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Use of cone beam computed tomography imaging for airway measurement to predict obstructive sleep apnea
No full textObjective: This retrospective chart review examined whether airway parameters were correlated with scores on the STOP-Bang questionnaire. Methods: Minimal upper airway area, upper airway volume, minimal retropalatal area, retropalatal volume, minimal retroglossal area, and retroglossal volume were calculated from cone beam computed tomography (CBCT) images. Patients were grouped based on their STOP-Bang scores (\u3c3 or ≥3) for obstructive sleep apnea (OSA), and airway parameters were compared across the 2 groups. Results: Thirty-one (43%) of 72 patients with a minimal upper airway area of \u3c110 mm2 had STOP-Bang scores of ≥3. Most patients (90%) with STOP-Bang scores of ≥3 had minimal retropalatal areas of \u3c110 mm2. Differences were found between groups for minimal upper airway area (p = 0.03), upper airway volume (p = 0.04), and minimal retropalatal area (p = 0.001). Discussion: To assess OSA risk, dentists should compare CBCT images with STOP-Bang scores
Care Coordination: A Valuable Adjunct To Dental Practice - Lessons Learned in a Public Health Setting
No full textBackground: Children and youth with special health care needs (CYSHCN) face numerous barriers in accessing dental care including a lack of providers who are comfortable and competent in addressing their needs. Care coordination is an effective and financially viable tool to navigate the complexities of the health care system and match patients to providers with the appropriate training and facilities to treat their specific needs. Care coordinators have been shown to improve access, reduce barriers and decrease health care costs for CYSHCN. Objectives: To present results of a care coordination pilot in two federally qualified health centers that worked with community dental care coordinators (CDCCs) as part of the Healthy Teeth Healthy Communities (HTHC) project to determine if this model is financially sustainable and potentially beneficial to connecting CYSHCN to dental care. Methods: Several case studies were examined to determine the efficacy of the care coordination model with regard to improving oral health outcomes by decreasing barriers to care for CYSHCN. Data were analyzed from two federally qualified health centers that participated in the dental care coordination pilot. Results: The results illustrate a positive correlation between care coordination and patients\u27 ability to establish a dental home. The data also show a decrease in the number of no-shows for the patients supported by care coordinators. Conclusions: This pilot demonstrated that care coordination improves access and continuity of care for all patient populations. Additional research and funding should be afforded to further investigate care coordination programs as a bridge to better oral health care for CYSHN
A CBCT Evaluation of Esthetic Preference Regarding the Perceived Facial Attractiveness of Young Korean Female Adults with a Normal Skeletal Pattern
No full textThe aim of this study was to determine the factors that affect esthetic preference regarding the perceived facial attractiveness of young Korean female adults with a normal skeletal pattern using cone-beam computed tomography (CBCT). After reorienting the CBCT images of 40 young Korean female adults, three-dimensional (3D) measurements were analyzed, and five 3D facial images were digitally constructed. A computer-based questionnaire was used to determine perceived facial attractiveness by scoring from 1 (very unattractive) to 10 (very attractive). Esthetic perception and the most influential facial view and component were examined and compared by orthodontists, general dentists, and laypeople to evaluate facial attractiveness. Compared to the unattractive group, the attractive group had significantly greater values for Pog-NB, L1SI-FH, U lip thickness, L lip-U lip, and Nasolabial angle, along with significantly lower values for U1SI-FH and Cant of U lip; the attractive group also had a more retruded U1MP (p \u3c 0.01), L1MP (p \u3c 0.01), U lip (p \u3c 0.05), and L lip (p \u3c 0.01) relative to N, as well as a more retruded U lip (p \u3c 0.05) and L lip (p \u3c0.001) relative to esthetic lines. Orthodontists and general dentists were more likely to consider the profile view. When evaluating facial attractiveness, orthodontists and laypeople more often focused on the lips and chin. When evaluating facial attractiveness, all evaluators showed a high esthetic preference for retroclination and retrusion of the incisors and lips, but there were some differences in how they perceived facial attractiveness. Therefore, the ultimate perception of facial attractiveness needs to be based on the esthetic perceptions of laypeople
Association of arm pain with overhead throwing and upper extremity range of motion, strength, and throwing velocity in collegiate baseball players
