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Biomedical subjects

P A Leggat

Publications and source records attributed to P A Leggat.

At least 19 recordsLinked to original sources
PubMed2006

Prevalence of percutaneous exposure incidents amongst dentists in Queensland.

BACKGROUND: Percutaneous exposure incidents (PEI) represent an important occupational health issue in dentistry, and one that can incur severe consequences from blood-borne infections. Given the importance of this topic, we considered it necessary to investigate the distribution and cause of PEI among Queensland dentists. METHODS: In 2004, a self-reporting questionnaire was mailed to a random sample of 400 dentists on the register of the Queensland Branch of the Australian Dental Association. RESULTS: A total of 285 questionnaires (73.1 per cent) were completed and returned. Of the respondents, 73.3 per cent were male and 26.7 per cent female, with a mean age of 45.2 years (SD = 11.9 years). Most were general dentists (89.1 per cent) with the remainder being specialists (10.9 per cent). More than three-quarters (78.5 per cent) reported damaging their gloves at least once during a clinical procedure in the previous 12-month period. Roughly one-quarter (27.7 per cent) had experienced at least one 'sharps' or needlestick injury in the previous 12 months, 16.1 per cent of which involved a contaminated instrument that had been previously used on a patient. The most common devices to cause 'sharps' injury in the previous 12 months were needles (14.4 per cent) and burs (10.2 per cent). CONCLUSIONS: Although PEI clearly remains a major occupational health problem for Queensland dentists, the prevalence of needlestick injuries appears to be lower than other studies from developed countries. The identification of needlestick injuries as a common cause of PEI again stresses the importance of preventive strategies with respect to potential blood-borne infections. Further research is now needed to more carefully identify effective measures for reducing PEI among dental personnel.

Adult↗
PubMed2001

Occupational hygiene practices of dentists in southern Thailand.

OBJECTIVES: The aims of this study were to investigate the prevalence and nature of infection control, radiation control and handling of mercury, reported by dentists in southern Thailand. METHOD: A cross-sectional study with self-report questionnaire to all 220 dentists working in 14 provinces in southern Thailand in 1997. RESULTS: 178 dentists (80.9%) aged 22-54 years responded. All reported wearing personal protective measures, at least sometimes and using high level disinfection (formerly sterilisation) procedures for handpieces. Most (93.8%) reported changing sterilised handpieces for each patient. The most commonly reported method of high level disinfection was alcohol (37.1%). Just over two-thirds (68.0%) reported having HBV vaccination. Most (94.3%) reportedly took precautions when radiographs were taken and (89.9%) reported protecting their eyes with a UV/blue light shield or filter while using these units. About half of dentists (51.7%) reported storing excess amalgam under water compared with 20.1% that they stored it in a closed box. 77.7% reported using sealed mercury amalgam capsule systems, at least sometimes. Nearly half (47.1%) reported disposing of used capsules in the bin. CONCLUSIONS: The present study has indicated that occupational hygiene practices of dentists in southern Thailand are generally consistent with published guidelines for infection control and also with other populations of dentists studied in the areas of infection control and radiation protection. Further continuing education and investigation of appropriate interventions to promote good occupational hygiene standards may also be needed.

Adult↗
PubMed2001

Bacterial aerosols in the dental clinic: a review.

A number of sources of bacterial aerosols exist within and outside the dental clinic. The concentration of bacterial aerosols and splatters appears to be highest during dental procedures, especially those generated by some procedures such as ultrasonic scaling, or using a high speed drill. Several infectious diseases could be transmitted to staff and patients by airborne bacterial and other contaminants in the dental clinic. Air-conditioning and ventilation systems should be regularly maintained to reduce environmental contaminants and to prevent recirculation of bacterial aerosols. Pre-procedural rinsing by patients with mouthwashes as well as vacuum and electrostatic extraction of aerosols during dental procedures could also be employed. Dental staff should also consider appropriate immunizations and continue to use personal protective measures, which reduce contact with bacterial aerosols and splatters in the dental clinic.

Aerosols↗
PubMed2001

Health of dentists in southern Thailand.

