Still Scholarworks (A.T. Still University)
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Assessing help-seeking strategies among nontraditional learners in distance education
No full textOnline education has significantly expanded in the United States, with enrollment in online programs among college students rising from 26% in 2013 to 73% in 2020. Nontraditional learners, including part-time students, full-time employees and first-generation students, face higher attrition and lower graduation rates. Self-regulated learning, particularly help-seeking strategies, is crucial to academic success. Using a quantitative, correlational design, this study examined the relationship between help-seeking strategies, GPA, demographics and class standing among online first-year nontraditional learners at A.T. Still University in the United States. A total of 33 out of the 231 first-year students enrolled participated in the study. Data from a stratified random sample were analyzed using Spearman’s Rank-order Correlation, the Chi-square Test of Independence and the Kruskal–Wallis H Test. Results showed a weak positive correlation between GPA and formal help-seeking strategies. In contrast, informal strategies had minimal use and a weak negative correlation. Demographic factors influenced preferences, with structured resources favored by married and employed students. Institutions should prioritize accessible digital resources and faculty engagement to support success
Standardizing clinical evaluations of periodontal condition to guide assessments and diagnoses using the Periodontal Assessment Protocol (GF-PAPro)
No full textIn a highly evolved and developed world, where professionals seek greater knowledge and understanding of advanced surgeries and high technologies, basic concepts have become distant, posing challenges in achieving an accurate periodontal diagnosis. Therefore, utilizing a step-by-step clinical and radiographic periodontal assessment protocol can facilitate precise diagnosis. This editorial introduces the Periodontal Assessment Protocol (GF-PAPro), developed based on the most substantial scientific literature, to guide clinicians and experts in standardized clinical periodontal assessments
Household-level resilience to food insecurity risk from financial shocks: exploring absorptive, adaptive, and transformative capacities
No full textThis study explored household-level resilience to household-level financial shocks (e.g. unexpected loss of income or large expenses)–a food insecurity risk factor. We conducted 47 semi-structured interviews across five states in the United States. The inductive thematic analysis revealed themes related to capacities a household may have to absorb, adapt, or transform their livelihood situation in response to a financial shock. Thirteen themes emerged related to monetary resources, social connections, situational barriers, and environmental factors that can impact resilience to food insecurity. Moving our focus upstream to better understand these issues may be crucial for intervention
Assessing fundamental clinical skills of osteopathic medical students
No full textContext: Clinically based performance assessments, including those employing standardized patients (SPs), have been utilized to educate and assess medical students and graduates. Starting in the 1990s, demonstrating competency on these types of assessments became part of the medical licensure pathway in some countries, and was re-added to the licensure pathway in the United States in 2004. Studies have been published to support the validity of the scores and associated pass/fail decisions obtained from SP assessments. With the onset of the COVID-19 pandemic, testing organizations were forced to suspend many of their in-person clinical skills assessments. There is widespread recognition that clinical skills are necessary for high-quality patient care. Nevertheless, there has been disparate interest in reestablishing national assessments of these skills. Objectives: Based on the recommendations of the Special Commission on Osteopathic Medical Licensure Assessment, the National Board of Osteopathic Medical Examiners (NBOME) established the Core Competency Capstone for Doctors of Osteopathic Medicine (C3DO). The objectives of this study were to describe the assessment and to ascertain the feasibility of administering it at multiple colleges of osteopathic medicine (COMs). Methods: Surveys of osteopathic medical school personnel and students taking the assessment were conducted to gather data on the feasibility of administering the C3DO, the challenges associated with a distributed model, and the educational value of the assessment. Reports submitted by the medical schools provided information on the cost of the assessment. Some psychometrics analyses of Phase 1 C3DO pilot data were conducted, including the quantification of measurement errors. Results: The NBOME, in collaboration of the COMs, was able to administer the C3DO to almost the entire class at four osteopathic medical schools. Although there were challenges, including data transfer from the schools, summary scores were derived for a total of 811 students, including nine repeat test takers. Medical students across sites indicated that the C3DO was a valuable educational assessment activity. The reliability of the ratings derived from the checklists (history building [HB], physical examination [PE]) and Communication and Respectfulness Evaluation (CARE) tool were adequate. Based on a variance components analysis, there was some evidence to suggest that at a given school, the choice of an SP portraying and scoring the case could have an impact on the student scores. Conclusions: The C3DO-distributed site model, which includes centrally developed cases, standardized training of SPs, and independent scoring of osteopathic manipulative treatment (OMT), provides the means to assess the clinical skills of osteoapthic medical students at different testing sites. The implementation of a distributed, school-based model for the assessment of osteopathic clinical skills is feasible, potentially economically advantageous, and if rigorously developed and administered, should provide for comparable student scores and associated competency decisions. Additional Phase 2 (2024-2025) and Phase 3 (2025-2026) studies are underway to establish the psychometric rigor of the assessment more fully
Consistency of Value Detection for Shade Matching Using Multiple Scanners
No full textObjective: Digital shade-matching systems allow for the selection of value, hue, chroma accurately to match the shade of the surrounding natural teeth. Significant variation exists during shade selection using different digital scanners.
Purpose: The purpose of this study was to examine the trueness and repeatability of shade value using multiple digital systems as compared to spectrophotometer (SPM) as a gold standard.
Methods: VITA Toothguide 3D-MASTER® tabs were scanned for their Value only (1M1, 2M1, 3m1, 4M1and 5M1) five times using a spectrophotometer and three different scanning systems: Trios3 Shape Scanner, Vita Easy Shade V and Prime Scan. Next, we conducted tests on human subjects by scanning sound teeth #8 or #9. Value was collected from the middle third of each tooth. Reliability analysis was performed to compare the consistency of detected values with each scanner against values detected with SPM by weighted Kappa values.
