Comparative analysis of Australian climate change and COVID-19 vaccine audience segments shows climate skeptics can be vaccine enthusiasts.

Denialism and the spreading of misinformation have occurred regarding both climate change and COVID-19, delaying uptake of urgent actions. Audience segmentation analysis identifies audience subgroups likely to have similar responses to messaging, and is a valuable tool for effective campaigns encouraging critical behaviors in both contexts. This study compared audience segmentations based on a representative sample of 1054 Australians. One segmentation was based on the 'Global Warming's Six Americas' online SASSY tool. The second segmentation applied the Theory of Planned Behavior and found five distinct COVID-19 vaccine segments. Both studies showed those most concerned and those most skeptical in the climate change segmentation tended to be in more enthusiastic COVID-19 vaccine segments, while those in the center on climate change were more skeptical on COVID-19 vaccines. Differences identified relating to age, gender, and political views may be explained by a combination of the specific nature and histories of these issues. These findings have implications for effective communication on science and health issues across diverse disciplines.

Audience segmentation analysis of public intentions to get a COVID-19 vaccine in Australia.

While previous studies provide broad categories of the public who intend to get a COVID-19 vaccine, few systematically segment and help understand and engage with distinct publics to improve COVID-19 vaccine uptake. Using data from a national sample of the Australian public (N = 1054) and using measures primarily based on the Theory of Planned Behaviour, a latent class analysis of 16 items was undertaken to identify COVID-19 audience segments for potential future message targeting. We found five different segments of COVID-19 vaccine intentions: vaccine enthusiasts (28%), supporters (26%), socials (20%), hesitant (15%) and sceptics (10%). These five audience segments also differ on demographic variables and their level of trust in mainstream media, scientists and health experts, social media and family and friends. Understanding the COVID-19 vaccine attitudinal and information-seeking characteristics of these sub-publics will help inform appropriate messaging campaigns.

Retention and recruitment of general dentists in an adjunct teaching model-A pilot study.

PURPOSE/OBJECTIVES: Retention and recruitment of part time clinical adjunct faculty members in dental education is becoming increasingly difficult as dental schools come to rely on this workforce for their increased involvement in clinical education. Contributing factors include full time faculty shortage, aging workforce, practice and student debt, practice and family commitments, and financial compensation. This study attempts to ascertain barriers to teaching so appropriate strategies can be formulated to address this issue. METHODS: In the spring of 2016 an email survey was sent to current and former adjunct faculty members to ascertain demographics and retention and recruitment strategies. Descriptive analyses were completed for all variables in the sample. RESULTS: Twenty nine of forty six subjects responded to the survey with a response rate of 63%. Subjects over the age of sixty comprised 55% with only 17% being under the age of forty five. Overall family and practice commitments along with compensation were the primary barriers to teaching part time. For new dentists, student loan debt was the primary barrier to teaching. Travel to teach was also a barrier as 70% of respondents drove 200 miles or less to the dental school. CONCLUSION: The study demonstrated that the aging part time work force is a great concern and new part time clinical adjunct faculty members must be recruited. Barriers to recruitment and retention of faculty must be considered and addressed to sustain this teaching model.

Patterns of complementary and alternative medicine (CAM) use among dental patients.

OBJECTIVES: Complementary and alternative medicine (CAM) is a diverse collection of approaches used to prevent or treat diseases. The goal of this study was to examine relationships between dental patient characteristics and current usage of CAM therapies. METHODS: The CAM definition encompassed 24 therapies excluding prayer. Associations and trends in usage were assessed for gender, income, education, and age. Multivariable logistic and negative binomial models were used to identify factors impacting the use and number of CAM therapies used. RESULTS: In dental patients (n = 402), nearly 67 percent of subjects reported at least one CAM treatment. Gender was significantly associated with recent utilization of CAM, biological, manipulative (all P < 0.01), and mind-body (P = 0.04) therapies, as well as the number (P < 0.01) of therapies used. Higher education levels were significant in usage of any CAM, biological, and mind-body therapies (P < 0.01). CONCLUSION: A large proportion of dental patients reported use of CAM therapies. While CAM therapies and those who use them are diverse, given their widespread use, they clearly have potential impacts on the oral health of the public. Knowledge of the characteristics of dental patients who use CAM therapies is a first step in developing a broader understanding how CAM therapies and associated beliefs may affect oral health and public health programs.

