Breast Radiation Therapy Survivorship and Cancer Support Groups: an Opportunity for Community Engagement and Education Through the Addressing Breast Cancer Dermatologic Side Effects (ABCDEs) Program.

Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer deaths in women in the USA. To serve under-insured breast cancer patients in South Texas, we designed a patient education program to improve health literacy of secondary dermatologic changes after completing radiation therapy. A needs assessment survey was distributed to better understand the patients' stage of treatment, experiences with radiation-induced dermatologic side effects, and over-the-counter skin products and home remedies used. Of the 33 patients that participated in this program, nearly all patients (93.94%, n = 31) are either currently undergoing treatment or have completed treatment. Of the 31 individuals, 74.19% of patients (n = 23) have completed treatment at least 9-12 months ago, 22.58% (n = 7) are currently receiving chemotherapy, and 3.23% (n = 1) are currently undergoing radiation therapy. Among the dermatologic side effects, patients experienced changes to skin color, redness, and burns/burning sensation at the greatest severity. The top products used by survey participants were prescription-strength topical corticosteroids (65.63%) followed by oral analgesics (28.13%) and compression sleeves (25.00%). Aloe vera (15.63%) was the most used complementary and alternative therapeutic treatment. By surveying experiences of radiation-induced dermatologic side effects in predominantly under-resourced and minority communities, we can better tailor patient education programs to reflect patients' experiences. Overall, this program can enhance clinicians' insight on under-resourced patient experiences to improve health literacy and dispel common misconceptions surrounding breast cancer treatment, management, and survivorship.

Membrane technology for treating decanted oily wastewater from marine oil spill operations: Comparison between membrane filtration and membrane bioreactor.

Canadian oil spill response regulations require collection of all liquids from a response operation, this involves many vessels and frequent trips to shore to dispose of collected liquids, which mainly comprise of water. Onsite treatment of decanted oily seawater would benefit operations by addressing vessel storage and trip frequency issues. Membrane technology has proven effective at treating oily wastewater from various industries; therefore, is a good candidate for onsite treatment of wastewater generated from response operations. In this study, oily seawater treatment efficiency of a pilot-scale physical membrane filtration and a bench-scale membrane bioreactor (MBR) were compared. Three main parameters were considered, total petroleum hydrocarbon, petroleum hydrocarbon fractions, and polycyclic aromatic hydrocarbons. 99.1 % and 98.2 % TPH removal efficiency were achieved by MBR (93.1 ppm initial oil concentration) and membrane filtration (28.3 ppm initial oil concentration), respectively. The MBR showed more promise than membrane filtration for onsite treatment of decanted wastewater.

The role of anterior insula-brainstem projections and alpha-1 noradrenergic receptors for compulsion-like and alcohol-only drinking.

Compulsion-like alcohol drinking (CLAD), where consumption continues despite negative consequences, is a major obstacle to treating alcohol use disorder. The locus coeruleus area in the brainstem and norepinephrine receptor (NER) signaling in forebrain cortical regions have been implicated in adaptive responding under stress, which is conceptually similar to compulsion-like responding (adaptive responding despite the presence of stress or conflict). Thus, we examined whether anterior insula (aINS)-to-brainstem connections and alpha-1 NERs regulated compulsion-like intake and alcohol-only drinking (AOD). Halorhodopsin inhibition of aINS-brainstem significantly reduced CLAD, with no effect on alcohol-only or saccharin intake, suggesting a specific aINS-brainstem role in aversion-resistant drinking. In contrast, prazosin inhibition of alpha-1 NERs systemically reduced both CLAD and AOD. Similar to systemic inhibition, intra-aINS alpha-1-NER antagonism reduced both CLAD and AOD. Global aINS inhibition with GABAR agonists also strongly reduced both CLAD and AOD, without impacting saccharin intake or locomotion, while aINS inhibition of calcium-permeable AMPARs (with NASPM) reduced CLAD without impacting AOD. Finally, prazosin inhibition of CLAD and AOD was not correlated with each other, systemically or within aINS, suggesting the possibility that different aINS pathways regulate CLAD versus AOD, which will require further study to definitively address. Together, our results provide important new information showing that some aINS pathways (aINS-brainstem and NASPM-sensitive) specifically regulate compulsion-like alcohol consumption, while aINS more generally may contain parallel pathways promoting CLAD versus AOD. These findings also support the importance of the adaptive stress response system for multiple forms of alcohol drinking.

