Innovative Model for Promoting Interprofessional Dialogue and Action Across Healthcare Stakeholders: The ASAHP Collaborative Stakeholder Engagement Model.

BACKGROUND: The ASAHP established the Clinical Education Task Force (CETF) in 2017 to identify strategies for clinical education. Implementing the CETF recommendations requires continuous collaboration between healthcare industry and academic partners. AIM: ASAHP Regional Summits were planned and implemented to offer an active learning environment for stakeholders, strengthen translational skills, identify gaps in interprofessional collaborative practice (IPC), and create lasting networking opportunities. METHODS: The Regional Summits were organized in a standard format across three hub sites. During a virtual "Harvest" session all sites were video linked to continue the local dialogue on a national level. Outcomes were analyzed using mixed methods, including pre- and post-session surveys quantitative methods. Notes from table discussions were analyzed using a qualitative approach. RESULTS: Qualitative results offered a rich dataset from the industry and academic perspective to provide a better understanding how the CETF recommendations are being understood. Ideas for future action and partnerships were identified. Various regions contributed insights that reflect unique environments. CONCLUSIONS: The ASAHP Collaborative Stakeholder Engagement Model offers a robust and reproducible active adult learning model for IPC that can lead to change and continued engagement. These findings identify opportunities for deepening the connections made through regional hubs.

Implementation of Virtual Interprofessional Observed Structured Clinical Encounters (OSCEs): A Pilot Study.

This pilot study was designed to investigate the feasibility of incorporating validated McMaster-Ottawa Team Observed Structured Clinical Encounters (TOSCEs) as a behavioral assessment in an interprofessional education (IPE) program using Zoom Communications. First- and second-year students from 11 health professional programs (e.g., audiology, dental hygiene, graduate psychology, healthcare administration and leadership, occupational therapy, pharmacy, physical therapy and athletic training, and physician assistant studies) at a single university participated and were assessed on the four Interprofessional Education Collaborative (IPEC) core competencies. Students completed three McMaster-Ottawa TOSCE stations (20 mins per station), followed by a large group debriefing for all participants to discuss the process and provide feed¬back. A validated, abbreviated version of the McMaster-Ottawa scoring rubric was utilized by faculty observers, and individual student scores were submitted using a Google form. Kruskal Wallis tests were used to analyze student performance related to the IPEC core competencies to deter¬mine whether significant differences existed between mean performance scores as compared by year in program (first year vs. second), and between case types. Kruskal-Wallis tests suggested differences on the collaborative patient performance item between the pediatric and diabetes cases only. There were no significant differences in performance across academic year in health professional programs, p > 0.05. Qualitative feedback highlighted the timely telehealth approach to collaborative practice and effective delivery of the interprofessional (IP) OSCE event across all of the student focus groups. The virtual IP OSCEs were feasible and recommended as a valuable IPE initiative at our institution.

Verbal Arguments That Precede Dating Violence Perpetration: A Qualitative Analysis.

Verbal arguments often precede physical dating violence perpetration, and research is needed to better understand the content and evolution of arguments in dating relationships in order to develop more targeted dating violence prevention programming. This multisite project qualitatively investigated the content of verbal arguments preceding physical dating violence perpetration reported by 30 undergraduate students. Participants completed a semi-structured interview inquiring about events preceding participants' most recent dating violence episode. Interviews were analyzed using a thematic analysis approach. Verbal arguments often preceded participants' most recent episode of physical dating violence perpetration, with a wide range of argument topics reported, including jealousy, partner noncompliance, and substance use. Findings highlight the need for research to better understand the context of verbal arguments that precipitate dating violence perpetration.

Dental education 2026: A scenario exploration.