OBJECTIVE: The aims of this study were to investigate the prevalence and nature of some health and lifestyle problems of dentists in southern Thailand. METHOD: The design was a cross-sectional study using a self-report questionnaire distributed to all 220 dentists working in 14 provinces in southern Thailand in 1997. RESULTS: One hundred and seventy-eight 178 (80.9%) dentists aged 22-54 years responded. Only about one third of dentists 65 (36.7%) reported exercising on a regular basis. Almost one fifth of dentists 35 (19.1%) reported that they consumed alcohol on a weekly basis. Few dentists 4 (2.4%) reported regular smoking. Almost all dentists reported that their practice of dentistry has increased stress or stress-related problems 171 (96.1%). More than two thirds of respondents had had some known or unknown systemic health problem since graduation 112 (71.8%), although most dentists reported having no systemic disease at present 104 (59.1%). CONCLUSIONS: The present study has indicated that dentists in southern Thailand report a high career prevalence of stress, a moderate career prevalence of work-related problems which may be related to job satisfaction, and moderate career prevalence of systemic disease. Further continuing education and investigation of appropriate interventions to improve rates of exercise amongst dentists in southern Thailand is needed.

Adult↗
PubMed2001

Travel insurance claims made by travellers from Australia for dental conditions.

BACKGROUND: Little is known about dental problems suffered by travellers abroad. This study was designed to investigate travel insurance claims made by travellers from Australia for dental conditions, particularly examining demographic factors, type of travel insurance coverage, nature and duration of travel, when dental treatment was sought during travel, use of emergency assistance, type of treatment, and claim outcome, including cost. METHODS: 1,289 claims submitted during 1998-99 to a major Australian-based travel insurance company were examined for dental claims. RESULTS: 104 (8.1%) claims for dental conditions were submitted, of which 45 (43.3%) were made by male and 59 (56.7%) by female travellers. The majority of claimants were in the 60 years and over age group 54 (52.4%). Dental conditions reported required conservative (mostly fillings) 31 (29.8%), endodontic (mostly root canal treatment) 19 (18.3%), prosthodontic 27 (26.0%), periodontal 8 (7.7%), oral and maxillofacial surgery 2 (1.9%) and other or multiple 17 (16.3%) treatments. Use of the travel insurance emergency telephone service for dental conditions was reported in only seven cases (6.7%). Almost two-thirds 64 (61.5%) of claims were accepted. Claims for prosthodontic treatment were significantly less likely to be accepted. The majority of dental conditions did not require further medical investigations, 74 (71.2%). The mean cost of payouts to claims was AU$238.06 for males and AU$182.58 for females. Claims for endodontic and prosthodontic treatment were significantly more expensive than other types of treatment. CONCLUSIONS: Claims for dental conditions represent a noteworthy proportion of travel insurance claims made by Australian travellers abroad. More than three-quarters of claims for dental conditions were for conservative, endodontic or prosthodontic treatment. Travellers should be advised to have a dental check-up before departure overseas and to take care with pre-existing dental conditions, which may not be able to be claimed on travel insurance.

Adult↗
PubMed2000

Occupational health problems of dentists in southern Thailand.

AIMS: To investigate the prevalence and nature of some occupationally related health problems in dentists in southern Thailand. DESIGN: A cross-sectional study using a self-report questionnaire distributed to all 220 dentists working in 14 provinces in southern Thailand in 1997. PARTICIPANTS: One hundred and seventy-eight dentists aged between 22 to 54 years responded. RESULTS: The most common occupational health problems were musculoskeletal pain (78 per cent) and percutaneous injury (50 per cent). Associated factors were analysed using multivariate analysis. About 22 per cent of these dentists had a history of contact dermatitis mostly caused by allergy to latex gloves, 15 per cent had eye problems, and 3 per cent had hearing problems. CONCLUSIONS: Continuing education in the avoidance of percutaneous injuries would be beneficial, as exposure to potential infectious agents is of concern. Further studies are needed to identify causes of musculoskeletal pain and to identify appropriate interventions to reduce its prevalence, as would similar measures to reduce exposure to agents which may be producing contact dermatitis.

Adult↗
PubMed1999

Health advice given by general practitioners for travellers from New Zealand.

