Abstract THE EFFECTIVENESS OF A PREVENTIVE RECALL STRATEGY IN CHILDREN FOLLOWING DENTAL REHABILITATION UNDER GENERAL ANESTHESIA By Amanda Kerns, DDS A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2016 Thesis Advisor: Elizabeth Berry, DDS, MPH, MSD Vice Chair, Assistant Professor, Department of Pediatric Dentistry Purpose: This was a prospective randomized controlled trial assessing the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood dental caries. Methods: 130 patients completed FMDR and were included in the analysis. Caries risk assessment (CRA), dental exam, and a caregiver oral health knowledge (OHK) questionnaire was completed for each patient. Patients were randomized into two groups; intervention returned at 3 and 6 months and control returned at only 6 months post-surgery. At each recall, CRA and dental exam information was recorded, and at the six month recall, all caregivers completed the OHK questionnaire. Results: Actual recall data showed a statistically significant difference in CRA at six months, with 71.8% of patients in the control and 44.8% of patients in the intervention assessed as high caries risk. Conclusions: The actual recall data suggests this recall strategy is effective in reducing CRA level following FMDR.

The purpose of this study was to examine the effectiveness of two short-term grief education curricula, didactic (lecture) and modeling, in teaching students about grief and how to effectively interact with someone who was grieving. A control group was included in which subject read articles on euthanasia. Subjects were 84 students (67 females, 17 males) enrolled at a southeastern university who volunteered to participate in exchange for extra credit, and who met the inclusion criteria that they not be acutely grieving. This study was unique in its incorporation of an analogue interaction that allowed for coding of subject responses to a grieving confederate. Subjects completed a demographic questionnaire, a grief knowledge test, and a death anxiety scale. They were ranked on the appropriateness of responses during the analogue interaction, and their responses in the analogue interaction were coded for degree of facilitativeness to the griever. / MANOVAs were used to analyze the dependent measures by instructional format. No major findings for instruction emerged. MANOVAs were also conducted to examine subject gender and confederate gender. Significant results were obtained for subject gender in which females scored higher on a death anxiety scale than males. For confederate gender, subject who interacted with male confederates had significantly higher death anxiety scores, fewer total observation responses, fewer nonfacilitative responses, and a lower percentage of nonfacilitative responses. / Potential limitations of the study were that the lecture and modeling instructional units may have been too brief, and the subject population may have been knowledgeable in therapeutic techniques and grief information, thereby deriving few benefits from instruction. / Source: Dissertation Abstracts International, Volume: 53-11, Section: B, page: 6000. / Major Professor: Charles Madsen, Jr. / Thesis (Ph.D.)--The Florida State University, 1992.

The primary purpose of this study was to determine the impact of accreditation committee recommendations on graduate programs in health services administration from 1982 to 1988. A second purpose was to determine the extent of compliance by graduate programs in health services administration with the criteria-related recommendations made by visit committees. A third purpose was to determine whether the characteristics of graduate programs awarded accreditation for five years or longer differ from those awarded accreditation for three years or less. A content analysis of site visit reports and progress reports substantiated the following conclusions: (1) Graduate programs met a relatively high degree of the ACEHSA criteria. (2) Curricula-Related deficiencies presented the most problems for graduate programs. (3) Research and Program Evaluation were found to be relatively high priorities for visit committees and for the ACEHSA. (4) Visit committees made recommendations consistent with the premise that graduate programs located in business schools have qualities which came closest to satisfying the ACEHSA criteria. These programs received the fewest number of criteria-related recommendations. (5) Graduate programs auspicious to acquire the human and financial wherewithal from their respective universities and external funding sources received longer lengths of accreditation. These programs, at minimum, had substantial budgets, critical masses of faculty, and considerable bases of full-time students. (6) ACEHSA follow-up procedures fostered a relatively high degree of compliance by graduate programs with recommendations made by visit committees. (7) Graduate programs granted longer lengths of accreditation met more recommendations than those programs awarded shorter lengths of accreditation. (8) The ACEHSA criteria made little or no provision for differences / between traditional and non-traditional programs, United States and Canadian Programs, and programs by administrative locations. (9) ACEHSA granted lengths of accreditation consistent with the premise that schools of public health, medical schools and graduate schools came closest to meeting the ACEHSA criteria. These programs were granted the longest lengths of accreditation. / Source: Dissertation Abstracts International, Volume: 51-03, Section: A, page: 0754. / Major Professor: Allan Tucker. / Thesis (Ph.D.)--The Florida State University, 1990.