Differential importance of nucleus accumbens Ox1Rs and AMPARs for female and male mouse binge alcohol drinking.

Alcohol use disorder exhausts substantial social and economic costs, with recent dramatic increases in female problem drinking. Thus, it is critically important to understand signaling differences underlying alcohol consumption across the sexes. Orexin-1 receptors (Ox1Rs) can strongly promote motivated behavior, and we previously identified Ox1Rs within nucleus accumbens shell (shell) as crucial for driving binge intake in higher-drinking male mice. Here, shell Ox1R inhibition did not alter female mouse alcohol drinking, unlike in males. Also, lower dose systemic Ox1R inhibition reduced compulsion-like alcohol intake in both sexes, indicating that female Ox1Rs can drive some aspects of pathological consumption, and higher doses of systemic Ox1R inhibition (which might have more off-target effects) reduced binge drinking in both sexes. In contrast to shell Ox1Rs, inhibiting shell calcium-permeable AMPA receptors (CP-AMPARs) strongly reduced alcohol drinking in both sexes, which was specific to alcohol since this did not reduce saccharin intake in either sex. Our results together suggest that the shell critically regulates binge drinking in both sexes, with shell CP-AMPARs supporting intake in both sexes, while shell Ox1Rs drove drinking only in males. Our findings provide important new information about sex-specific and -general mechanisms that promote binge alcohol intake and possible targeted therapeutic interventions.

Psychosocial Intervention for Youth With High Externalizing Behaviors and Aggression Is Associated With Improvement in Impulsivity and Brain Gray Matter Volume Changes.

Background: Stop, Now And Plan (SNAP) is a cognitive behavioral-based psychosocial intervention that has a strong evidence base for treating youth with high aggression and externalizing behaviors, many of whom have disruptive behavior disorders. In a pre-post design, we tested whether SNAP could improve externalizing behaviors, assessed by the parent-rated Child Behavior Checklist (CBCL) and also improve behavioral measures of impulsivity in children with high aggression and impulsivity. We then investigated whether any improvement in externalizing behavior or impulsivity was associated with gray matter volume (GMV) changes assessed using structural magnetic resonance imaging (sMRI). We also recruited typically developing youth who were assessed twice without undergoing the SNAP intervention. Methods: Ten children who were participating in SNAP treatment completed the entire study protocol. CBCL measures, behavioral measures of impulsivity, and sMRI scanning was conducted pre-SNAP and then 13 weeks later post-SNAP. Twelve healthy controls also completed the study; they were rated on the CBCL, performed the same behavioral measure of impulsivity, and underwent sMRI twice, separated by 13 weeks. They did not receive the SNAP intervention. Result: At baseline, SNAP participants had higher CBCL scores and performed worse on the impulsivity task compared with the healthy controls. At the second visit, SNAP participants still had higher scores on the CBCL compared with normally-developing controls, but their performance on the impulsivity task had improved to the point where their results were indistinguishable from the healthy controls. Structural magnetic resonance imaging in the SNAP participants further revealed that improvements in impulsivity were associated with GMV changes in the frontotemporal region. Conclusion: These results suggest that SNAP led to improvement in behavioral measures of impulsivity in a cohort of boys with high externalizing behavior. Improvement in impulsivity was also associated with increased GMV changes. The mechanism behind these brain changes is unknown but could relate to cognitive behavioral therapy and contingency management interventions, important components of SNAP, that target frontotemporal brain regions. Clinically, this study offers new evidence for the potential targeting of brain regions by non-invasive modalities, such as repetitive transcranial magnetic stimulation, to improve externalizing behavior and impulsivity.