Complementary and alternative medicine in predoctoral dental curricula: an exploratory survey of U.S. dental schools.

The purpose of this study was to identify the prevalence of complementary and alternative medicine (CAM) education in U.S. dental schools. A survey was administered via e-mail to each U.S. dental school's academic dean, and data were collected from respondents in a fillable PDF form submitted electronically to the study investigators. The survey asked respondents whether CAM was taught at the institution; if the response was yes, information was requested regarding the CAM therapies included, credentials of the instructor, number of hours taught, reason for teaching CAM, and format in which CAM was taught. Of the sixty dental schools contacted, twenty-two responded to the survey (37 percent response rate). Of these respondents, ten (45.5 percent) reported offering instruction in CAM as part of their predoctoral curricula. Herb/drug interactions were found to be taught with more frequency than any other CAM topic (in six out of the ten institutions). Limitations of the study are discussed, and suggestions for future studies are made.

Toward defining dentists' evidence-based practice: influence of decade of dental school graduation and scope of practice on implementation and perceived obstacles.

Academic dental institutions today seek to provide curricular content and learning opportunities for students to develop an essential skill set for evidence-based practice. To support that effort, studies that explore current practice patterns are valuable in identifying factors that influence the evidence-based habits and behaviors of dental school graduates. The purpose of this study was to explore the knowledge, perceptions, and behavior of private practice dentists in the state of Iowa with respect to evidence-based dentistry and to determine the influence of the dentist's education and the scope of his or her practice on those opinions and habits. A questionnaire addressing practitioners' familiarity with, understanding of, and adoption of an evidence-based philosophy of practice was mailed in September 2009 to all dentists licensed and practicing in Iowa. Questionnaires were returned by 518 practitioners, for an overall response rate of 38.4 percent. The majority of respondents reported awareness, understanding, and adoption of an evidence-based approach to their practice of dentistry. Recent graduates were more likely to report insufficient time as the primary obstacle to practicing evidence-based dentistry. Dental specialists indicated a higher level of comfort in assessing scientific information, as well as implementing current reliable, valid published research in practice, than did general practitioners.

Complementary and alternative medicine usage by patients of a dental school clinic.

This pilot study investigated the prevalence and specific reasons for usage of complementary and alternative medicine (CAM) among patients of a dental school clinic. Four hundred and two patients completed a 30-page survey on CAM usage. A higher rate of CAM usage was found in this dental school clinic population than rates previously reported in a general population. More than three-quarters (76.1%) of the respondents reported using at least one CAM treatment in the past 12 months; 93.3% reported using at least one CAM treatment at some time in their lives. High rates of chiropractic use were found in this population. Tooth pain was the most frequently reported dental condition motivating CAM use. About 10% of dental school clinic patients use topical oral herbal and/or natural products to treat dental conditions, most frequently for preventive/oral health reasons or for tooth pain.

Informational resources utilized in clinical decision making: common practices in dentistry.

This study investigated current trends of Iowa dental practitioners with regard to acquisition and utilization of scientific information resources to support decision making in the clinical practice of dentistry. A survey questionnaire regarding the utilization of various sources of information to support clinical decisions was mailed in September 2009 to all dentists licensed and practicing in the state of Iowa. Dentists appointed full-time within the University of Iowa College of Dentistry were excluded from this study. Continuing education courses were the most frequently utilized and preferred information source by respondents, followed by print journals and consultation with other health care professionals. Practice patterns according to decade of dental school graduation as well as scope of practice were noted. The results of this study demonstrate that dental practitioners utilize a variety of evidence-based and non-evidence-based information resources to support decisions in clinical practice. The habits of newer graduates vary somewhat from those of earlier graduates; the habits of specialists vary from those of general practitioners.

The use of a respiratory rate biofeedback device to reduce dental anxiety: an exploratory investigation.

