A conceptual model using CliftonStrengths® to support dental hygiene students' professional development.

PURPOSE: Professional development is instrumental in the ongoing success of healthcare professionals and students. The purpose of the second year of this 2-year study was to continue to apply the results from the CliftonStrengths® assessment to support entry-level dental hygiene students' professional development and to create a conceptual model for professional development in dental hygiene education. METHODS: CliftonStrengths® was incorporated into didactic and community learning experiences throughout year two of the dental hygiene curriculum. At the end of year two, focus group interviews assessed student perceptions of professional strengths based on these learning experiences. Co-investigators used a qualitative analysis software program to identify codes and themes. Investigator triangulation and member checks were used to validate responses. RESULTS: All second-year dental hygiene students (n = 32) participated in year two of the study. Two themes were identified: relevance of CliftonStrengths® and professional development. Within the theme of relevance, the subthemes of adaptability, making connections and teamwork emerged. The theme of professional development yielded three subthemes: appreciation, personal and professional identity and insight. CONCLUSION: This study demonstrated CliftonStrengths® can be used to promote professional development among dental hygiene students. As a result, a conceptual model was developed for professional development in dental hygiene education. This model can be used as a framework for teaching and to improve student learning experiences.

Prevalence of coccidioidomycosis in cystic fibrosis patients residing in Southern Arizona.

Sparse data exists about patients with cystic fibrosis (CF) and their risk of contracting coccidioidiomycosis or Valley Fever, which is highly endemic in southern Arizona. A retrospective review of medical records of 79 adult CF patients residing in Arizona was performed. Two cases only of coccidioidomycosis were documented between in the 790 patient years. However, false-positive serologies were found in 15 patients. This 10-year retrospective review of 79 adult CF patients found that there was a lower prevalence of coccidioidomycosis in CF patients compared to that of the general population of the area. LAY SUMMARY: Patients with cystic fibrosis (CF) suffer from chronic lung infection. Little is known about CF and fungal infection. Coccidioidomycosis is a fungal infection common in Arizona and this study shows a lower infection rate from Coccidioidomycosis in CF patients compared to the general population.

De novo coccidioidomycosis among solid organ transplant recipients 1 or more years after transplant.

Solid organ transplant recipients who contract coccidioidomycosis are at risk for complicated, protracted, disseminated, and severe disease. To date, no studies have described outcomes for patients who develop coccidioidomycosis only after the first posttransplant year. This study was a joint project of Mayo Clinic Hospital, Phoenix, Arizona, and the University of Arizona/Banner University Medical Center, Tucson, Arizona. We retrospectively reviewed electronic health records for patients with a history of solid organ transplant between January 1, 1998, and October 11, 2014, who developed coccidioidomycosis after the first transplant year. We identified 91 patients. Of those, 37/91 (40.7%) had pulmonary coccidioidomycosis (29/37 [78.4%] were symptomatic); and 5/91 (5.5%) had extrapulmonary disease (all were symptomatic). One patient (1.1%) died. Coccidioidomycosis was evident in 2/91 (2.2%) patients within 3 months of antirejection treatment. Many of the patients (51/91 [56.0%]) had asymptomatic coccidioidomycosis, 27 (27.9%) of whom were followed up closely but did not receive antifungal medication and had no sequelae. Although solid organ recipients taking low-level immunosuppression after the first posttransplant year appeared to have less symptomatic, disseminated, or fatal coccidioidal infection than historical cohorts, this remains an important infection with morbidity and mortality even after the first posttransplant year.

A Conceptual Model Using CliftonStrengths® to Support Dental Hygiene Students' Professional Development.

Purpose Professional development is instrumental in the ongoing success of healthcare professionals and students. The purpose of the second year of this two-year study was to continue to apply the results from the CliftonStrengths® assessment to support entry-level dental hygiene students' professional development and to create a conceptual model for professional development in dental hygiene education.Methods CliftonStrengths® were incorporated in didactic and community learning experiences throughout year two of the dental hygiene curriculum. At the end of year two, focus group interviews assessed student perceptions of professional strengths based on these learning experiences. Co-investigators used a qualitative analysis software program to identify codes and themes. Investigator triangulation and member checks were used to validate responses.Results All second-year dental hygiene students (n=32) participated in year two of the study. Two themes were identified: relevance of CliftonStrengths® and professional development. Within the theme of relevance, the subthemes of adaptability, making connections, and teamwork emerged. The theme professional development yielded three subthemes: appreciation, personal and professional identity, and insight.Conclusion This study demonstrated CliftonStrengths® can be used to promote professional development among dental hygiene students. As a result, a conceptual model was developed for professional development in dental hygiene education. This model can be used as a framework for teaching and to improve student learning experiences.