Differences and similarities in lying frequency, moral evaluations, and beliefs about lying among children with and without conduct problems.

The current study examined whether children (6-12 years old) with varying levels of conduct problems differ from those without conduct problems in three key areas: their perceptions of how often other people tell lies, their moral evaluations of truth- and lie-telling in different social contexts, and how often they tell antisocial and prosocial (i.e., "white") lies. Using a continuous measurement of conduct problems, we found that children with greater conduct problems believed that other people tell lies more often compared with children with fewer conduct problems. However, unexpectedly, children's moral evaluations of truth- and lie-telling in antisocial and prosocial contexts did not significantly differ based on conduct problems. Using parent-report methods, we found that children tell more antisocial lies with increasing severity of conduct problems, but they tell prosocial lies at a similar rate regardless of conduct problems. Finally, after grouping children based on level of conduct problems (none, low, or high), we found that children in the group with no conduct problems told more prosocial lies than antisocial lies, but the reverse was found for children in the group with high conduct problems. These findings highlight the importance of considering social context when examining the development of lying in children experiencing conduct problems.

Nursing Administrators' Views on Oral Health in Long-Term Care Facilities: An exploratory study.

Purpose: To explore the knowledge, attitudes, and practices of supervising nurse administrators (SNAs) regarding the oral care provided to long-term care facility (LTCF) residents and the role of dental professionals in those facilities.Methods: The investigators of this study partnered with the National Association of Nursing Administrators to send this cross-sectional study consisting of a 35-item electronic survey to its members whose email addresses were in their database. Online software tabulated responses and calculated frequencies (percentages) of responses for each survey item.Results: Of the 2,359 potential participants, 171 (n=171) completed the survey for a 7% response rate. Only 25% of the respondents were familiar with the expertise of dental hygienists (DHs), however once informed, the majority were interested in having DHs perform oral health staff trainings, oral screenings, and dental referrals and initiate fluoride varnish programs. Most respondents correctly answered the oral health-related knowledge items, understood that oral health is important to general health, but reported that the LTCF residents' oral health was only "good" or "fair." Fewer than half, (48%) of the SNAs were "very satisfied" with the quality of oral care provided to the residents. While more than half reported that they had no dentist on staff or on-site dental equipment, 77% reported that they would consider on-site mobile oral care services. Oral health training for staff was provided primarily by registered nurses, however only 32% reported including identification of dental caries as part of the in-service training.Conclusion: This exploratory study lays the foundation for more extensive research investigating various strategies to improve the oral health of LTCF residents, including increased collaboration between DHs and SNAs.

The Alarming Rate of Major Disruptive Events in Primary Care Practices in Oklahoma.

PURPOSE: In primary care practices, sustainability of performance improvements and ability to deliver continuity of care to patients can be adversely affected by major disruptive events, such as relocations and changes in ownership, clinicians, and key staff. This study documented the rates of major disruptive events in a cohort of primary care practices in Oklahoma. METHODS: Practices were included if they had existed for 1 year before enrollment and remained in the project for at least 1 year after enrollment. Practice characteristics for 208 practices and major disruptive events during the preenrollment year were collected by survey. Postenrollment major disruptive events were prospectively collected by practice facilitators. We compiled frequency statistics and conducted bivariate analyses for each data set. RESULTS: Of 208 eligible practices, 81 (39%) were clinician owned, and 51 (25%) were health system owned. One hundred nine practices (52%) were in nonmetropolitan counties. One hundred seventy-five major disruptive events occurred in 120 (58%) practices during the preenrollment year, with 42 practices having experienced multiple events. During the first year of the project, 89 major disruptive events occurred in 67 (32%) practices, with 20 practices experiencing multiple events. The major disruptive events reported most often during both periods were loss of personnel and implementation of electronic health records and billing systems. Practice size was associated with occurrence of these events. CONCLUSIONS: During a 2-year period, major disruptive events occurred at an alarming rate, adversely affecting quality improvement efforts. Most reported events involved losses of clinicians and staff. More research is needed to identify and address the root causes of these events.