Schools, and in particular physical education (PE), have been increasingly recognised for the role that they play in promoting healthy, active lifestyles amongst children and young people in light of the public health agenda (Armour and Harris, 2013). However, whilst schools have been recognised for the role that they can play in promoting health to children and young people, concerns have been expressed with regard to the status of health in PE and the approaches and practices used to address health-related learning (Cale et al., 2016). A particular concern in this regard is what children and young people know and understand about health , and how they come to conceive this within PE, with a growing body of literature suggesting that pupils conceptions are relatively superficial and simplistic (see Harris et al. (2016) for an overview). Accordingly, the purpose of this research is to explore pupils conceptions of health within PE. The research was comprised of four phases which took place over an 18-month period within the East Midlands region of England. Phase one involved an online survey being distributed to all state secondary schools (n = 293) and with a total of 52 schools responding. Phase two involved semi-structured interviews being conducted with 13 PE teachers at two case study schools and focus groups with 117 pupils (aged 11-12) at the same schools. A participatory approach underpinned the study and relevant methods/techniques were employed within pupil focus groups to generate discussion and elicit pupils conceptions of health . Examples of the methods/techniques employed included: drawings, concept cartoons and statement sheets. Pupils worked interactively with one another to undertake and discuss tasks/activities in line with the youth voice agenda that underpinned the research. This agenda is often allied with participatory methods (Heath et al., 2009) and seeks to privilege the voices of younger participants, recognising that children and young people are competent social agents, capable of both understanding and articulating their own experiences (Christensen and James, 2008). Phase three involved follow-up focus groups with the same pupils who participated during the preceding phase, and a similar participatory approach was employed. Phase four involved semi-structured focus groups being conducted with the same PE teachers at each school. Data generated were analysed using a Foucauldian-inspired discourse analysis. The findings of the study highlight that the vast majority of pupils conceptions of health were reductive, limited and limiting. These conceptions of health were identified as being underpinned by: corporeal notions, aesthetic orientations and healthist influences. In addition, they aligned with normative conceptions of health , that were evidently influenced by public health discourses, which may well have been promulgated by and through PE. Whilst pupils did not necessarily consider that PE influenced their conceptions of health , there were evident links, which PE teachers themselves acknowledged and problematised. Positively, it was highlighted that there were some pupils who were able to disrupt normative conceptions of health and, in doing so, they demonstrated their capacity for criticality. As such, the challenge for PE is now to consider how it might support pupils to develop their capacities to receive, interpret and be critical of health-related information. If it can do so, it may well be that critically-inclined conceptions of health can be fostered within, through and by the subject.

Objective: To determine the demographic, economic, geographic, and health infrastructure factors related to the percentage of students by school who comply with state-mandated dental screenings in Iowa. Methods: An exploratory, cross-sectional study was conducted, utilizing secondary data sources from the Iowa Department of Public Health, the Iowa Department of Education, and the U.S. Department of Agriculture, to examine factors related to dental screening compliance rates for public school kindergarteners in Iowa (AY year 2014-15). Both school-level and county-level factors were considered. A ninety percent student compliance rate was established as the criteria for a school to satisfy the threshold for being compliant with screening requirement. Multivariable logistic regression analyses were conducted to evaluate the relationship of the independent variables on whether the schools satisfactorily met the criteria for compliance. Results: Fifty-six percent of the 504 schools included in the study satisfactorily met the established criteria. Schools located in dental health professional shortage areas or in urban adjacent areas were more likely to have a greater percentage of kindergarten students exceed the 90% compliance threshold (p<0.05). Schools where a greater percentage of students were screened by a dentist or where larger populations of children were eligible for free or reduced price lunch (FRPL) (≥40%) were less likely to meet the compliance threshold. Conclusions: Schools with more lower income students, those in metro areas, and those with a higher reliance on dentists performing the oral health screenings could benefit from targeted efforts to improve compliance with mandated dental screenings.

No description available.