AIMS: To investigate where general practitioners (GP's) in New Zealand view travel health advice best given and where they refer for this advice, the prevalence of travel health advice reported to be given, and the prevalence of written advice, including a doctor's letter. METHOD: This was a descriptive cross-sectional study, using self-report questionnaires, sent to 400 GPs randomly selected from the register of the New Zealand Medical Council. RESULTS: Three hundred and thirty-two GPs (83%) responded. Most GPs reported that they saw travel medicine as best practised in general practice (241/308, 78%) or in a combination of locations, usually including general practice (28/308, 9%). Most GPs (223/308, 72%) did not refer travellers for travel health advice. Health advice concerning malaria (310/310, 100%), immunisation (309/310, 100%), travellers' diarrhoea (296/305, 97%), insect avoidance (287/ 299, 96%), sexually transmitted diseases/human immunodeficiency virus (233/283, 82%), water purification (235/293, 80%) and other areas (35/75, 47%) was given. Written advice was usually given by 23% of GPs (69/302). Written advice was significantly more likely to be provided by those GPs with an interest in travel medicine (chi2=5.67, df=1, p<0.005), experience in tropical medicine/developing countries (chi2=6.69, df=1, p<0.001), a policy on travel medicine (chi2=21.4, df=1, p<0.001), a written policy on travel medicine (chi2=302.0, df=1, p<0.001), who saw a higher number of travellers per week (t=-2.51, df=296, p<0.05) and who saw a significantly higher proportion of patients who were travellers (t=-3.27, df=-295, p=0.001). Almost all GPs (303/310, 98%) reported giving their travelling patients a doctor's letter at least sometimes but only 7% (23/310) always gave travellers a doctor's letter. GPs with training in travel medicine/related area were significantly more likely to provide travellers with a doctor's letter (chi=11.61, df=3, p<0.01). CONCLUSIONS: This study confirmed that GPs in New Zealand see travel health advice as best given in general practice. Travel health advice, as recommended by New Zealand guidelines, should continue to be given. With limited time in general practice to advise travellers, GPs should also consider giving written advice, including a doctor's letter, more often. Epidemiological and specialist support by public health units and commercial groups, continuing medical education and training in travel medicine for GPs are among the major considerations. Further studies are needed concerning the adequacy and currency of destination-specific advice for travellers.

Chi-Square Distribution↗
PubMed1999

Travel insurance and health.

Travel insurance normally underwrites travel, medical, and dental expenses incurred by travelers abroad and arranges aeromedical evacuation of travelers under conditions specified by the travel insurance policy. Because of the costs of medical and dental treatment abroad and the high cost associated with aeromedical evacuation, all travelers should be advised of the need for comprehensive travel insurance and be advised to read their policies carefully to see what is covered and to check for any exclusions. In particular, those travelers who have known preexisting conditions, who are working overseas, or who are going to undertake any form of hazardous recreational pursuit may need to obtain a special travel insurance policy, which may attract a higher premium. Conservatively, it is estimated that between 30-50% of travelers become ill or injured whilst traveling. Relative estimated monthly incidence rates of various health problems have been compiled elsewhere. The risk of severe injury is thought to be greater for people when traveling abroad. These risks should be covered by travel insurance to protect the traveler, however it is not known what proportion of travel agents or airlines give advice routinely on travel insurance. Travel insurance is the most important safety net for travelers in the event of misadventure, and should be reinforced by travel health advisers. Although only 4% of general practitioners (GPs) in a late 1980's study in the United Kingdom would advise a traveler going to Turkey about travel insurance,4 more recent studies have shown about 60% of GPs in New Zealand and 39% of travel clinics worldwide usually advised travelers concerning travel insurance. In addition, 54% of GPs in New Zealand usually also advised travelers about finding medical assistance abroad, but only 19% of GPs recommended travel insurance companies as a source of medical assistance while traveling.

Humans↗
PubMed1999

Training, experience and interest of general practitioners in travel medicine in New Zealand.