No full textPurpose: To investigate whether shoulder and elbow range of motion (ROM), upper extremity (UE) strength, and throwing velocity differ between collegiate baseball players with UE pain and those without pain. Methods: Twenty-seven Division II baseball players participated. Athletes completed an injury surveillance survey detailing past and present arm injuries and pain. Bilateral shoulder/elbow ROM and strength were measured with a goniometer and dynamometer, respectively. Throwing velocity was measured with a radar gun. Differences between dominant and non-dominant arm measurements were analyzed, as were differences between groups complaining of pain versus no pain. Results: Pain was reported in 11 athletes. Compared to the non-dominant arm, significant decreases were noted in dominant arm ROM measurements of shoulder flexion (p = 0.02), abduction (p \u3c 0.01), internal rotation (IR) (p \u3c 0.01), and total ROM (p = 0.03). External rotation (ER) was significantly increased in the dominant arm (p \u3c 0.01). Dominant shoulder IR and ER strength were greater (p \u3c 0.01) and thumb-down abduction strength was decreased in the pain group (p = 0.02) with respect to the non-dominant arm. Remaining strength measurements and velocity were not notably different between pain and no pain groups. Univariate analysis revealed total elbow ROM as a pain indicator (p \u3c 0.01). Regression analysis showed the odds of pain with throwing were 17% higher for every 1° decrease in total elbow ROM. Conclusion: Despite differences in dominant arm measurements, shoulder ROM was not related to pain in the shoulder of participants. However, decreased supraspinatus strength and total elbow ROM did appear to be related to upper extremity pain
Use of Occupational Therapy to Optimize Feeding in the Transition Home from the NICU
Get PDFCurrent literature demonstrates a need for occupational therapy services following fragile infants’ discharge from a neonatal intensive care unit (NICU), specifically regarding feeding. Infants receive necessary medical attention and therapy services while in the NICU but are often discharged without a plan of care for continued services. NICU follow up programs (NFUs) strive to close the gap in services by providing immediate follow up post NICU discharge for the infants and their caregivers. However, occupational therapists (OTs) remain inconsistently consulted in these programs, creating potential for missed opportunities to provide the best possible health outcomes for these fragile infants. This capstone responded to this knowledge gap by observing an NFU for 14 weeks to evaluate potential new roles of OT that optimize feeding outcomes. The researcher concluded an OT would be an asset to NFUs and would optimize the potential for the best possible health outcomes by focusing on feeding, development, and caregiver mental health. This paper concludes with limitations and areas of future study to continue the expansion of occupational therapy in NFUs and feeding
Fostering Healthy Therapeutic Relationships: Foster Parent Education Program
Get PDFBackground: Children who have been placed in the foster care system due to trauma often have difficulty coping with past experiences. These traumatic experiences can often affect their development, physically and mentally, and emotional regulation, relationships, and attachment. As of April 2021, more than 13,400 children were placed in the foster care system in Arizona. While removing children from their birth home to a safer environment is critical, it brings along many challenges such as emotional trauma and inconsistent caregiving. Methods: The foster parent educational program described in this paper, “Fostering Healthy Therapeutic Relationships,” is a foster and adoptive parent educational resource that consists of weekly sessions twice a week via Zoom. The education sessions cover a wide range of topics such as attachment and trust, challenging behaviors, and grief and loss. Additionally, the instructor discussed information on culture and transracial adoption in a fourth optional class. This educational program is for foster and adoptive parents who have foster children or are looking to foster in the future. The sessions offer the ability to increase parenting skills and knowledge through discussions and interactive tools such as videos and handouts. The purpose of this program is to educate foster parents of Jose’s Closet through an occupational-based approach designed to equip foster parents with the basic knowledge and skills to fulfill their roles and responsibilities as foster parents. Results: The demographics have shown that the foster parent experience can range from having little to having no experience (fewer than 12 months) to 27 years and beyond. Forty-nine foster parents participated in the foster education program “Fostering Healthy Therapeutic Relationships.” Throughout the capstone experience, many parents expressed how beneficial it was to have discussions throughout the class, handouts, and videos. After