Current research on the important issue of the determinants of child welfare at the family level has focused on parental attainment of education as an important determinant of the health and well being of the child. The unique and defining role of the mother as chief caretaker, and the critical need to arm her with sufficient information to counterbalance the entrenched poor living conditions of most sub-Saharan African regions sets the background for this research The research focuses on the influence of the mother's attainment of a greater threshold of education achievement on child welfare among Ghanaian and Kenyan children under the age of 36 months. The maternal attainment of at least some secondary education exceeds various socioeconomic indicators, including source of drinking water, as the major determinant of the health and well being of the child. These findings are persistent in both country analyses The finding is robust using multivariate analyses across selected socioeconomic measures, and remains intact when the outcome variable is controlled for by urban-rural residency. Those measurements include: source of drinking water, prevalence of disease, educational attainment, child's age, access to a radio, mother's age, and mother's awareness of oral rehydration therapy. An additional sub-analysis investigated factors associated with whether the child was taken to a medical facility for treatment Indicators employed to proxy the condition of poverty were found to be statistically significant correlates of child well being. However, these variables do not duplicate the persistent and strong results obtained from the education indicator. The amassment of maternal knowledge precedes and mitigates the impact of the basic accouterments of water connections and health practice factors on the health and well being of the child Thus socioeconomic and infrastructure factors are not a substitute for the commanding influence of greater maternal education on the well being of the child. Moreover, information received by mothers resulting from the completion of primary schooling is insufficient to reverse the trend of poor health outcomes among children under the age of three Policy must prioritize the allocation of resources toward maternal education at a level which exceeds primary schooling or basic education in order to effect sustainable change / acase@tulane.edu

OBJECTIVE: To establish baseline data of dental utilization and determine the predictors of receipt of dental procedures by Medicaid-enrolled senior adults who reside in Iowa nursing facilities. METHODS: This was a longitudinal retrospective analysis of Iowa Medicaid claims data for SFY 2007-2014 of senior adults who were 68 years or older upon entry to a nursing facility and continuously enrolled (eligible 58 out of 60 months) in Medicaid for three years prior to and at least two years after admission. RESULTS: Controlling for the subject and nursing facility level variables, the strongest predictor of dental utilization after entry was the receipt of a dental procedure before entry (p< 0.001). Subjects residing in a facility located in an urban area (p< 0.002) or in two regions of Iowa (p=0.035, p=0.019, respectively) also had increased odds of receiving a dental procedure. CONCLUSION: Our results show that approximately 50% of the subjects never received a dental procedure in the 5-year study period. The strongest predictor of receipt of dental procedures in the 2 years after entry was the receipt of dental procedures in the 3 years before entry. It is important for Medicaid-enrolled senior adults to establish a dental home while community-dwelling.

Associations Between Dietary Factors and Malocclusion. Blackwelder AC*, Warren JJ, Levy SM, Marshall TA, Bishara SE (University of Iowa, Iowa City, IA) Purpose: Malocclusions, including crowding, have a multifactorial etiology, but it has been suggested that dietary factors may be a risk factor for malocclusion. Thus, the objective was to assess associations between dietary factors and dental crowding in a sample of Iowa Fluoride Study participants. Methods: As participants in the Iowa Fluoride Study, subjects were followed up from birth to 102 months using questionnaires and diet diaries periodically to gather information on dietary intake. Subjects were also examined clinically around age 5 (n=168) and 9 (n=125) with dental casts made to gather information on malocclusion such as Tooth Size Arch Length Discrepancy (TSALD) and Canine Arch Width (CAW), as well as body mass index (BMI). Relationships between dietary factors and malocclusion were assessed. Results: The maxillary and mandibular TSALD values for the age 5 and age 9 exams were correlated with the dietary data. The age 5 maxillary TSALD (1.74 mm) was statistically significant when correlated with kilocalories (P=.031) before and after adjusting for BMI. Further examination of the extreme TSALD values with dietary data was completed using Student's t-test. The age 9 mandibular extreme TSALD value and kilocalories was also statistically significant (P=.028). The age 5 CAW was correlated with the dietary data and kilocalories was also statistically significant (P=.012). Other dietary factors were found to approach statistical significance but were not significant at the alpha=0.05 level. Conclusions: The findings from this study suggest that dietary factors may be associated with crowding of the dentition as measured by TSALD and CAW; however, further research is needed.

Oral health disparities in children is an important public health issue in the United States. A growing body of evidence exists supporting the social determinants of oral health, moving beyond individual predictors of disease to family- and community-level influences. The goal of this study is to examine one such social determinant, social capital, at the family and neighborhood levels and their relationships with oral health in Iowa children. A statewide representative data source, the 2010 Iowa Child and Family Household Health Survey, was analyzed cross-sectionally for child oral health status as the outcome, a four-item index of neighborhood social capital and four separate indicators for family social capital as the main predictors, and seven covariates. Soda consumption was checked as a potential mediator between the social capital variables and oral health status. A significant association was found between oral health status and the neighborhood social capital index (p=0.005) and family frequency of eating meals together (p=0.02) after adjusting for covariates. Neighborhood social capital and family function, a component of family social capital, may independently influence child oral health outcomes.