PURPOSE: The purpose of the following papers is to explore plausible alternative futures for dental education. The COVID-19 pandemic, challenges emerging from racism in the US, and social unrest were the precipitating factors leading to this consideration of academic dentistry in approximately 5 years. METHODS: In 2020-2021, five teams of six individual followed a seven-step process to develop five different scenarios of dental education in 2026. Four of these scenarios are constructed by considering a range of uncertainties associated with economic sustainability and educational innovation. A fifth scenario describes the optimal case for dental education's role should another pandemic occur. RESULTS: Each scenario is presented as a narrative in three parts: scenario highlights (summary), life in the scenario (fictional case), and scenario details (a description of significant factors within the envisioned future of the scenario). As a strategic tool, these scenarios will assist leaders, institutions, and stakeholders to anticipate and prepare for different futures, identify key indicators that a particular future is emerging, and guide decision-making to create the most desirable future in a changing environment. CONCLUSION: Institutions are encouraged to incorporate these scenarios into their strategic and contingency planning efforts and to use them to generate dialogue during faculty development initiatives. This study provides institutions with a process and model they can follow to create scenarios at the institutional level. The final paper in this collection is a guide that provides ideas and instructions for using the scenarios in curricular and extracurricular activities with faculty members and students.

Emotion Dysregulation as a Moderator of the Association Between Relationship Dependency and Female-Perpetrated Dating Aggression.

The dependency-possessiveness model proposes that individuals who are highly dependent on their intimate partner and fear partner abandonment, particularly among those with emotion dysregulation problems, may be at heightened risk for intimate partner aggression (IPA) perpetration. Despite prior research establishing a link between relationship dependency and male IPA perpetration, it is unknown whether this association extends to female-perpetrated aggression, occurs in dating relationships, and is moderated by emotion dysregulation. Thus, the purpose of the current study was to investigate the association between relationship dependency and female-perpetrated dating aggression and determine if emotion dysregulation moderated this hypothesized relationship. Female undergraduate students (N = 119) completed measures assessing relationship dependency, emotion dysregulation, and female-perpetrated physical and psychological dating aggression as part of a larger study investigating the context of dating aggression episodes. Anxious attachment was significantly correlated with female-perpetrated psychological and physical dating aggression. Regression analyses indicated a significant interaction between the Spouse-Specific Dependency Scale [SSDS] Anxious Attachment subscale and emotion dysregulation predicting female-perpetrated physical dating aggression, suggesting moderation. There was a positive association between anxious attachment relationship dependency and female-perpetrated physical dating aggression at high levels of emotion dysregulation. A significant interaction was also found between the SSDS Emotional Dependency subscale and emotion dysregulation predicting female-perpetrated physical dating aggression, such that among those with low scores in emotion dysregulation, there was a positive relationship between emotional dependency and female-perpetrated physical dating aggression. Findings suggest that the ability to regulate emotions may play an important role in the association between relationship dependency and female-perpetrated dating aggression.

Can interprofessional case conferences effectively teach interprofessional core competencies? A case study.

BACKGROUND: The establishment of interprofessional education (IPE) as an effective method for training future health care providers, the subsequent establishment of IPE requirements in accreditation standards, and the challenges to integrating IPE into professional-centric curricula have created an environment that encourages opportunity for innovation and collaboration in curriculum design. INTERPROFESSIONAL EDUCATION ACTIVITY: Interprofessional Education Collaborative (IPEC) Core Competencies were integrated into an Interprofessional Case Conference (ICC) model that included six annual case conferences involving students from eight health professions across multiple campuses. Students worked in groups of eight with no more than two students from each profession per group. Interprofessional teams facilitated live progressive cases consisting of iterative guided student discussion alternating with group problem solving, followed by "talk-show style" reports. A retrospective pre-post study design using the validated IPEC Competency Self-Assessment V3 and Student Perspective of Interprofessional Clinical Education tools assessed student perspectives of the ICC model. The online survey was sent to participants who attended at least one ICC in 2015-2016 and 2016-2017. DISCUSSION: Pre-/post-data was available from 94 students. Results revealed modest, but significant, score changes across both instruments, confirming the value of IPE and the ICC training model. IMPLICATIONS: The ICC formula allowed flexibility in applying IPE, resolved scheduling and resources challenges, complemented other IPE programming, and assisted in meeting pharmacy accreditation requirements and the diverse IPE needs of health professions education. The model is flexible, inexpensive, and could be readily replicated at other institutions.