BACKGROUND: In New Zealand, general practitioners (GPs) are a major group of travel health advisers. This study was designed to investigate the prevalence of training, experience, and interest in travel medicine or related areas, interest in undertaking training in travel medicine and how training might be best delivered. METHOD: Four hundred GPs were randomly selected from the register of the New Zealand Medical Council and sent self-administered questionnaires. Two reminders were sent. RESULTS: Three hundred and thirty-two (83%) GPs responded and these GPs advised an average of two travelers per week. Most GPs (257/282, 91%) reported that they had no training in travel medicine/related area. Training in travel medicine/related areas was significantly associated with age group (x2=14.09, df=6, p<.05), with the proportion of GPs with training in travel medicine/related area tending to be higher in the 45-49 and 50-54 years age groups, and also with GP college membership/fellowship (x2=6.39, df=1, p<.05). Forty-one percent (121/298) of respondents stated that they had previous experience working in tropical medicine/developing country. There was a significant association between GPs having experience working in tropical medicine/developing countries and training in travel medicine (x2=14. 19, df=1, p<.001) and those who were non-New Zealand graduates (x2=7. 84, df=1, p<.01). Forty-four percent (131/300) of respondents stated that they had an interest in travel medicine. Nearly two thirds of respondents (200/309, 65%) indicated that they would be interested in undertaking various types of travel medicine training, with a short course most commonly identified (159/309). The interest for training in travel medicine was significantly associated with those GPs with an interest in travel medicine (x2=26.45, df=1, p<.001), in younger age groups (x2=41.30, df=6, p<.001), a lower mean number of years since graduation (t value=5.70, df=297, p<.001), a higher mean proportion of patients who were travelers (t value=23.15, df=303, p<. 01), and a higher mean number of travelers seen per week (t value=22. 94, df=303, p<.01). The most common postgraduate qualification amongst GPs was membership/fellowship of a GP college (85/282, 30%), which was significantly more prevalent amongst the older age groups (x2=18.18, df=8, p<.05). Membership of travel medicine was very low. CONCLUSIONS: This cross-sectional study found that most GPs in New Zealand did not have any formal training in travel medicine, although more than two fifths of GPs indicated an interest in travel medicine and experience in tropical medicine/related area. GPs mainly wanted continuing medical education (CME) on travel medicine in the form of short and certificate level courses. As membership in GP colleges and other organizations was limited, other providers of CME should also be considered for providing more of these courses, such as universities and pharmaceutical companies. Providers of CME may target less experienced GPs and those GPs who may be seeing more travelers and use various approaches. Undergraduate and postgraduate medical curricula may also need to include more training in travel medicine.

Adult↗
PubMed1999

Risk to tourists posed by wild mammals in South Africa.

BACKGROUND: One of South Africa's principal tourist attractions is the opportunity to encounter Africa's large mammals in the wild. Attacks by these mammals can be exceptionally newsworthy with potentially deleterious effects on tourism. Little is known about the risk of injury and death caused by wild mammals to visitors to South Africa's nature reserves. The aim of this study was to determine the incidence of fatal and nonfatal attacks on tourists by wild mammals in South Africa and to ascertain avoidable factors, if any. METHODS: Commercial press records covering all South African Newspapers archived at the Independent Newspapers' central library were systematically reviewed for a 10-year period, January 1988 to December 1997 inclusive, to identify all deaths and injuries to domestic and international tourists resulting from encounters with wild mammals in South Africa. All of these incidents were analyzed to ascertain avoidable factors. RESULTS: During the review period seven tourists, including two students from Thailand and a German traveler, were killed by wild mammals in South Africa. Three of the four deaths ascribed to lions resulted from tourists carelessly approaching prides on foot in lion reserves. A judicial inquiry found that the management of a KwaZulu-Natal Reserve was culpable for the remaining death. Tourist ignorance of animal behavior and flagrant disregard of rules contributed to the two fatalities involving hippopotami. The unusual behavior manifested by the bull elephant responsible for the final death, resulted from discomfort caused by a dental problem to this pachyderm. During the same period there were 14 nonfatal attacks on tourists, including five by hippo, three by buffalo, two by rhino, and one each by a lion, leopard, zebra and musth elephant. Only the latter occurred while the visitor was in a motor vehicle. Tourist ethological naivete and failure to determine the experience of trail guides prior to travel, resulted in inadvertent agonistic behavior, unnecessary risk-taking and avoidable injury. CONCLUSIONS: This retrospective study has shown that attacks on tourists by wild mammals in South Africa are an uncommon cause of injury and death. Sensible precautions to minimize this risk include remaining in a secure motor vehicle or adequately fenced precincts while in the vicinity of large mammals, rigidly observing nature reserve instructions, never approaching animals that appear ill, malnourished, displaying aggressive behavior traits or female wild mammals with young, and demanding adequately trained and experienced game rangers when embarking on walking trails. Any behavior that might be construed as antagonistic and which could provoke an attack by large mammals should be avoided (e.g., driving directly at a lion). Visitors need to be informed of classic signs of aggression, in particular in elephants, which will allow timely avoidance measures to be taken. The risk-enhancing effect of excessive alcohol intake is undesirable in the game reserve setting, as is driving at high speed after dusk in areas where hippos graze. Local advice on personal safety in wildlife reserves and the credentials of trail guides should be obtained from lodge or reserve management, tourism authorities or the travel industry prior to travel to game reserves.

Adolescent↗
PubMed1998

Safety advice for travelers from New Zealand.