Conducting evaluation research with children exposed to violence: How technological innovations in methodologies and data collection may enhance the process.

Research and program evaluation processes that engage children and youth are becoming much more common due to influences from children's rights and the acknowledgement that children have the capacity to contribute to research, both as participants and co-researchers (Roberts, 2017). Recent technological advances in the form of tablet and internet-based applications have provided researchers with additional methodological tools to better capture the voices and experiences of children and their caregivers (Livingstone & Blum-Ross, 2017). However, little has been written on the ways in which these new technological advances can improve research experiences for children who have been exposed to intimate partner and family violence, as well as other forms of traumatic experiences. This paper provides a review of current literature and a case study example of how one children's mental health agency has implemented tablet-based data collection procedures.

ST product characteristics and relationships with perceptions and behaviors among rural adolescent males: a qualitative study.

Although smoking declines in the United States, the prevalence of male adolescent smokeless tobacco (ST; moist snuff and chewing tobacco) use remains unchanged. ST product characteristics, such as flavoring, packaging, and branding, could influence adolescents' ST initiation and continued use. This qualitative study examines the potential role of product characteristics in shaping ST-related perceptions and behaviors among rural adolescent males. Semi-structured individual interviews were conducted at three California rural high schools. ST users were asked about their experiences and perceptions related to product characteristics. Interviews were transcribed, coded, and analyzed using a general inductive approach. Participants associated flavored ST with appealing non-tobacco products, such as chewing gum and alcohol. Availability of different varieties and flavors stimulated interest and curiosity in sampling or switching between ST products. Time-limited promotional flavors and packaging also enhanced product appeal. Adolescent ST users preferred certain brands based on perceived brand features and perceived nicotine content, associating higher-strength brands as better suited for experienced ST users. Brand preferences frequently reflected perceived ST brand popularity within peer groups. Based on these observations, potential ST regulation and health education campaigns to address misconceptions about ST characteristics could influence adolescents' ST-related perceptions and reduce ST use among this vulnerable population.

Perceptions Related to Use of Electronic Cigarettes among California College Students.

Purpose: To assess electronic cigarette (e-cigarette) use, factors associated with use, and exposure to e-cigarette-related information from health professionals in a sample of college students attending a public university in northern California, using a web-based survey.Methods: In this quantitative cross-sectional study, survey items assessed e-cigarette use, perceived risks and benefits, and exposure to e-cigarette-related information from health professionals and were pilot tested for feasibility and acceptability. Participants were recruited from three courses taught at a northern California public university and were given an electronic link to the survey with informed consent information. Frequency distributions and cross-tabulations were calculated for survey responses. The Mann-Whitney U-test was used to compare differences in perceived risks, benefits, and social consequences between ever-users and never-users.Results: Ninety-one individuals completed the web-based survey. Among respondents, 89% were aware of e-cigarettes, 49% were ever-users, and 10% were current (past-30 day) e-cigarette users. Compared to e-cigarette ever-users, never-users perceived a higher chance of experiencing 5 out of 8 physical and social risks from e-cigarette use (P<0.05). E-cigarettes, marijuana, and hookah were perceived to be less harmful to health than cigarettes. Few participants reported receiving counseling regarding e-cigarettes from health professionals, including dental hygienists. Counseling about the adverse health effects of cigarettes was more common in this study population.Conclusion: Dental hygienists must stay current with the scientific evidence related to e-cigarette use and incorporate such information into their client tobacco-related counseling. Addressing the perceived physical and social risks associated with e-cigarette use when counseling college students may deter them from initiating or continuing e-cigarette use.

Smokeless Tobacco Decision-Making Among Rural Adolescent Males in California.