completing the foster parent education program, many parents indicated that they felt very confident in the areas of topics presented (1) attachment and trust, (2) challenging behaviors, and (3) grief and loss. In the fourth optional class offered, parents indicated that they felt very confident or fairly confident about culture and transracial adoption. Furthermore, many parents have expressed the need for more advanced training that is applicable to their current situation. Foster parents’ highest priority of needs were (1) dealing with trauma, (2) managing challenging behaviors, and (3) self-care/how to manage grief. Discussion: Children who are placed in foster care often present with unique challenges, requiring different parenting approaches to adequately meet a foster child’s needs. Foster care children who have undergone significant childhood trauma will often have higher rates of behavioral problems and developmental disorders (Liming & Grube, 2018). During class discussions, foster parents continued to benefit from learning about challenging behaviors, trauma, and attachment. This capstone project aimed to identify education gaps for foster parents, focusing on foster parents’ satisfaction, needs, and competence in foster parenting tasks. This project identified that more research and advanced training are needed in the following areas of trauma-informed care, challenging behaviors, and attachment to continue to increase the knowledge of prospective and current foster care parents’ needs for training
Establishing Test-Retest Reliability and Internal Consistency of the Occupational Resilience Measure
Get PDFWithout a clear understanding of the dynamic relationship between resilience and occupation, occupational therapy has lacked the tools necessary to optimize resilience in research and clinical practice.
Occupational resilience is defined as “the capacity for persistence in the performance of an occupation, whereby capacity is reflected in both duration and intensity of engagement in a specified occupation” (Muriithi et al., 2022).
Occupational Resilience Measure 1.0 (ORM) and the Occupational Resilience Individual Perception Scale (ORIPS) to be used as the primary assessment tools for measuring resilience in individual occupations.
Aim: Establish the test-retest reliability and internal consistency of the ORM; establish the test-retest reliability of the ORIPS.
Purpose: The results of this study will be used by Dr. Muriithi to substantiate the ORM and ORIPS as reliable assessment tools for future use in occupational therapy practices.
Establishing psychometric properties of the ORM and ORIPS is an important step for the future clinical and research use of occupational resilience as a new occupational therapy construc
Going Beyond the State Law: Investigating High School Sport-Related Concussion Protocols
No full textContext: State laws provide general guidelines for sportrelated concussion (SRC) management but do not comprehensively address the multiple layers of management for this complex injury. Although high schools are encouraged to develop SRC protocols that include both state law tenets and additional management practices, the execution of these protocols warrants examination. Objective: To investigate state law compliance and practice components included in high school SRC protocols and determine whether the degree of sports medicine coverage influenced protocol quality. Design: Qualitative document analysis. Setting: High school athletics. Patients or Other Participants: In total, 184 Pennsylvania high schools (24.3% of schools statewide; full-time athletic trainers [ATs] = 149, part-time ATs = 13, missing = 22) voluntarily provided copies of their protocols from the 2018- 2019 academic year. Main Outcome Measure(s): Four ATs conducted document analyses using a 67-item component analysis guide. Frequencies were computed for included protocol components related to the state law, preparticipation and prevention, recognition and assessment, and management. The difference in the total number of included components (maximum = 60) by sports medicine coverage was assessed using a Mann-Whitney U test. Results: Heterogeneity existed in the components included in the submitted protocols. Only 23.4% included all mandatory state law tenets. Immediate removal from play was noted in 67.4% of protocols, whereas only 1.6% contained prevention strategies. Return to play was addressed more frequently than return to learn (74.5% versus 32.6%). The sample had a mean of 15.5 ± 9.7 total components per protocol. Schools with fulltime sports medicine coverage had more protocol components than those with part-time ATs (15 [interquartile range=8.5-22.5] versus 6 [3-10.5] median components; U = 377.5, P \u3c .001). Conclusions: School-level written SRC protocols were often missing components of the state law and additional bestpractice recommendations. Full-time sports medicine coverage in high schools is recommended to increase SRC protocol and health care quality