Utilizing CliftonStrengths® to Increase Professional Development in Dental Hygiene Students.

Purpose Undergraduate dental hygiene education programs may not provide sufficient training in professional development to prepare graduates to be primary health care providers. The purpose of the year one of a two-year study was to apply the results from a strengths assessment instrument to entry-level dental hygiene students' learning experiences and faculty instruction of students.Methods An exploratory research design including quantitative and qualitative methods was used among a convenience sample of entry-level dental hygiene students. A validated assessment instrument (CliftonStrengths®) was used at the beginning of the academic year to determine the professional strengths of the participants. Frequencies and percentages were used to summarize the top five strengths of each participant. Focus group interviews were conducted to assess student and faculty perceptions of professional strengths based on learning experiences at the end of the first academic year. Virtual interviews were transcribed, and the codes and themes were identified. Investigator triangulation and member checks were used to validate responses.Results Thirty-two hygiene students and 28 faculty agreed to participate in the study. The top five strengths identified for both students and faculty (n=60) were in the executing, strategic and relationship building domains. All students (n=32) participated in the focus groups and the following themes were identified: awareness, application, positive approach, successful strategies, and personal growth. Of the faculty participants (n=28), 14 participated in the focus groups. Faculty themes identified were recognition, change in perspective, personalized approach, participatory environment, and empowerment.Conclusion Results this study highlight the potential benefits of a strengths-based approach to undergraduate dental hygiene education. Helping students utilize their professional strengths in a challenging educational setting may lead to increased empowerment, professional growth and development. Further study with year two data may offer an opportunity to understand how identification of professional strengths influences students' learning experiences.

Antiretroviral Laboratory Monitoring and Implications for HIV Clinical Care in the Era of COVID-19 and Beyond.

In the era of COVID-19, providers are delaying laboratory testing in people with HIV (PWH). The purpose of this study was to examine the clinical significance of renal, liver, and lipid testing. We reviewed the charts of 261 PWH who initiated care at an academic HIV clinic between January 1, 2016 and December 21, 2018. Analysis included one-sided binomial exact tests and multiple linear, Poisson, and Beta regression models. The most common abnormality was a glomerular filtration rate (GFR) <60 mL/min (10%). Age <40 years [estimated relative rate (rr) 0.017, 95% confidence interval (CI) 0.207 to 0.494], cobicistat (rr 0.284, 95% CI 0.128 to 0.63), and tenofovir alafenamide (rr 0.295 95% CI 0.151 to 0.573) were associated with a decreased risk of GFR <60 mL/min. An increased AST and ALT ≥2 × upper limit of normal (ULN) was found in 5% and 3%, respectively. Hepatitis C and use of darunavir and lopinavir were associated with increased AST or ALT. When a GFR was <60 mL/min or an AST or ALT was ≥2 × ULN, no action was taken in 53% of cases. In 18% of cases the only intervention was repeat testing. The most common interventions after lipid results were calculation of a 10-year cardiovascular risk score (31%) and addition of a statin (18%). Taking action after lipid results was strongly associated with age ≥40 (rr 7.37, 95% CI 3.0 to 18.3). Young PWH without hepatitis C rarely have renal, liver, or lipid test results that alter clinical care. Decreased testing should be considered.

Attributes of Effective Clinical Teachers in Dental Hygiene Education.