Anxiety experienced by individuals visiting the dental office to receive treatment is common. Evidence has shown biofeedback to be a useful modality of treatment for numerous maladies associated with anxiety. The purpose of the current pilot study was to investigate the use of a novel biofeedback device (RESPeRATE™) to reduce patients' pre-operative general anxiety levels and consequently reduce the pain associated with dental injections. Eighty-one subjects participated in this study, forty in the experimental group and forty-one in the control group. Subjects in the experimental group used the biofeedback technique, while those in the control group were not exposed to any biofeedback. All subjects filled out a pre-injection anxiety survey, then received an inferior alveolar injection of local anesthetic. Post-injection, both groups were given an anxiety survey and asked to respond to four questions regarding the injection experience using a Visual Analog Scale (VAS). With the use of the respiratory rate biofeedback device, there was a significant reduction of negative feelings regarding the overall injection experience, as measured by a VAS. Our findings demonstrate that this novel biofeedback technique may be helpful in the amelioration of dental anxiety, and may help produce a more pleasant overall experience for the patient.

A model for overview of student learning: a matrix of educational outcomes versus methodologies.

A concise overview of an institution's aspirations for its students becomes increasingly elusive because dental education has evolving emphases on priorities like critical thinking and adapting to new technology. The purpose of this article is to offer a learner-oriented matrix that gives a focus for discussion and an overview of an institution's educational outcomes. On one axis of the matrix, common educational outcomes are listed: knowledge, technical skills, critical thinking, ethical and professional values, patient and practice management, and social responsibility awareness. On the other axis, methodologies are listed: definition, cultivation strategies, measures (summative/formative, objective/subjective), institutional coordination, and competency determination. By completing the matrix, an overview of the process by which students reach these outcomes emerges. Each institution would likely complete the matrix differently and, ideally, with active discussion. While the matrix can first be used to establish "Where are we now?" for an institution, it can also be a starting point for more extensive matrices and further discussion. Vertical and horizontal analyses of the matrix provide a unique lens for viewing the institution's learning environment.

Comparison of student productivity in four-handed clinic and regular unassisted clinic.

Although four-handed dentistry is routine in most dental practices in the United States, solo unassisted clinical practice is the norm for students at many North American dental schools. The objective of this study was to compare the clinical productivity of fourth-year dental students practicing in a four-handed model to the clinical productivity of those same fourth-year dental students practicing in a solo, unassisted mode at the University of Iowa College of Dentistry for the three academic years 2005-08. Students averaged 2.62 patient visits per day in the four-handed Dental Auxiliary Utilization (DAU) Clinic and 1.74 visits per day in the regular Family Dentistry Clinic. Charging fees that are approximately 50 percent of prevailing local private practice fees, the mean daily charges for services provided by individual students averaged $329 in the DAU Clinic and $190 in the Family Dentistry Clinic. The mean daily productivity differentials were 0.88 patient visits and $139. While students averaged 51 percent more patient visits and 75 percent higher charges daily in the DAU Clinic as compared to the regular Family Dentistry Clinic, the increased revenues might not be sufficient to offset increased expenses incurred in the four-handed clinical operation.

Correlation of quantity of dental students' clinical experiences with faculty evaluation of overall clinical competence: a twenty-two-year retrospective investigation.

The purpose of this study was to investigate the correlation between the quantity of a student's clinical experiences in the final year of dental school and the student's overall clinical competence at graduation, as evaluated by faculty at the University of Iowa College of Dentistry. Further, the authors sought to determine whether this correlation changed over time, as new generations of students come to dental school. Information including year of graduation, age at graduation, final grade in the course Clinical Competencies in Comprehensive Care, and final total Clinical Experience Units (CEUs) earned by each student in the D4 Family Dentistry Clinic was collected for 1987-2008 graduates of the University of Iowa College of Dentistry. Spearman's rank correlation coefficient (r(s)) was computed for the association of final clinical course grade and final CEU total for each graduation year. The correlation between final course grade and final CEU total was variable, ranging from moderately strong (r(s)=0.614, Class of 1991) to negligible (r(s)=-0.013, Class of 2008). This correlation generally tended to become weaker over time. The results of this study suggest that the terminal quality of a dental student's work is not solely a function of repetitions of prescribed procedures and that repetition of procedures may have even less influence on the quality of clinical performance for the new generation of dental students.