Smokeless tobacco (ST) use among US high school males living in rural areas exceeds national levels. Subgroups at heightened risk of ST use have been identified, but less is known regarding ST decision-making within high-risk groups. The study objective was to describe rural adolescent males' perceived ST acceptability, health risks, and social implications and how those perceptions differ between ST users and never-users. Semi-structured individual interviews were conducted with a purposeful sample of 55 male students (32 ST ever-users) at three rural California high schools. Interviews were audio recorded and professionally transcribed. Investigators collaboratively developed a codebook based on thematic content and then independently coded transcripts, reconvening frequently to achieve consensus. Coded text was systematically organized into themes following a general inductive approach. ST users and non-users shared multiple ST-related perceptions, including: that ST is a common, normative way of life in rural "country" culture among certain groups; that ST use conveys oral health risks; and that the decision to use (or not to use) is rooted in personal choice. ST users' and never-users' perceptions differed regarding the immediacy, severity, and inevitability of health risks, particularly relative to cigarette smoking. Other differences included perceived parental permissiveness and the expected social benefits of ST use, such as peer acceptance and conveying maturity. Within this population of rural male adolescents, ST users emphasized the social benefits of ST use, while acknowledging but discounting health risks. Differences and similarities in tobacco perceptions among adolescents living in similar environments may inform effective health communication.

Effect of adsorbent addition on floc formation and clarification.

Adding adsorbent into the coagulation process is an emerging treatment solution for targeting hard-to-remove dissolved organic compounds from both drinking water and industrial wastewater. The impact of adding powdered activated carbon (PAC) or organoclay (OC) adsorbents with ferric chloride (FeCl3) coagulant was investigated in terms of potential changes to the coagulated flocs formed with respect to size, structure, and breakage and regrowth properties. The ability of dissolved air flotation (DAF) and sedimentation (SED) clarification processes to remove hybrid adsorbent-coagulant flocs was also evaluated through clarified water quality analysis of samples collected in bench-scale jar test experiments. The jar tests were conducted using both a synthetic fresh water and oily wastewater test water spiked with dissolved aromatic compounds phenol and naphthalene. Results of the study demonstrated that addition of adsorbent reduced the median coagulated floc size by up to 50% but did not affect floc strength or regrowth potential after application of high shear. Experimental results in fresh water demonstrated that sedimentation was more effective than DAF for clarification of both FeCl3-PAC and FeCl3-OC floc aggregates. However, experimental tests performed on the synthetic oily wastewater showed that coagulant-adsorbent floc aggregates were effectively removed with both DAF and sedimentation treatment, with lower residual turbidity achieved in clarified water samples than with coagulation treatment alone. Addition of OC or PAC into the coagulation process resulted in removals of over half, or nearly all of the dissolved aromatics, respectively.

The Dental Hygiene Scholarly Identity and Roadblocks to Achieving It.

PURPOSE: Progress in the dental hygiene discipline is predicated on the development of a community of scholars with a dental hygiene scholarly identity who explore questions central to the art and science of dental hygiene and in doing so create conceptual models to expand the discipline's structural hierarchy of knowledge. Graduate dental hygiene education is challenged to develop programs that stimulate and nurture dental hygiene scholars as well as scientists. The need for the development of dental hygiene doctoral education is critical to strengthening our discipline's scholarly identity.The authors explore the tyranny of the "Queen-Bee" and the paralyzing nature of the "Imposter Syndrome," as pathologic non-productive behavior patterns that create roadblocks not only for the individual to move forward, but also for the discipline as a whole. Recognizing and eliminating these maladaptive syndromes will empower the individual as well as strengthen the collective to build a strong dental hygiene scholarly identity. The significance of dynamic "Follower-ship" as an often undervalued concept is offered as an antidote to overcome roadblocks and energize the collective's value of a scholarly identity for dental hygiene.

The changing tobacco landscape: What dental professionals need to know.