Many health professions have identified characteristics of an effective clinical instructor and used this information to create tools to measure clinical teaching effectiveness (CTE) in their disciplines. However, minimal research has been conducted to explore the attributes of an effective clinical instructor in dental hygiene education. The aim of this study was to identify the attributes of dental hygiene clinical instructors associated with effective teaching. This study used a Delphi research design to iteratively survey an expert panel of 14 dental hygiene instructors in dental hygiene programs from 13 U.S. states in 2019. A cumulative overall response rate of 89.3% was achieved after conducting three survey rounds. The results showed statistically significant consensus on 91 CTE characteristics. Participants agreed that effective clinical instructors should possess the ability to clearly communicate, foster interpersonal relationships, encourage a climate of mutual respect, and act as good role models who are emotionally intelligent, caring, trustworthy, fair, honest, and supportive. There was also agreement that effective clinical instructors were those who created a safe learning environment centered on collaboration, motivation, guidance, and positive corrective feedback. These results were similar to those identified in other health professions. However, there is a need for dental hygiene education to develop its own CTE assessment tool for use in professional development.

Perceptions of Dental Hygienists About Thesis Completion in Graduate Education.

Few studies have been published on thesis completion experiences of master's degree students. However, for doctoral students, dissertation completion has been found to be dependent on individual, relational, and institutional factors. The aim of this study was to examine dental hygienists' perceptions of their experiences completing a thesis as a requirement for an advanced degree. A qualitative phenomenological research design was used utilizing virtual focus groups with a national purposive sample of dental hygienists (n=25) who had graduated from a degree program in which a thesis was a requirement for the degree. Data analysis used an inductive approach to identify themes using Liechty et al.'s framework of individual, relational, and institutional factors impacting completion of a dissertation. Liechty et al.'s framework is based on Vygotsky's sociocultural theory of learning. In the results, individual factors identified included family/work responsibilities, lack of understanding of the thesis process, time management, health issues, and reaching personal and professional goals. Relational factors focused primarily on positive and negative experiences with the thesis advisor/committee and support from expert peers/family. Institutional factors included the thesis structure, financial concerns, and challenges in recruiting research participants. This study found many factors influencing the thesis experience that may help guide the process in graduate degree programs. In addition, the findings suggest a need to provide mentoring and support for thesis advisors and committee members to more effectively guide students through the thesis process. Effective modifications of these may improve retention of students and facilitate timely completion of thesis research.

Bridging the Theory-Practice Gap with Dental Hygiene Instrumentation Videos.

Dental educators are challenged to bridge the theory-practice gap to enhance the educational experience and meet the diverse learning needs of students. The aim of this study was to explore dental hygiene students' perceptions of the effectiveness, appeal, and satisfaction regarding instrumentation videos as a resource to improve learning in the clinical environment. All 152 first-year students in a U.S. baccalaureate dental hygiene program at two sites in two consecutive years were invited to participate in the study. Survey questions addressed demographics, effectiveness, appeal, and satisfaction with the instrumentation videos along with open-ended questions to explore students' perceptions of the videos' value and benefits. A total of 143 students completed the survey, for a response rate of 94%. The results showed that 50% to 70% of the respondents agreed or strongly agreed with questions relating to effectiveness, appeal, and satisfaction with the videos. Most participants used the videos while practicing (83%). Students who spoke English as a second language were less likely to feel the videos were effective, found them less appealing, and were less satisfied with them (p<0.05). Participants who practiced while using the videos were more likely to report them as being effective and appealing and were more satisfied with the videos than were participants who did not practice with them (p<0.05). Thematic analysis revealed the following themes in the open comments: helpfulness of the videos in clinical practice to clarify, reinforce, and visualize skills learned. These students reported satisfaction with the instrumentation videos, suggesting these learning aids have potential value in closing the theory-practice gap in clinical dental hygiene education.

Prophylactic Antibiotics Are Not Needed Following Rattlesnake Bites.

BACKGROUND: Antibiotics are sometimes administered to victims of rattlesnake bites in the hope of preventing infections. Experts in the field recommend that prophylactic antibiotics not be used because secondary infections are rare. Current recommendations are based on a small number of studies conducted in the United States. We decided to reexamine the issue by taking advantage of a large database on snakebites in Arizona. This allowed us to determine how often prophylactic antibiotics were used and whether or not they were effective. METHODS: We obtained data from the Arizona Poison and Drug Information Center electronic medical record, Toxicall. Rattlesnake bites occurring over 18 years (1999-2016) were analyzed according to the descriptors: infection, pus, isolation of bacteria, and antibiotic use. RESULTS: There were 2748 evaluable patients identified as having rattlesnake bites. The mean number of bite victims was 153 per year. Most (72%) were male. Their ages ranged from 8 months to 91 years. Prophylactic antibiotics were administered to 120 of 2748 (4.4%) victims. There were 27 postbite infections (0.98%) but no deaths. Victims sometimes manipulated the wound sites. Microorganisms were isolated from only 9 patients. Only a Salmonella sp. was of certain reptilian origin; the others were likely of human origin. CONCLUSIONS: This large study supports recommendations that prophylactic antibiotics not be used following rattlesnake bites in the United States. The incidence of postbite infections was low, <1%. All but 1 of the bacteria isolated from the wounds were common inhabitants of human skin and not found in oral secretions of rattlesnakes.

