Legislation, Dental

立法,牙科
  • 文章类型: Journal Article
    目的:镇静和全身麻醉是治疗特殊人群中许多人的必需品,如身体和智力残疾的人,恐惧/焦虑,或需要大量程序的个人。这项研究旨在发现可能导致牙医麻醉师提供的麻醉服务有限的调节因素。
    结果:该研究包括一项在线调查,该调查由经过2年或2年以上正式麻醉培训的自我报告的牙科医生完成。该调查于2019年4月在芝加哥举行的美国牙医麻醉医师协会全国会议上分发。参与者回答了有关特定州法规对在特定州执业决定的影响以及这些法规如何影响患者安全和护理障碍的问题。对牙医麻醉师设备/用品的移动性的规则和法规限制以及其他州麻醉品运输法规被认为在未能提高安全性方面具有统计学意义。需要对设施的提供者和工作人员进行气道和镇静培训并不妨碍护理。规则和法规不是在一个州建立临床实践而不是另一个州的因素。
    结论:负责影响麻醉服务监管环境的个人和组织应改进法规,以促进牙医麻醉师的流动性。
    OBJECTIVE: Sedation and general anesthesia are necessities for the treatment of many individuals within special populations such as those with physical and intellectual disabilities, fear/anxiety, or individuals requiring extensive procedures. This study aims to discover regulatory factors that may be contributing to the limited access to anesthesia services provided by dentist anesthesiologists.
    RESULTS: The study included an online survey completed by self-reported dentist anesthesiologists with 2 or more years of formal anesthesia training. The survey was distributed at the April 2019 American Society of Dentist Anesthesiologists national meeting in Chicago. Participants responded to questions regarding the effect of specific state regulations on decisions to practice in a particular state and how such regulations influenced patient safety and barriers to care. Rules and regulatory restrictions on the mobility of dentist anesthesiologist equipment/supplies and additional state narcotic transportation regulations were deemed statistically significant in failing to improve safety. Requiring airway and sedation training for a facility\'s provider and staff were not barriers to care. Rules and regulations were not a factor to establishing clinical practice in one state over another state.
    CONCLUSIONS: Individuals and organizations responsible for influencing the regulatory environment of anesthesia services should improve regulations to facilitate the mobility of dentist anesthesiologists.
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  • 文章类型: Journal Article
    背景:本研究的目的是评估一组普通牙医和专家对专业法律和疏忽对他们的心理影响的了解程度。
    方法:这项横断面研究的样本包括伊斯法罕市的400名牙医(普通牙医和专家),伊朗。设计了问卷并确认了其有效性和可靠性,我们在网上发表的论文由牙医完成。所获得的数据采用描述性统计分析,t检验,和方差分析测试。最佳知识被确定为75%,P值<0.05被认为具有统计学意义。
    结果:大多数牙医(75%)的知识很差。平均知识得分(范围:0-21,最大可获得:24)为9.58±4.5。60名牙医(15%)报告说他们经历了疏忽。Further,278(69.5%)报告说,他们在实践经验中不知何故经历了渎职的发生。法律疏忽在普通牙医中比专家更普遍(17.8VS8%,p<0.001)。关于法律投诉历史,男性和女性(P=0.015)以及不同类别的工作经验年(P=0.000)之间存在显着差异。此外,在那些有法律投诉史的人中,96.7%出现心理症状,70%有身体症状,80%的人在法律投诉后表现出与压力有关的社会症状。
    结论:这项研究的结果表明,应通过在课程和继续教育计划中考虑适当的培训课程来提高对牙科专业规章制度的了解。超过一半的参与者认为自己在这方面犯有过失。
    BACKGROUND: The aim of the present study was to evaluate the extent to which a group of general dentists and specialists had knowledge of the professional laws and psychological effects of negligence on them.
    METHODS: The sample in this cross-sectional study consisted of 400 dentists (General dentists and specialists) in Isfahan city, Iran. Having designed the questionnaire and confirmed its validity and reliability, we published online to be completed by the dentists. The obtained data were analyzed using descriptive statistics, t-test, and ANOVA test. Optimal knowledge was determined to be 75%, and P-value<0.05 was considered to be statistically significant.
    RESULTS: The majority of the dentists (75%) had poor and very poor knowledge. The mean score of knowledge (range: 0-21, maximum obtainable: 24) was 9.58 ± 4.5. Sixty dentists (15%) reported they had experienced negligence. Further, 278 (69.5%) reported they had somehow experienced the occurrence of malpractice during their practical experience. Legal negligence was more prevalent among the general dentists than specialists (17.8 VS 8%, p < 0.001). Regarding the legal complaint history, a significant difference was observed between the males and females (P = 0.015) and among different categories of work experience years (P = 0.000). Moreover, among those who had a history of a legal complaint, 96.7% showed psychological symptoms, 70% had physical symptoms, and 80% displayed social symptoms related to the stress following legal complaints.