BACKGROUND: Tobacco products in the United States and the patterns of tobacco use are changing. Although cigarette smoking prevalence has declined, dental professionals are likely to encounter substantial numbers of patients who have tried and are continuing to use new and alternative tobacco products, including cigars, water pipes (hookahs), and electronic cigarettes, as well as conventional and new smokeless tobacco products. METHODS: The authors reviewed conventional and new tobacco products in the United States, their adverse oral and systemic health effects, and their prevalence of use. RESULTS: Tobacco products other than cigarettes account for a substantial portion of tobacco use. For this reason, tobacco-use prevention and cessation counseling provided by dental health care professionals must address all tobacco products, including cigarettes, cigars, water pipes, and electronic cigarettes, as well as conventional and new smokeless tobacco products. Cigarette smoking and smokeless tobacco use are associated with immediate and long-term adverse health effects, including nicotine addiction, oral and systemic disease, and death. Novel products may attract new tobacco users, potentially leading to addiction that results in enduring tobacco product use and associated adverse health effects. CONCLUSIONS: This critical review of conventional, new, and emerging tobacco products presents information that dental professionals can use in providing tobacco-related counseling to patients who use or who are at risk for using tobacco products. PRACTICAL IMPLICATIONS: It is essential that dental professionals are knowledgeable about tobacco products and are able to answer patients' questions and provide them with evidence-based tobacco-related counseling. This information may prevent patients from initiating use or help reduce or cease use to avoid immediate and long-term adverse health effects, including nicotine addiction, oral and systemic disease, and death.

Forensic assessment of polycyclic aromatic hydrocarbons at the former Sydney Tar Ponds and surrounding environment using fingerprint techniques.

Polycyclic aromatic hydrocarbons (PAHs) were assessed spatially and temporally within and adjacent to a former coking and steel manufacturing facility in Sydney, Nova Scotia, Canada. Concentrations of PAHs were measured in surface soils, marine and estuary sediments prior to and during remediation of the Sydney Tar Ponds (STPs) site which was contaminated by nearly a century of coking and steel production. Previous studies identified PAHs in surficial marine sediments within Sydney Harbour, which were considered to be derived from STP discharges. Numerous PAH fingerprint techniques (diagnostic ratios, principal component analysis, quantitative and qualitative analysis) were applied to soil and sediment samples from the STPs and surrounding area to identify common source apportionment of PAHs. Results indicate coal combustion (from historical residential, commercial and industrial uses) and coal handling (from historic on-site stockpiling and current coal transfer and shipment facilities) are likely the principal source of PAHs found in urban soils and marine sediments, consistent with current and historical activities near these sites. However, PAH fingerprints associated with STP sediments correlated poorly with those of urban soils and marine sediments, but were similar to coal tar, historically consistent with by-products produced by the former coking operations. This study suggests PAH contamination of Sydney Harbour sediments and urban soils is largely unrelated to historic coking operations or recent remediation of the STPs site, but rather a legacy of extensive use of coal for a variety of activities.

Oral Health Prevention and Toddler Well-Child Care: Routine Integration in a Safety Net System.

BACKGROUND AND OBJECTIVE: Applying topical fluoride varnish (FV) to young children's teeth is an effective therapeutic strategy for preventing early childhood caries (ECC). In 2008, the pediatricians at Contra Costa Regional Medical Center and Health Centers became concerned that our low-income pediatric patients had high rates of ECC and very limited access to dental care. We formed an interdisciplinary safety net-academic partnership with the University of California San Francisco to implement routine FV applications, along with oral health education, screening, and referral during well-child exams for children aged 1 to 5 years. METHODS: Over 3 years, the team developed clinical policies, educational materials, billing, and support systems to facilitate implementation in the primary care setting. A pilot study was performed in 2 health centers; improvements to the implementation plan were made. A team of local providers and academic partners performed system-wide didactic and hands-on trainings and spread this intervention to the remaining 6 health centers. Continued improvement strategies and provider feedback were pursued with each measurement cycle. RESULTS: In August 2012, 95% of all children aged 1 to 5 years who were seen for well-child checkups received a FV application and oral health education during their primary care well visit. Repeat measurement in April 2014 showed a sustained rate of 97% application of FV for children in this age group seen for well-child visits. CONCLUSIONS: With institutional commitment and an academic partnership, a safety net institution can integrate routine FV applications and oral health interventions into well-child visits to reduce ECC.