Results: None of the scanned values were the same as values detected with SPM. The measurements obtained from the Vita Easyshade demonstrated a strong agreement with a Kappa value of 1, followed by the Prima Scan, which showed a Kappa value of 0.763. In contrast, the Kappa values for the human subjects were all below 0.3.Conclusion: Different scanners produced variable results as compared to spectrophotometer which may impact patient satisfaction with the appearance of a final restoration
Parental Acceptance of Silver Diamine Fluoride in Anterior vs Posterior Teeth
No full textDental caries is the most common chronic disease among children in the United States. Silver Diamine Fluoride (SDF) offers a cost-effective treatment option by combining the antibacterial properties of silver with the remineralizing effects of fluoride. However, SDF has a notable drawback: when it reacts with carious lesions, it causes permanent black staining at the site. Our study aimed to assess parental acceptance of SDF for anterior versus posterior teeth through a survey conducted at the ASDOH pediatric clinic. The survey included information on SDF, its side effects, and before-and-after images. The results revealed strong parental acceptance of SDF for treating caries in posterior teeth, while opinions were mixed for anterior teeth. Additionally, factors such as socioeconomic status, child behavior, and the non-invasive nature of SDF influenced parental approval. Overall, our findings suggest that SDF is a valuable treatment option for dental caries regardless of tooth location, with significantly higher acceptance for posterior teeth. Furthermore, we identified a potential link between socioeconomic status and parental acceptance of SDF. Future research could explore this relationship further, address the impact of socioeconomic factors on access to dental care, and examine the long-term effects of SDF in pediatric patients
Impact of Comorbid Mental Health Disorders on Oral Health Behaviors
No full textBackground: Mental health disorders (MHD) can significantly influence daily self-care behaviors, including oral hygiene behaviors (OHB). OHB in patients with a single MHD versus multiple MHD are unknown. The aim of this retrospective study was to compare OHB in patients with self-reported single and multiple MHD.
Methods: Electronic dental records for patients treated in an academic dental clinic between 2018 through 2021 were reviewed to identify presence of self-reported anxiety, dental anxiety, depression, bipolar disorder, PTSD, Schizophrenia and OHB. Specific OHB included self-reported frequency of daily toothbrushing (TB), interdental cleaning (ID), use of fluoride toothpaste (FTP) and mouthwash (MW), and recommended preventive recare interval and frequency of returning for recare within a 2-year period. Descriptive statistics, Mann-Whitney U and Wilcoxon rank-sum tests were used for data analysis.
Results: 854 charts were reviewed, with 253 records identified with self-reported MHD. Anxiety was the most common MHD (n=156, 62%), followed by depression (n=154, 61%), dental anxiety (n=64, 25%), bipolar disorder (n=37,15%), PTSD (n=22, 9%) and Schizophrenia (n=15, 6%). There were no significant differences in OHB, recare intervals or frequency of recare visits by MHDs except for Schizophrenia: those with Schizophrenia brushed less frequently (W=1296.000, p=0.014). Individuals with one MHD brushed (W=16207.000, p=0.016) and used MW more frequently (W=16488.000, p=0.02) than those with more than one MHD. Men and women differed for TB (W=11818.500, p=0.004) and FTP (W=11864.500, p=0.008), with women showing greater frequency of use. Mean recommended recare interval was 6 months, with \u3c2 visits reported by all types of MHD.
Conclusions: OHB were poor among dental patients with MHD
Mechanisms of nebivolol-mediated effects on bFGF-induced vascular smooth muscle cell proliferation and migration
No full textBackground: Nebivolol is a β-adrenergic receptor antagonist that has intrinsic activity on β3-adrenergic receptors (β3-ARs). Previous studies suggest that nebivolol inhibits bFGF-induced vascular smooth muscle cell (VSMC) proliferation and migration and vascular injury-induced neointima formation through activation of β3-ARs. However, our recently published data shown that activation of β3-ARs produced the opposite results, suggesting that the mechanisms of nebivolol-mediated effects are not fully understood. The current project was to study the mechanisms of nebivolol\u27s effects on bFGF-induced VSMC proliferation and migration by comparing to the selective β3-AR agonist, CL316,243. Methods: VSMCs isolated from Sprague Dawley rat aortas were pretreated with nebivolol or CL316,243 followed by stimulation with bFGF. Cell proliferation and migration and phosphorylation of ERK and AKT were measured. Results: We found that pretreatment of VSMCs with nebivolol produced biphasic effects on bFGF-induced VSMC proliferation, manifested as potentiation at lower concentrations and inhibition at the higher concentration. The effects of low concentrations of nebivolol on bFGF-induced VSMC proliferation was blocked by the selective β3-AR antagonist, SR59230A. Nebivolol inhibited bFGF-induced cell migration at all concentrations tested. In addition, only higher concentrations of nebivolol significantly inhibited bFGF-induced AKT phosphorylation but not ERK phosphorylation whereas CL316,243 at all concentrations tested significantly enhanced bFGF-induced VSMC proliferation and migration and higher concentrations of CL316,243 not only enhanced bFGF-induced AKT phosphorylation but also ERK phosphorylation. Conclusion: Our data suggest that the effect of nebivolol on bFGF-induced cell proliferation is concentration-dependent. The enhancement on bFGF-induced cell proliferation at lower concentrations appears to be mainly mediated by activation of β3-ARs but the inhibitory effects on bFGF-mediated cell proliferation as well as migration may occur through different mechanisms. AKT signaling is only involved in high concentrations of nebivolol-mediated effects