BACKGROUND: Accidents and injuries are important preventable causes of morbidity and mortality for travelers. This study was designed to investigate the prevalence of advice given by general practitioners (GPs) on personal safety, health and travel insurance, and finding medical assistance abroad in the event of misadventure or ill health. METHOD: Four hundred general practitioners were randomly selected from the register of the New Zealand Medical Council and sent self-administered questionnaires. Two reminders were sent. RESULTS: Three hundred and thirty-two (83%) GPs responded. Advice to travelers on health and travel insurance (164/273, 60%), personal safety (127/255, 50%), and finding medical assistance abroad (165/308, 54%) was given by half or just over half of GPs. Giving advice on medical assistance abroad was significantly associated with giving advice on health and travel insurance (x2 = 18.89, df = 1, p<.001) and personal safety (x2 = 25.26, df = 1, p<.001). Seeing a higher proportion of patients who were travelers was significantly associated with giving advice on health and travel insurance (t-value = -3.39, df = 267, p = .001) and personal safety abroad (t-value = -2.63, df = 249, p < .01). Those GPs with previous experience in tropical medicine/developing countries were significantly more likely to advise travelers on personal safety abroad (x2 = 6.55, df = 1, p<.05) and about seeking medical assistance abroad (x2 = 4.11, df = 1, p<.05). Those GPs in older age groups (45-49 years and over) were significantly more likely to advise travelers on health and travel insurance (x2 = 16. 31, df = 8, p<.05) and personal safety abroad (x2 = 19.88, df = 8, p<.05). Those GPs with an interest in travel medicine were significantly more likely to advise travelers about seeking medical assistance abroad (x2 = 11.07, df = 1, p<.001) and health and travel insurance (x2 = 16.31, df = 8, p<.05). When advising travelers about seeking medical assistance abroad, GPs most commonly recommended contacting travel insurance companies (60/308, 19%), a specific medical service (48/308, 16%), tour company (30/308, 10%), specific doctor (29/308, 9%), New Zealand embassy (27/308, 9%), local medical service (23/307, 7%), personal contact (21/307, 7%), and other sources (12/307, 4%). CONCLUSIONS: This cross-sectional study found that only around half of New Zealand GPs were giving advice to travelers on personal safety, health and travel insurance, and finding medical assistance abroad. Continuing education providers should reinforce the need for this advice to be given to all travelers. There was also considerable variability in what New Zealand GPs recommended to travelers about seeking medical assistance abroad, including several nonmedical sources.

Adult↗
PubMed1998

Culture shock and travelers.

As travel has become easier and more affordable, the number of people traveling has risen sharply. People travel for many and varied reasons, from the business person on an overseas assignment to backpackers seeking new and exotic destinations. Others may take up residence in different regions, states or countries for family, business or political reasons. Other people are fleeing religious or political persecution. Wherever they go and for whatever reason they go, people take their culture with them. Culture, like language, is acquired innately in early childhood and is then reinforced through formal and complex informal social education into adulthood. Culture provides a framework for interpersonal and social interactions. Therefore, the contact with a new culture is often not the exciting or pleasurable experience anticipated. When immersed in a different culture, people no longer know how to act when faced with disparate value systems. Contact with the unfamiliar culture can lead to anxiety, stress, mental illness and, in extreme cases, physical illness and suicide. "Culture shock" is a term coined by the anthropologist Oberg. It is the shock of the new. It implies that the experience of the new culture is an unpleasant surprise or shock, partly because it is unexpected and partly because it can lead to a negative evaluation of one's own culture. It is also known as cross-cultural adjustment, being that period of anxiety and confusion experienced when entering a new culture. It affects people intellectually, emotionally, behaviorally and physically and is characterized by symptoms of psychological distress. Culture shock affects both adults and children. In travelers or workers who have prolonged sojourns in foreign countries, culture shock may occur not only as they enter the new culture, but also may occur on their return to their original culture. Children may also experience readjustment problems after returning from leading sheltered lives in expatriate compounds. This readjustment back to their own culture after a period of time abroad has been termed "reverse culture shock, a condition which has been studied in both corporate managers and Peace Corps volunteers. With culture shock and many other processes of psychological adjustment, people tend to suffer alone, thinking that they are the only ones not coping well with their new circumstance. The objective of this paper was to bring the phenomenon of culture shock to the awareness of travel health advisors, who can in turn advise travelers, especially longer term travelers, about having realistic expectations of their travel and life in new cultures.

Acculturation↗