Genital Reconstructive Surgery in Male to Female Transgender Patients: A Systematic Review of Primary Surgical Techniques, Complication Profiles, and Functional Outcomes from 1950 to Present Day.

CONTEXT: Genital reconstructive surgery (GRS) is a necessary part of transitioning for many transwomen, and there is evidence of positive effects on a person's well-being and sexual function. Surgical techniques have evolved, from pursuing aesthetic outcome to now functional outcome with natal females as the standard. OBJECTIVE: To systematically review the evidence, identifying the surgical techniques used in primary GRS, their complications, functional outcomes, and the tools used to assess them. EVIDENCE ACQUISITION: The clinical question was designed using the standard PICOS format. The search complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 statement and was performed by two independent reviewers. EVIDENCE SYNTHESIS: Europe, USA, and Thailand favour the penoscrotal technique for vaginoplasty, whereas in the UK, the penile inversion (PI) technique predominates. Primary vaginoplasty using a segment of bowel is less common, and all three techniques have comparable rates of intraoperative rectal injury. The incidence of rectovaginal fistula is reportedly higher in the PI technique. Wound haematoma and vaginal prolapse rates are comparable. Higher rates of clitoral necrosis, urethral meatal stenosis, and wound infection are reported in PI. However, the ability to orgasm, ability to have penetrative sexual intercourse, and satisfaction with aesthetic result are better with PI. CONCLUSIONS: The evidence for GRS complications and functional outcomes is of low level. Standardised nomenclature reporting of adverse events and robust patient-reported outcome measures (PROMs) are lacking. PROMs are a powerful assessment tool, and standardised definitions of adverse events and functional outcomes should be a priority of future research. PATIENT SUMMARY: We looked at all studies published on genital reconstructive surgery from 1950 to the present day. We assessed each surgical technique and their associated complication rates, sexual and urinary function outcomes, and how they were reported. We found the evidence to be low and weak. We suggest more robust ways of reporting complications, and the impact on patients' quality of life should be investigated.

The Role of Yoga in Treating Stress-Related Symptoms in Dental Hygiene Students.

CONTEXT: Research has provided evidence for yoga's effectiveness in the prevention and treatment of pain and stress, both of which have been implicated as significant negative moderators of student performance and experience. AIMS: This study investigated the feasibility and preliminary impact of a 10-week yoga intervention with dental hygiene students to reduce perceptions of stress and stress-related symptoms. SETTINGS AND DESIGN: Students self-selected into a yoga treatment versus control condition. They completed stress and pain measures at four time points during and after the intervention or control period of 10-weeks. METHODS: Participants were students enrolled in a dental hygiene program. All 77 participants completed a 10-week study, self-selecting into an intervention or control group. They completed three self-report questionnaires assessing pain and stress, administered at baseline, mid-point, postintervention, and two follow-ups. The 10-week yoga intervention consisted of 10 90-min yoga sessions that provided check-ins, breathing exercises, sequences of postures, relaxation exercises, and closing meditations. STATISTICAL ANALYSIS USED: Independent samples t-tests were used to compare perceived stress levels of participants in the control versus treatment groups. Paired t-test was used to assess differences in stress-related symptom levels across time. RESULTS: Results suggested that a yoga intervention is feasible for this group and that active yoga practice can lower perceived stress across multiple domains and across time. CONCLUSIONS: A specially adapted and designed 10-week yoga protocol appears to be an accessible option for dental hygiene programs that seek to support their students in improving overall wellbeing.

Consensual Sexting among College Students: The Interplay of Coercion and Intimate Partner Aggression in Perceived Consequences of Sexting.

