PubMed Health⌕ Search

Biomedical subjects

K Shay

Publications and source records attributed to K Shay.

30 records · Page 2Linked to original sources
PubMed1990

New programs for advanced training in dental geriatrics.

The unprecedented increase in the number and percentage of Americans who are older than the age of 65 is presenting the health care system with unique diagnostic, therapeutic, fiscal, and ethical challenges. Chronic disease, complex pharmacotherapeutic regimens, and psychosocial and physical dysfunction are prevalent in this age group. The dental profession is faced not only with an increase in the number and complexity of older patients, but with the fact that growing numbers of older patients are retaining a greater proportion of their natural dentitions for longer periods. To help meet the need for increased professional skill to deal with these issues, the Health Resources and Services Administration of the Department of Health and Human Services is supporting 23 medical school based geriatrics training programs, designed expressly for physicians and dentists. The programs offer a mixture of experiences in: clinical care of the elderly in a variety of settings; design and conduct of research relevant to geriatric and gerontologic issues; enhancement of pedagogical skills; and program administration. Physicians and dentists share many of the training experiences, providing both groups with unique insights into the presentation and management of their patients' problems, and an enriched awareness of each other's contributions to the care of the elderly.

Aged↗
PubMed1989

A follow-up report of occupational stress in urban EMT-paramedics.

A survey completed by 280 nonvolunteer, urban emergency medicine technician (EMT)-paramedics revealed high levels of occupational stress. We used a four-component model of occupational stress in medical environments to show indications that much variation in the manifestation of stress was accounted for by the rank and job description of the EMT-paramedic, the district served by the EMT-paramedic, and the patient population served by the EMT-paramedic. Stress exhibited by field EMT-paramedics tended to manifest in more negative attitudes toward patients, whereas administrative-level paramedics exhibited more organizational stress. We noted that the age of the EMT-paramedic and the length of time employed as an EMT-paramedic correlated with the level of occupational stress (P less than .05). The recent occurrence of significant life events also was significantly related to the level of stress (P less than .05). An EMT-paramedic's gender, marital status, and number of calls per shift had no significant correlation to the level of occupational stress. Based on these results, we recommend tailoring occupational stress programs to meet the needs of individual EMT-paramedics. Special attempts should be made to identify and counsel EMT-paramedics who are undergoing stressful life events. Finally, we suggest that rotating EMT-paramedics through various districts on a regular basis may help alleviate the negative impact on patient care in areas that have been identified as particularly stressful. Further studies are needed to verify our hypothesis.

Administrative Personnel↗
PubMed1989

Integrating geriatric dentistry into general practice residency programs.

As the proportion of elderly people in society increases, so will the general practitioner's professional contact with the geriatric patient. Such a change will necessitate an alteration in patterns of practice. The "new elderly" are presenting with complicated restorative needs, and they increasingly expect the high quality of dentistry they have received much of their lives. Their expectations will require an enhancement and refinement of the general practitioner's diagnostic and therapeutic skills in geriatric dentistry. Yet the predoctoral dental curriculum is unable to provide the depth of experience and knowledge required. The amount of information that must be assimilated and the type of supervised clinic activities that must be experienced to prepare a student adequately in geriatric oral health care are too extensive to be included in a four-year program. Under the existing dental educational system, the fully skilled, professionally secure, and clinically astute general practitioner capable of managing the complex needs of the elderly will emerge from the general practice residency.

Curriculum↗
PubMed1988

The absence of an age effect on enamel solubility in phosphoric acid.

The growing proportion of older Americans and the projections in declining edentulousness in future cohorts of elderly necessitate elucidation of the responses of the aging human dentition to existing restorative techniques. This study investigated the results of the acid etch process as a function of age of specimen donors as well as a function of race, tooth type, and time between extraction and etch. Statistical analysis of data showed no significant effect on solubility by age, race, or length of time from extraction until etch. Molars were significantly less soluble than other teeth. The most frequently observed microscopic texture was an irregular, granular configuration termed 3g. Widely textural variation was observed in each specimen. A possible explanation for the observations is the distribution of prismless enamel. The widespread belief that older teeth are less efficaciously etched may be based on the greater frequency of composite restoration failures in the elderly, which in turn is more likely a factor of restoration size and changes in intraoral environment than of age.

Acid Etching, Dental↗
PubMed1985

Margin placement of esthetic veneer crowns. Part IV: Postoperative patient attitudes.

Ninety-one subjects with a total of 196 esthetic veneer crowns with visible gingival margins were surveyed. An esthetic analysis of crown margins showing with a normal smile and an exaggerated smile was performed and recorded. Patient satisfaction or dissatisfaction with the esthetic veneer crowns was assessed. The conclusions of this study support the results reported in the first three parts of this study, indicate that satisfactory results can be obtained on many individuals when the crown margins of esthetic veneer crowns are placed supragingivally, and support the philosophy that individual patient education and analysis are essential to the selection of optimum margin placement when esthetic veneer crowns are the treatment of choice.

Attitude↗
PubMedDate not supplied

Restorative considerations in the dental treatment of the older patient.

The older person and his or her dentition will have a clinical presentation and a reaction to treatment that is influenced by his or her unique blend of aging and disease processes. Changes seen in enamel, dentin, pulp, and cementum of the older patient are described in terms of their causes and the impacts of the changes on clinical presentation and treatment choices.

Acid Etching, Dental↗
PubMedDate not supplied

Root caries in the elderly: an update for the next century.

Root caries is an emerging challenge to the dental professions because of the growing number of increasingly aging adults who have retained many or all of their teeth. Risk factors for developing root caries point to both intraoral and environmental factors, making the management of root caries complex and multidisciplinary. Prevention is the most desirable approach for management, but patients who have developed caries of the roots can be treated with remineralization strategies or a variety of restorative approaches. Dental professionals need to keep abreast of new approaches emerging for the management of root caries.

Aged↗