complete maxillary dentures. Overdentures are feasible alternatives in many instances in attempting to achieve an optimal clinical result. The case of a 56-year-old female patient requiring prosthetic rehabilitation is discussed. A complete maxillary denture and a complete mandibular overdenture were constructed.

Denture, Complete, Upper↗
PubMedDate not supplied

Drawing specimens for coagulation testing: is a second tube necessary?

Three recent studies discussed the possibility that the National Committee for Clinical Laboratory Standards (NCCLS) recommendations that the coagulation specimen should be the second or third tube collected are unnecessary. However, only one reagent/instrument was used in each study. Our protocol differed from the previous studies because we performed the assays on three different reagent/instrument systems on the same samples. Our study used photo-optic, mechanical, and nephelometric systems of clot detection. After obtaining informed consent, we obtained two blue-stoppered tubes of blood from 95 subjects: 15 normal patients and 80 patients currently on coumadin therapy. No discard tube was drawn for coagulation testing. A prothrombin time with an international normalized ratio and an activated partial thromboplastin time, were performed on each tube. Laboratory One used a MLA 1600C (Hemoliance) with Thromboplastin DS (Pacific-Hemostasis, ISI of 1.11) and APTT-LS (Pacific-Hemostasis). Laboratory Two used an STA (Diagnostica-Stago) with Neoplastine CI+ (Diagnostica-Stago, ISI of 1.14) and PTT-LT (Diagnostica-Stago). Laboratory Three used an ACL 300 with Plastinex (Biodata, ISI of 1.67) and Actin FSL (Dade Behring). No clinical or statistically significant differences were seen between the first or second tubes on any of the three reagent/instrument combinations in the PT in seconds, international normalized ratio reporting, or APTT results. Our results indicate that the NCCLS guidelines for obtaining a second tube when performing coagulation testing should be considered for elimination when new revisions are published.

Anticoagulants↗