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Objectives: Pre-doctoral dental programs must provide opportunities for students to become proficient in self-assessment, communication skills, health literacy, and cultural competence, essential for independent unsupervised practice. This study aimed to assess how student learning through a classroom education service-learning program addresses the Commission on Dental Accreditation (CODA) standards 2-11 and 2-17; specifically through the examination of self-assessment, communication skills, health literacy, and cultural competence., Methods: This 2022 retrospective mixed methods cohort study examined unstructured faculty comments on drafted lesson plans and structured evaluations of classroom education service-learning rehearsal sessions. A random sample of faculty comments from three academic years, 2018, 2019, and 2020, were deidentified and analyzed by five researchers for emerging themes using NVivo. Quantitative data from rehearsal presentations were analyzed with descriptive statistics to assess the concordance of self and faculty feedback on specific evaluation criteria., Results: Six major themes from faculty lesson plan feedback emerged: knowledge, professionalism, communication, presentation skills, cultural competence, and program logistics. Concordance between faculty feedback and student self-assessment ranged from 83% to 92.4% across all evaluation criteria over the 3 years: spoke clearly and confidently at the right pace, provided accurate dental terminology and facts, used grade-appropriate language, provided clear instructions to follow, appeared enthusiastic throughout the rehearsal presentation, and designed a well thought out lesson plan that will engage children for the entire presentation., Conclusion: Findings support the classroom education service-learning program as a framework to provide opportunities for student self-assessment and feedback on communication skills, health literacy, and cultural competence aligned with CODA standards 2-11 and 2-17., (© 2024 American Dental Education Association.)

Introduction: In 2015, the National Institute of Dental and Craniofacial Research (NIDCR) launched the Multidisciplinary Collaborative Research Consortium to Reduce Oral Health Disparities in Children, supporting four randomized trials testing strategies to improve preventive care. A Coordinating Center provides scientific expertise, data acquisition and quality assurance services, safety monitoring, and final analysis-ready datasets. This paper describes the trials' economic analysis strategies, placing these strategies within the broader context of contemporary economic analysis methods., Methods: The Coordinating Center established a Cost Collaborative Working Group to share information from the four trials about the components of their economic analyses. Study teams indicated data sources for their economic analysis using a set of structured tables. The Group meets regularly to share progress, discuss challenges, and coordinate analytic approaches., Results: All four trials will calculate incremental cost-effectiveness ratios; two will also conduct cost-utility analyses using proxy diseases to estimate health state utilities. Each trial will consider at least two perspectives. Key process measures include dental services provided to child participants. The non-preference-weighted Early Childhood Oral Health Impact Scale (ECOHIS) will measure oral health-related quality of life. All trials are measuring training, implementation, personnel and supervision, service, supplies, and equipment costs., Conclusions: Consistent with best practices, all four trials have integrated economic analysis during their planning stages. This effort is critical since poor quality or absence of essential data can limit retrospective analysis. Integrating economic analysis into oral health preventive intervention research can provide guidance to clinicians and practices, payers, and policymakers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Spetz, Rose, Kahn, Lin, Levy, Pugach, Hyde, Borrelli, Henshaw, Martin, Nelson, Ramos-Gomez and Gansky.)

Background: Tooth brushing is effective in preventing early childhood caries. However, it is unclear how children's and caregiver's tooth brushing are reciprocally related., Purpose: The current study investigated whether the longitudinal relationships between children and caregiver tooth brushing are moderated by a caregiver-targeted child oral health intervention and caregiver depression., Methods: Secondary analysis of a randomized clinical trial that tested whether caregiver-targeted oral health text messages (OHT) outperformed child wellness text messages (CWT) on pediatric dental caries and oral health behaviors (n = 754, mean child age = 2.9 years, 56.2% Black, 68.3%

Oral health is an essential part of healthy aging and very little data exists around the disease burden for older adults in a long-term care setting. The aim of this scoping review was to estimate the disease burden of dental caries, periodontal disease, and tooth loss among older adults in Long-Term Care (LTC). This scoping review was conducted in accordance with the Joanna Briggs Institute methodology. A detailed strategy was used to conduct a comprehensive search of electronic databases: PubMed, Embase, and Dentistry and Oral Sciences Source (DOSS). The Rayyan AI platform was used to screen abstracts for assessment by one of five co-investigators. Results indicate that only one in three might have a functional dentition upon entry into LTC, and among those who are dentate, most might expect to develop at least one new coronal and one new root caries lesion each year. There is a need to better document the disease experiences of this group to tailor approaches to care that might reduce the avoidable suffering as a result of dental caries and periodontal disease.

