The increasing number of aging Americans who will need long-term care, coupled with the need to keep this care affordable, represents a formidable challenge to the healthcare system. Some response must be made to address what will soon become immediate need. A significant part of the approach to this problem lies in making long-term care as efficient, cost effective, and affordable as possible. Reducing turnover of certified nursing assistants (CNAs) will help achieve these goals. This article discusses the extent, implications, and causes of this turnover and puts forth a program to correct the problem.

This article reports the findings of a survey-based study conducted in 2006 to determine graduating dental hygiene students' attitudes toward ethical dilemmas in eight areas of practice: substandard care, overtreatment of patients, scope of practice, fraud, confidentiality, impaired professionals, sexual harassment, abuse, and health status. The findings, based on responses from 1,165 students at 141 U.S. dental hygiene programs, indicate that many dental hygiene students do not understand what behaviors in the patient care environment are consistent with ethical practice and which are not. Responding students believed that hygienists have a strong duty to report, intercede, or educate in areas of abuse, sexual harassment, detection of cancer, and smoking cessation. However, they were less likely to report concerns about ethical transgressions such as fraud, inadequate infection control, exceeding practice scope, and failure to diagnose disease when such disclosures could potentially threaten their employment status. Based on the results, we recommend that dental hygiene programs explore curriculum enhancements to improve students' comprehension of what constitutes fraud and other ethical transgressions and the proper reporting mechanisms.

One of the consequences of morbid obesity that has been overlooked is oral health. This paper discusses the oral consequences associated with drugs used to control weight, as well as the oral side effects produced by medications used to treat comorbidities of obesity. We also address how dietary behaviors, and the ergonomic inability to obtain dental care, affect oral health. The relationship between poor oral health and behavior in the bariatric patient are also discussed. Finally, an assessment tool is presented that can assist bariatric nurses evaluate the oral health of bariatric patients.

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