An in vitro comparison of vertical marginal gaps of CAD/CAM titanium and conventional cast restorations.

PURPOSE: To determine if there was a significant difference between the vertical marginal openings of cast restorations, computer-aided design, and computer-aided machining restorations. MATERIALS AND METHODS: Ten working dies were created from a single master die and used to fabricate ten restorations in each of the following groups: computer-aided design/computer-assisted machining (CAD/CAM), WAX/CAM, and WAX/CAST. The CAD/CAM titanium restorations were fabricated using the scanning and crown design modules of the KaVo Everest system. The WAX/CAM titanium restorations were fabricated using the double scan technique with the KaVo Everest system. The WAX/CAST high noble copings were fabricated using the conventional lost wax casting technique. The restorations were seated on the master die, and high-resolution digital photographs were made of the marginal area on all four sides. The vertical marginal opening was then measured using a calibrated digital software program. One-way ANOVA and Tukey's post hoc tests were used to determine the presence of statistically significant differences. RESULTS: The vertical margin openings were CAD/CAM: 79.43 +/- 25.46 microm; WAX/CAM: 73.12 +/- 24.15 microm; WAX/CAST: 23.91 +/- 9.80 microm. There was a statistically significant difference between the WAX/CAST group and the remaining groups. CONCLUSIONS: There was no difference between the vertical marginal gaps of the CAD/CAM and WAX/CAM. The WAX/CAST technique resulted in smaller vertical marginal gaps than either CAD/CAM or WAX/CAM.

Associations among predental credentials and measures of dental school achievement.

The purpose of this study was to investigate the associations among several dental school admission criteria and several measures of dental school achievement. Data were collected for 2000-07 University of Iowa dentistry graduates, including five specific preadmission credentials and five specific measures of dental school achievement for each student. Pearson product moment correlations or Mann-Whitney U statistics were computed for the association of each of the ten variables with the nine others. The strongest correlation observed was between predental science grade point average (GPA) and overall predental GPA. Dental Admission Test (DAT) Academic Average was very strongly correlated with DAT Total Science, and both of these were each moderately correlated with DAT Perceptual Ability, predental science GPA, and overall predental GPA. Among the measures of dental school achievement, the strongest association was observed between National Board Dental Examination (NBDE) scores and dental school GPA. These were also moderately correlated with final clinical grade. All of the measures of dental school achievement were slightly stronger for candidates who passed the Central Regional Dental Testing Service (CRDTS) examination than for those who failed that exam. Of the predental credentials considered, predental science GPA and overall predental GPA were the best predictors of dental school GPA. DAT Academic Average was the best predictor of NBDE scores. Although DAT Perceptual Ability was the best predictor of clinical competency at the time of graduation, these two variables were only weakly correlated. DAT Perceptual Ability scores and overall predental GPA were slightly higher for candidates who passed the CRDTS examination than for those who failed that exam.

Introducing dental students to clinical patient care: the Complete Denture Prosthodontics Transition Clinic.

Using complete denture treatment as an introduction to clinical patient care for dental students, the purposes of the Complete Denture Prosthodontics Transition Clinic at the University of Colorado School of Dentistry are to reduce the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience, and to encourage development of student self-confidence and skills. In the 2002 spring semester, faculty at the University of Colorado School of Dentistry initiated the Complete Denture Prosthodontics Transition Clinic for DS-II (second-year) dental students, as an introduction to clinical patient care. Each patient was assigned to a team of two dental students. Three Division of Prosthodontics faculty members staffed each clinic session, providing a student-to-faculty ratio of approximately 6.6:1 and a patient-to-faculty ratio of approximately 3.3:1. All DS-II students in the Class of 2004 delivered their first complete dentures no later than 8 months (average, 184 days) after the last day of the preclinical complete denture prosthodontics course. The time from the diagnostic appointment through the denture placement appointment averaged 39 days for patients treated in this program, compared with an average of 98 days or more for previous classes. The program was successful in achieving the goal of reducing the time lapse between the preclinical complete denture prosthodontics course and the first denture patient experience.