Ex Vivo Cytokine Release, Determined by a Multiplex Cytokine Assay, in Response to Coccidioidal Antigen Stimulation of Whole Blood among Subjects with Recently Diagnosed Primary Pulmonary Coccidioidomycosis.

The elements of the cellular immune response in human coccidioidomycosis remain undefined. We examined the ex vivo release of an array of inflammatory proteins in response to incubation with a coccidioidal antigen preparation to ascertain which of these might be associated with diagnosis and outcome. Patients with a recent diagnosis of primary pulmonary coccidioidomycosis and a control group of healthy subjects were studied. Blood samples were incubated for 18 h with T27K, a soluble coccidioidal preparation containing multiple glycosylated antigens, and the supernatant was assayed for inflammatory proteins using the multiplex Luminex system. The presentation and course of illness were compared to the levels of the inflammatory proteins. Among the 31 subjects studied, the median time from diagnosis to assay was 15 days. Of the 30 inflammatory proteins measured, the levels of only 7 proteins, granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-1 receptor alpha (IL-1RA), interleukin-1ß (IL-1ß), interferon gamma (IFN-γ), IL-2, IL-13, and tumor necrosis factor alpha (TNF-α), were more than 10-fold above the levels seen without antigen stimulation. The levels of IFN-γ and IL-2 were significantly elevated in those subjects not receiving triazole antifungal therapy compared to those who were receiving triazole antifungal therapy. While the levels of IL-1RA were nonspecifically elevated, elevated levels of IL-13 were seen only in those with active pulmonary coccidioidomycosis. Only six cytokines were specifically increased in subjects with recently diagnosed primary pulmonary coccidioidomycosis. While IFN-γ, IL-2, and TNF-α have been previously noted, the finding of elevated levels of the innate cytokines GM-CSF and IL-1ß could suggest that these, as well as IL-13, are early and specific markers for pulmonary coccidioidomycosis.IMPORTANCE Coccidioidomycosis, commonly known as Valley fever, is a common pneumonia in the southwestern United States. In this paper, we examined the release of 30 inflammatory proteins in whole-blood samples obtained from persons with coccidioidal pneumonia after the blood samples were incubated with a preparation made from the causative fungus, Coccidioides We found that six of these proteins, all cytokines, were specifically released in high concentrations in these patients. Three of the cytokines were seen very early in disease, and an assay for all six might serve as a marker for the early diagnosis of Valley fever.

Knowledge, attitude, and practices associated with the diagnosis and management of skin and soft-tissue infections among medical students, residents, and attending physicians.

Skin and soft-tissue infections (SSTIs) are commonly encountered by medical students, residents, and trainees. The Infectious Diseases Society of America (IDSA) has updated its recommendations regarding SSTI diagnosis and management in June 2014. We assessed knowledge, attitude, and practices toward diagnosis and management of SSTIs using an online survey. We disseminated the survey to medical students, residents, and attending physicians practicing in family and internal medicine department at a university-based hospital. A total of 103 surveys were completed out of 121 sent (85.1%) between July 2015 and March 2016. There were nine medical questions in the survey. The mean of correct answers was 4.5/9 ± 2.0. Medical knowledge correlated with the level of education (P < 0.001) but not with subspecialty (P = 0.97). Around 35% were familiar with the updated IDSA guidelines pertaining to SSTIs. The majority (85%) responded that the hospital staff would benefit from additional training and 75% agreed that more antibiotic stewardship education is needed. Our study shows that there are significant opportunities for development among students and physicians who encounter SSTIs.