Recent empirical data suggests that the majority of adolescents and emerging adults utilize digital technology to engage with texting and social media on a daily basis, with many using these mediums to engage in sexting (sending sexual texts, pictures, or videos via digital mediums). While research in the last decade has disproportionately focused on the potential risk factors and negative consequences associated with sexting, the data are limited by failing to differentiate consensual from non-consensual sexting and account for potential influences of intimate partner aggression (IPA) and sexting coercion in these contexts. In the current study, we assessed the positive and negative consequences associated with sexting, using behavioral theory as a framework, to determine the relationship between an individual's personal history of IPA victimization and the perceived consequences. Undergraduate students (N = 536) who reported consensual sexting completed a series of measures examining their most recent sexting experience, including perceived sexting consequences, and their history of sexting coercion and IPA. Results suggested that those reporting a history of any type of IPA victimization endorsed more negative reinforcing consequences after sending a sext, and those with a history of physical or sexual IPA victimization endorsed more punishing consequences after sending a sext than those without such history. Additionally, experience with IPA was found to be positively correlated with perceived pressure/coercion to send a sext. The implications of these data for research, policy, prevention, and intervention are explored.

Mental Health and Self-Care Practices Among Dental Hygienists.

Purpose: Occupational stress and burn-out among dental hygienists may produce a decrease in overall mental health and well-being. The purpose of this study was to determine prevalence of mental health concerns as well as perceived stressors and self-care strategies among dental hygienists in Oregon.Methods: Dental hygienists belonging to the Oregon Dental Hygienists' Association were invited to participate in an electronic survey. The validated and pilot tested-survey consisted of 28 items that addressed experiences with stress, mental health issues and coping mechanisms. Descriptive and inferential statistics were used to analyze the data.Results: Of the email invitations that were successfully delivered (n=251), 83 dental hygienists volunteered to participate (n=83), for a 33% response rate. Difficulty maintaining work-life balance (35%, n=28), dysfunctional work teams (34%, n=28), and not enough time in the work schedule (65%, n=54) were the most common stressors. Respondents who worked ≥20 hours per week were more likely to attribute their daily stress primarily or entirely to work (p=0.009). Self-care methods included exercise, quiet time, spending time with loved ones, and self-care activities. Only 21% of respondents (n=17) reported that they received information or training on stress management and or burn-out in as part of their dental hygiene education.Conclusion: Symptoms linked to depression and anxiety are common among dental hygienists in Oregon. Stress management education and training should be incorporated in dental hygiene educational programs to prepare graduates to effectively manage the stressors that may lead to burn-out. Additional research should be conducted on a national level to gain a more representative sample.

Novel cytokinetic ring components drive negative feedback in cortical contractility.

Actomyosin cortical contractility drives many cell shape changes including cytokinetic furrowing. While positive regulation of contractility is well characterized, counterbalancing negative regulation and mechanical brakes are less well understood. The small GTPase RhoA is a central regulator, activating cortical actomyosin contractility during cytokinesis and other events. Here we report how two novel cytokinetic ring components, GCK-1 (germinal center kinase-1) and CCM-3 (cerebral cavernous malformations-3), participate in a negative feedback loop among RhoA and its cytoskeletal effectors to inhibit contractility. GCK-1 and CCM-3 are recruited by active RhoA and anillin to the cytokinetic ring, where they in turn limit RhoA activity and contractility. This is evidenced by increased RhoA activity, anillin and nonmuscle myosin II in the cytokinetic ring, and faster cytokinetic furrowing, following depletion of GCK-1 or CCM-3. GCK-1 or CCM-3 depletion also reduced RGA-3 levels in pulses and increased baseline RhoA activity and pulsed contractility during zygote polarization. Together, our results suggest that GCK-1 and CCM-3 regulate cortical actomyosin contractility via negative feedback. These findings have implications for the molecular and cellular mechanisms of cerebral cavernous malformation pathologies.

Measuring the Efficacy of a Foundational Interprofessional Education Course Using the Attitudes Towards Health Care Teams Scale.