Predoctoral clinical curriculum models at U.S. and Canadian dental schools.

In fall 2002, the ADEA Section on Comprehensive Care and General Dentistry conducted a survey of the predoctoral clinical curriculum models at sixty-four North American dental schools. Fifty-eight percent of the schools reported that most patient care is provided in a comprehensive care clinic setting, 22 percent reported that most patient care is provided in discipline-specific settings, and 20 percent reported a hybrid of comprehensive care and discipline-specific settings. While ten Primarily Discipline-Based (PD) schools have instituted new Primarily Comprehensive Care (PCC) or Hybrid clinical curricula since 1997, one PCC school has converted to a Hybrid model, and one PCC school has converted to a PD model. PCC curriculum models were frequently associated with the following institutional factors: more densely populated metropolitan areas; private institutional sponsorship; location within a university medical center; larger class size; and more students enrolled in advanced training at the school. Curriculum factors frequently associated with PCC models included the following: increased use of simulation technology: higher proportion of clinical/teaching track faculty; higher proportion of part-time faculty; higher proportion of generalist faculty; same faculty supervising both treatment planning and patient treatment; and use of competency exams as the main requirement for completion of the curriculum.

Measurement of cadaver lumbar spine motion segment stiffness.

STUDY DESIGN: Prospective. OBJECTIVES: To measure lumbar spine motion segment stiffness and relate it to the degree of disc degeneration. SUMMARY OF BACKGROUND DATA: The association between the instability of the lumbar spine motion segment and disc degeneration remains unclear. The traditional method for determining motion segment instability at the time of decompressive surgery is a manual test performed by the surgeon. To quantify instability of the lumbar spine, a vertebrae distractor was developed in the authors' laboratory to measure motion segment stiffness by applying a defined load at a constant rate. METHODS: Lumbar stiffness was measured by subjecting cadaver lumbar spine motion segments to a constant rate flexion-traction load and recording the magnitude of the resistance to distraction versus the range of motion. Disc degeneration was measured by pressure-volume discography and by grading of disc morphology. RESULTS: Motion segment stiffness decreased with the initial stages of disc degeneration and then increased with severe disc degeneration. This measure of motion segment stiffness correlated well with a manual stiffness measure. CONCLUSIONS: The observed results follow an accepted hypothesis of motion segment instability associated with disc degeneration.

Intraoperative measurement of lumbar spine motion segment stiffness.

STUDY DESIGN: Prospective trial. OBJECTIVES: To test an intraoperative diagnostic tool to determine if it provided the surgeon with a safe, reproducible, accurate, quantitative measure of lumbar spine motion segment stability. SUMMARY OF BACKGROUND DATA: Several devices have been developed to measure motion segment stiffness, however, few have been tested intraoperatively on humans, and none, to the best of the authors' knowledge have been tested as extensively as the device described in this study. Objective criteria, such as those provided by an intraoperative gauge, can be helpful in determining when and what type of fusion of a degenerated spinal motion segment unit should be performed following decompressive surgery. METHODS: The spinal stiffness gauge, placed between spinous processes of adjacent vertebrae, applies a controlled, constant loading rate along the spine's longitudinal axis, producing a load-displacement curve from which stiffness, range of motion, and hysteresis can be computed. Measurements from this tool were then used to investigate differences in stiffness of the motion segment before and after decompressive surgery, between spine levels, and between male and female subjects. RESULTS: The spinal stiffness gauge stiffness measurements correlated with the surgeon's subjective stiffness measurements on the same motion segments. The stiffness measurements had excellent repeatability. Stiffness was dependent on the spine level, gender, and degree of disc degeneration. CONCLUSIONS: This study demonstrated the efficacy of the spinal stiffness gauge for providing an objective, quantitative, intraoperative stiffness (stability) measurement of the lumbar spine motion segment.