Perceptions of California Dental Hygienists Regarding Mandatory Continued Competence Requirements as a Condition of License Renewal.

Purpose: To determine the perceptions of California dental hygienists (DHs) regarding mandatory continued competence requirements (MCCRs) as a condition for license renewal.Methods: A quantitative cross-sectional survey was distributed through email by the California Dental Hygienists' Association (CDHA). The CDHA agreed to send a link to the survey and informed consent information to DHs whose email addresses were in the CDHA database. The online survey consisted of 19 items. All survey responses were analyzed using frequency distributions for categorical variables and means for continuous variables. Chi-square tests assessed associations between variables and differences between groups. The Wilcoxon signed rank test assessed relationships between perceptions and support of MCCRs for license renewal.Results: Almost all (93%) believed that they have remained competent to deliver care since licensure. Over half agreed that continued competence should be verified throughout ones' professional career (53%). Most (81%) agreed that continued competence is important for patient safety and well-being. Less than half (47%) supported MCCRs as a condition of license renewal; however, 51% of those who agreed that competence is important for patient safety and well-being and 67% of those who agreed with verification of competence were in support of MCCRs.Conclusion: While California DHs agreed that continued competence is important for patient safety and well-being and verification of competence is important, less than half supported MCCRs. Prior to instituting mandate for license renewal in California, continued competence and methods to ensure continued competence throughout ones' career should be defined.

Oral Health Care of Vietnamese Adolescents: A Qualitative Study of Perceptions and Practices.

PURPOSE: To explore the oral health perceptions and practices of Vietnamese adolescents 13 to 17 years old in San Jose, Calif. METHODS: A purposeful sample of 10 Vietnamese parents with adolescent children were recruited at a Temple in San Jose, Calif. After gaining parental consent and adolescent assent, Vietnamese adolescents participated in an audio-taped, 20 to 30 minute, individual, semi-structured interview in English to explore their perceptions about oral health. Interview data were transcribed verbatim. All statements related to each question were identified, and similar statements were grouped into categories. RESULTS: Ten adolescents participated in the study. All reported tooth appearance as the most important reason for oral care, and that oral health, diet and general health were related. All were concerned about dental pain. Of the respondents, 9 believed that having good teeth would give them more confidence, and help them find jobs and romantic partners, while 2 did not follow recommended oral hygiene routines or recognize early signs of disease. Seven participants favored U.S. dentists over Vietnamese dentists. Frequently reported barriers to seeking dental care were fear of dental treatment (n=7) and inability to pay for dental care (n=6). CONCLUSION: When educating Vietnamese adolescents, dental hygienists need to highlight availability of pain control, encourage better performance of personal oral hygiene and recommend dental clinics with sliding fee scales to low-income families. This approach to oral health education may enhance dental health and seeking of regular dental visits.

California Dental Hygiene Educators' Perceptions of an Application of the ADHA Advanced Dental Hygiene Practitioner (ADHP) Model in Medical Settings.

PURPOSE: To assess California dental hygiene educators' perceptions of an application of the American Dental Hygienists' Association's (ADHA) advanced dental hygiene practitioner model (ADHP) in medical settings where the advanced dental hygiene practitioner collaborates in medical settings with other health professionals to meet clients' oral health needs. METHODS: In 2014, 30 directors of California dental hygiene programs were contacted to participate in and distribute an online survey to their faculty. In order to capture non-respondents, 2 follow-up e-mails were sent. Descriptive analysis and cross-tabulations were analyzed using the online survey software program, Qualtrics™. RESULTS: The educator response rate was 18% (70/387). Nearly 90% of respondents supported the proposed application of the ADHA ADHP model and believed it would increase access to care and reduce oral health disparities. They also agreed with most of the proposed services, target populations and workplace settings. Slightly over half believed a master's degree was the appropriate educational level needed. CONCLUSION: Among California dental hygiene educators responding to this survey, there was strong support for the proposed application of the ADHA model in medical settings. More research is needed among a larger sample of dental hygiene educators and clinicians, as well as among other health professionals such as physicians, nurses and dentists.