BACKGROUND: Interprofessional education (IPE) has been widely embraced over the past several years, in a variety of ways among different institutions. Due to heterogeneity of IPE programming, it has been challenging to determine the efficacy of pre-professional IPE across the field. However, individual institutions need to assess efficacy of their own IPE programming. The purpose of this study was to assess whether the interprofessional competence course (IPC) at Pacific University was effective as determined by changes in pre- to post-course scores on the Attitudes Towards Health Care Teams Scale (ATHCTS). METHODS: First-year students in the College of Health Professions completed the ATHCTS on the first and last days of the IPC course. Descriptive and inferential analyses were completed using SPSS. RESULTS: Student cohorts from both 2016 (n=423) and 2017 (n=445) demonstrated significant improvements in scores on the ATHCTS (p<0.01). Changes in attitudes differed as a function of gender, with men demonstrating a larger improvement (p=0.013). Changes in attitudes did not differ as a function of professional program. CONCLUSIONS: The IPC course demonstrated effective content delivery as measured by changes in the ATHCTS scores.

Focused Multisensory Anatomy Observation and Drawing for Enhancing Social Learning and Three-Dimensional Spatial Understanding.

The concept that multisensory observation and drawing can be effective for enhancing anatomy learning is supported by pedagogic research and theory, and theories of drawing. A haptico-visual observation and drawing (HVOD) process has been previously introduced to support understanding of the three-dimensional (3D) spatial form of anatomical structures. The HVOD process involves exploration of 3D anatomy with the combined use of touch and sight, and the simultaneous act of making graphite marks on paper which correspond to the anatomy under observation. Findings from a previous study suggest that HVOD can increase perceptual understanding of anatomy through memorization and recall of the 3D form of observed structures. Here, additional pedagogic and cognitive underpinnings are presented to further demonstrate how and why HVOD can be effective for anatomy learning. Delivery of a HVOD workshop is described as a detailed guide for instructors, and themes arising from a phenomenological study of educator experiences of the HVOD process are presented. Findings indicate that HVOD can provide an engaging approach for the spatial exploration of anatomy within a supportive social learning environment, but also requires modification for effective curricular integration. Consequently, based on the most effective research-informed, theoretical, and logistical elements of art-based approaches in anatomy learning, including the framework provided by the observe-reflect-draw-edit-repeat (ORDER) method, an optimized "ORDER Touch" observation and drawing process has been developed. This is with the aim of providing a widely accessible resource for supporting social learning and 3D spatial understanding of anatomy, in addition to improving specific anatomical knowledge.

Corrigendum: Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Gender Non-conforming Adults: Comparative Levels and a Proposed Mediational Model.

[This corrects the article DOI: 10.3389/fpsyg.2018.02692.].

Opinions on Dental Therapists: A comparison of dentists and dental hygienists in the Pacific Northwest.

Purpose: As the United States continues to face increasing demands for oral health care, many states are examining alternative provider models as well as the role the dental hygienist (DH) can play in meeting access to care needs. The purpose of this study was to assess the opinions of dentists and DHs about incorporating a dental therapist (DT) into a regional dental group (RDG) located in the Pacific Northwest.Methods: Cross-sectional, validated electronic surveys were sent to the dentists (n=220) and DHs (n=187) employed by a RDG. Survey items included open and close ended questions and Likert scale items. Descriptive statistics were used to analyze the data.Results: Responses were received from 38% of the dentists (n= 84) and 46% of the DHs surveyed (n=86). Dentists and DHs differed significantly in their opinions of the need for a DT midlevel provider, the level of supervision needed, scope of practice, and appropriate tuition for DT education programs (p<0.001). Three-fourths of the DH respondents indicated that they were very or somewhat interested in becoming a DT. A majority of dentists (58%) and DHs (76%) were open to having a DT as part of their RDG (p=0.017).Conclusion: Although dentists and DHs differed significantly in their opinions regarding the dental therapy midlevel provider, the majority of dentists and DHs surveyed were open to having a DT as part of their team within the RDG.

Supplemental Oxygen Does Not Influence Self-selected Work Rate at Moderate Altitude.

