Does Catastrophizing Predict Response to Treatment in Patients With Vestibular Disorders? A Prospective Cohort Study.

OBJECTIVE: Determine levels of catastrophizing in patients with vestibular disorders and prospectively evaluate their relationship with patient-reported outcome measures. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary care neurotology vestibular disorders clinic. PATIENTS: Adult patients with various vestibular disorders. INTERVENTIONS: Patients were given the Dizziness Handicap Inventory (DHI) and the Dizziness Catastrophizing Scale (DCS) at a baseline visit and follow-up visit after treatment. MAIN OUTCOME MEASURES: Correlation studies were used to determine the relationships between DHI and DCS. Multivariable linear regression was performed to determine the relationship between DCS and DHI change with treatment, accounting for demographic variables. RESULTS: Forty-six subjects completed both the DHI and the DCS before and after treatment. Patients with higher baseline DCS scores had higher baseline DHI scores ( p < 0.001). There was a significant improvement in both DHI score ( p < 0.001) and DCS ( p < 0.001) at follow-up. Patients who had reduction in DCS scores during were more likely to show reduction in DHI scores ( p < 0.001). A subset of patients had a mindfulness-based stress reduction program included in their treatment. These patients had a greater reduction in both DCS and DHI scores at follow-up compared with those who received other treatments. CONCLUSIONS: Catastrophizing is associated with higher pretreatment DHI scores and worse treatment outcomes. Addressing dizziness catastrophizing may help improve vestibular outcomes.

Trends in Behavioral Sciences Education in Dental Schools, 1926 to 2016.

This article outlines the journey of behavioral sciences education from a multidisciplinary array of topics to a discipline with a name, core identity, and mission in dental schools' curricula. While not exhaustive, it covers pivotal events from the time of the Gies report in 1926 to the present. Strengths and weaknesses of current behavioral sciences instruction in dental schools are discussed, along with identification of future opportunities and potential threats. Suggestions for future directions for behavioral sciences and new roles for behavioral sciences faculty in dental schools are proposed. This article was written as part of the project "Advancing Dental Education in the 21st Century."

A novel approach for effective integration of new faculty leadership.

PURPOSE: We report on an accelerated and effective way of assimilating a new leader into a team at a large academic dental school department. METHODS: At University of California, San Francisco (UCSF), a new Chair was recruited through a national search to lead its largest department in the School of Dentistry. Two months after arrival, the new Chair embarked on a process of leadership assimilation among her executive team, facilitated by a professional consultant. Within four weeks, team members participated in one-on-one interviews with the professional facilitator consultant and then completed the leadership assimilation questionnaire and returned it electronically to the facilitator. The facilitator then summarized all answers into themes and met with the team members without the Chair to debrief. Thereafter, the facilitator met with the Chair to discuss the major themes. Next, the Chair met with the team members in a facilitated session to discuss the results and negotiate a path forward. RESULTS: Approximately half of the feedback described the "how" of leadership: comments on communication, building relationships, building trust, and understanding UCSF history. The remaining half described the "what": comments on vision, strategy, and operations. Team members indicated that the first debriefing session was helpful to alleviate initial anxiety and to start building team spirit. The session with the Chair was perceived as open and fruitful in which team members were able to express their concerns and hopes for the Department, while the Chair showed commitment to the team and the communication process. CONCLUSION: Leader assimilation allows teams to share their expectations and anxieties with the new leader early in the relationship in an open way, before new habits and beliefs are formed. Conversely, for the leader, it effectively and efficiently allows a window into the team members' thinking at a critical time period when otherwise first impressions occur. With a safe space created for open communication, the process allowed siloed individual division leaders to move toward a cohesive group while at the same time solidifying a commitment to the success of the new leader.

Dental health literacy and California's clarion call.

Demographic changes in California require a multicultural paradigm shift in oral health care. The shift encompasses attention to health literacy in all forms of communication: signage, oral and written communication, consent forms, postop instructions, and patient education materials. California dentists may find it necessary to adapt their practices to reflect community demographics and health literacy needs. This article provides a toolbox of recommendations to address these needs.

The hierarchical cluster analysis of oral health attitudes and behaviour using the Hiroshima University--Dental Behavioural Inventory (HU-DBI) among final year dental students in 17 countries.

OBJECTIVE: To explore and describe international oral health attitudes/ behaviours among final year dental students. METHODS: Validated translated versions of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) questionnaire were administered to 1,096 final-year dental students in 17 countries. Hierarchical cluster analysis was conducted within the data to detect patterns and groupings. RESULTS: The overall response rate was 72%. The cluster analysis identified two main groups among the countries. Group 1 consisted of twelve countries: one Oceanic (Australia), one Middle-Eastern (Israel), seven European (Northern Ireland, England, Finland, Greece, Germany, Italy, and France) and three Asian (Korea, Thailand and Malaysia) countries. Group 2 consisted of five countries: one South American (Brazil), one European (Belgium) and three Asian (China, Indonesia and Japan) countries. The percentages of 'agree' responses in three HU-DBI questionnaire items were significantly higher in Group 2 than in Group 1. They include: "I worry about the colour of my teeth."; "I have noticed some white sticky deposits on my teeth."; and "I am bothered by the colour of my gums." CONCLUSION: Grouping the countries into international clusters yielded useful information for dentistry and dental education.

Better understanding your patient from a psychological perspective: early identification of problem behaviors affecting the dental office.

Early assessment of problem patient behaviors can be a complex and time-consuming task. These negative behaviors can frequently interrupt and misdirect treatment goals. Most dentists, due to private practice demands, do not have the time and training to assess these behaviors. The emotional stability of each patient is taken for granted. Subtle negative behavioral clues can be detected during medical history taking and the initial patient interview. Current prescription medications can also provide clues concerning past or current treatment for depression, anxiety, psychiatric problems, or substance abuse. The burden of properly assessing behaviors and their impact on dental treatment rests on the dentist's acumen in history taking. All practices have some difficult patients. It is important that dentists recognize patients who have special needs such as those with high anxiety, dependency, depression, obsessional somatic focus, or prior negative dental experiences.