    CONCLUSIONS: Findings of this study indicated that refining the knowledge of the rules and regulations of the dental profession should be enhanced by considering appropriate training courses in the curricula and continuous education programs. More than half of the participants considered themselves guilty of negligence in this regard.
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  • 文章类型: Journal Article
    在下文中,瑞士法律制度实践下的法律案件,涉及瑞士在刑事领域的牙科实践,将审查过去20年的责任和行政法。目的是以真实个案为基础,提高对牙病法律后果的认识,并提出具体的改进建议,这最终有助于提高牙科实践的质量。
    刑事领域的相关法律案件,责任和行政法是在电子数据库和州法院的帮助下收集的。
    结果包括19项法院判决,这实质上涉及专业执照的撤销,禁止实践,人身伤害犯罪和伪造证书。在这19个案例中,有15个,牙医至少被一个法庭认定有罪,在其中两个中,所有提到的法院都宣判无罪,在另外两个中,牙医因没有适当的执照而被定罪。
    这相当于牙医应充分了解法律制度并进行透明沟通。此外,患者应该捍卫自己的权利,而不是采取不适当的法律行动。此外,瑞士法律制度可以通过建立州际数据库来帮助减少非法颁发的专业执照的数量。
    In the following, legal cases under the Swiss legal system practice concerning dental practice in Switzerland in the fields of criminal, liability and administrative law of the last 20 years will be examined. The objective is to raise awareness of the legal consequences of dental malpractices on the basis of real cases and to make specific suggestions for improvement, which can ultimately contribute to improving the quality of dental practice.
    Relevant legal cases in the fields of criminal, liability and administrative law were collected with the help of electronic data bases and cantonal courts.
    The results consist of nineteen court decisions, which in essence concern the withdrawal of professional licenses, prohibition from practice, bodily injury offenses and forgery of certificates. In fifteen of these nineteen cases, the dentist is found guilty by at least one court, in two of them the concerned is acquitted by all the courts mentioned, and in another two, the dentist is convicted for working without an appropriate license.
    It amounts to the fact that dentists should be fully aware of the legal system and communicate transparently. Moreover, it would be appropriate for patients to stand up for their rights but not to take inappropriate legal action. Furthermore, the Swiss legal system could help to reduce the number of unlawfully issued professional licenses by establishing an intercantonal database.
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  • 文章类型: Journal Article
    Wish fulfilling medicine (human enhancement (therapy)) concerns medical treatment without a direct medical need. In traditional medicine, a classical triad applies: 1. after investigation symptoms of illness lead to 2. a diagnosis, followed by 3. a proposal for treatment by the health care provider. In wish fulfilling medicine, the emphasis lies on patient\'s wishes. Wish fulfilling medicine concerns medical treatment, often at the request of the patient, and should be distinguished from shared decision-making,a form of communication seeking to meet the preferences of the patient and to actively involve the patient in his treatment. In the Netherlands, in accordance with the Healthcare Quality, Complaints and Disputes Act, health care providers have to offer good care at a good level, which is safe, effective, efficient and client-orientated, offered in a timely fashion and geared to the real needs of the client. Good care has to meet professional standards. In this way, fulfilling patients\' wishes for treatment without a medical need can be restricted by law.
    Wensgeneeskunde/-tandheelkunde betreft (be)handelingen zonder direct medische/tandheelkundige noodzaak. Binnen de reguliere geneeskunde/tandheelkunde geldt een klassieke trias: 1. symptomen van ziekte leiden na onderzoek tot 2. een diagnose, vervolgens tot 3. een voorstel voor behandeling door de zorgverlener. Bij wensgeneeskunde ligt de nadruk op wat de patiënt wil en wenst. Wensgeneeskundige behandeling betreft medisch handelen, vaak op verzoek van de patiënt, en moet worden onderscheiden van gezamenlijke besluitvorming, een vorm van communicatie om aansluiting te zoeken bij preferenties van de patiënt en de patiënt actief bij zijn behandeling te betrekken. De Wet kwaliteit, klachten en geschillen zorg bepaalt dat zorgverleners goede zorg moeten verlenen: van goed niveau, veilig, doeltreffend, doelmatig en cliëntgericht, tijdig verleend, en afgestemd op de reële behoefte van de cliënt. Goede zorg wordt afgemeten aan de professionele standaard. Dit kan in juridische zin de tegemoetkoming aan een bepaalde wens tot behandeling zonder medische noodzaak beperken.
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    文章类型: Editorial
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    文章类型: Journal Article
    特别是年轻的牙医需要警惕工作机会,这些工作机会建议在无薪试运行后未来就业。
    Young dentists in particular need to be wary of job offers that suggest future employment after unpaid trial run.
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