INTRODUCTION: It is well known that supplemental oxygen can increase aerobic power output during high-intensity and/or maximal efforts at moderate altitude, yet the effects on self-selected work rate during lower-intensity, submaximal exercise are unknown. We reasoned that if the degree of arterial oxygen saturation (SaO2) influences teleoanticipatory regulation of power output, supplemental oxygen given at moderate altitude would increase average power output during exercise performed at self-selected work rates corresponding to RPE 9 (very light) and 13 (somewhat hard). METHODS: Twenty-three subjects (17 males, 6 females) completed one familiarization [fraction of inspired O2 (FIO2) = 0.209] and two blinded, experimental trials (FIO2 = 0.209 and FIO2 = 0.267). In each trial, subjects self-regulated their work rate on a cycle ergometer to maintain RPE 9 for 5 min and RPE 13 for 10 min, before performing an incremental step test to exhaustion (25 W·min). Oxygen consumption (V˙O2) and SaO2 via pulse oximetry (SpO2) were continuously monitored. Subjects were asked to guess the experimental condition after each stage of the protocol. RESULTS: Supplemental oxygen increased SpO2 throughout exercise (~4%; P < 0.001) and was associated with greater peak power output (4% ± 4%; P < 0.001) and V˙O2 (5% ± 10%; P = 0.010) during the incremental test, but did not increase average power output selected during exercise at RPE 9 (P = 0.235) or 13 (P = 0.992). Subjects were unable to perceive the difference in FIO2 at any stage (P > 0.14). CONCLUSIONS: Small increases in inspired oxygen concentration at moderate altitude are imperceptible and do not appear to influence selection of submaximal work rates at RPE ≤ 13.

Empirical Studies Addressing the Opioid Epidemic: An Urgent Call for Research.

Opioid misuse has become one of the most pressing public health problems facing the country. In this article, we briefly review literature regarding the opioid epidemic in the United States and the negative consequences of opioid use disorder. We provide information regarding treatment and relapse using a variety of intervention approaches. We call for research on people with opioid use disorder that can contribute to a variety of areas: improving medication-assisted treatment, addressing chronic pain, examination of adjunctive behavioral interventions, overdose, high risk behaviors and infections, pregnancy, diverse populations, and other psychological factors. Collectively addressing these crucial areas of research will advance the field and help alleviate suffering and prevent death from opioid use disorder.

Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model.

In this study we sought to compare eating disorder attitudes and behaviors, and proneness to an eating disorder ("ED proneness"), between gay men, lesbian women, and transgender and non-conforming (TGNC) adults. A further aim was to identify and compare risk and protective factors, and examine a mediational model based on the interpersonal theory of eating disorders (IPT-ED), whereby the association between interpersonal factors and ED proneness would be mediated by psychological constructs pertaining to the self and negative affect. Data was obtained from a larger national study of health risk and protective factors among sexual minority and gender diverse populations. The sample included 97 gay men, 82 lesbian women, and 138 TGNC adults. Participants completed the National College Health Assessment, Eating Disorders Screen for Primary Care, Patient Health Questionnaire Depression scale, Generalized Anxiety Disorder 7 scale, Self-Compassion Scale-Short Form, Negative Social Exchange subscale of the Multidimensional Health Profile, Interpersonal Needs Questionnaire, and Perceived Stigma Scale. There was a significant difference between groups in ED proneness, with lesbian women (66.7%) having a significantly higher percentage than gay men (47.6%). There was also a significant difference between groups in weight-based self-worth, with the lowest percentage in gay men (63%) and the highest percentage in lesbian women (82%), as well as dissatisfaction with eating patterns, with the highest percentage in TGNC adults (69.8%) and the lowest percentage in gay men (47.7%). There was a low percentage of inappropriate compensatory behaviors, with no significant difference between groups. Logistic regression analyses showed that the predictor variables of ED proneness were depression, perceived stigma, and self-compassion in gay men; depression in lesbian women; and self-compassion in the TGNC adults. Mediation analyses showed that thwarted belongingness (i.e., an unmet to belong) and perceived stigma had an indirect association with ED proneness that was mediated by self-compassion and depression (for perceived stigma alone) in gay men, depression in lesbian women, and self-compassion in TGNC adults. The interpersonal theory of eating disorders therefore extends to sexual minority and gender diverse populations; however, the results suggest a broadening of theoretical models and intervention programs to include the role of stigma and self-compassion.