Objective: Oral health self-efficacy is a modifiable determinant of early childhood caries, which is one of the most prevalent childhood diseases. Yet, two common measures of self-efficacy (i.e., context-specific and behavior-specific) lack validation and clarity in the prediction of children's oral health behaviors. This study examined the psychometric properties of two caregiver oral health self-efficacy measures and investigated the predictive ability and age-varying effects of caregiver oral health self-efficacy on child oral health behaviors., Method: In this secondary data analysis of caregiver-child dyads ( n = 754, M child age = 2.4, 56.2% Black or African American, 68.3% below poverty level), caregivers reported their oral health self-efficacy and their child's tooth brushing frequency, diet, and sugar-sweetened beverage (SSB) consumption at baseline and 4, 12, and 24 months. Psychometrics were examined with confirmatory factor analyses (CFAs) and the predictive ability and age-varying effects of caregiver self-efficacy on child oral health behaviors were examined with time-varying effect models (TVEMs)., Results: The context- and behavior-specific oral health self-efficacy CFA models indicated mixed model fit. In the predictive TVEM models, greater behavior-specific, but not context-, oral health self-efficacy predicted greater child tooth brushing across all ages. Greater context-specific oral health self-efficacy predicted healthier child diet throughout childhood, but greater behavior-specific self-efficacy only predicted healthier child diet in older children. Greater behavior-specific self-efficacy predicted lower SSB consumption throughout childhood while greater context-specific self-efficacy only predicted lower SSB consumption in younger children., Conclusions: Both caregiver oral health self-efficacy measures were psychometrically comparable and differentially predicted oral health behaviors across varying childhood ages. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Oral health behaviour change interventions are gaining momentum on a global scale. After lagging behind other disciplines, oral health behaviour change is becoming an area of fast and important development. Theories used in medicine and healthcare more generally are now being applied to oral health behaviour change with varying results. Despite the importance of using theories when designing and developing interventions, the variety and variation of theories available to choose from create a series of dilemmas and potential hazards. Some theories, like the COM-B (Capability, Opportunity, Motivation-Behaviour) model, and frameworks, like the Behaviour Change Wheel might represent areas of opportunity for oral health behaviour change interventions with careful consideration vital. Different methodological approaches to intervention development are actively utilized in oral health with a wide host of potential opportunities. The issue of co-designing and co-developing interventions with intended users and stakeholders from the start is an important component for successful and effective interventions, one that oral health behaviour change interventions need to consistently implement. Oral health behaviour change interventions are utilizing technology-based approaches as a major vehicle for intervention delivery and, innovative solutions are implemented across a wide host of oral health behaviour change interventions. With multiple options for designing, developing, and delivering interventions, careful selection of appropriate, user-inclusive, and adaptable approaches is essential. With a lot of available information and evidence from other disciplines, oral health behaviour change interventions need to reflect on lessons learned in other fields whilst also maximizing the potential of the wide variety of theories, frameworks, methodologies, and techniques available at present., (© 2023 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Objectives: The importance of tackling ongoing dental health inequities, observed both within and across countries, cannot be overstated. Alarmingly, health inequities in some areas are widening, resulting in an urgent need to act. The objective of this commentary is to explore oral health inequities through the lens of behavioral science and discuss adapting evidence based interventions for populations experiencing health inequities., Method/results: The first section of this paper aims to describe the role of health disparities and inequities within oral health, with a specific focus on behaviours. The determinants, from upstream to downstream, and the interplay between these levels of intervention are discussed. This is followed by an overview of oral health promotion interventions, again with a focus on behaviours, which could potentially improve oral health while also taking into account oral health inequities. It is essential to translate evidence-based interventions (EBIs) to populations that have the greatest burden of disease. The second section of this paper discusses the rationale for cultural adaption of EBIs, criteria to justify EBIs and considers different cultural adaptation strategies necessary for the development and testing of effective, engaging, equitable and culturally relevant interventions., Conclusions: We conclude with future directions for the development of theory-based multi-level interventions, guided by extent evidence-based interventions, and transdisciplinary approaches to science and key stakeholders such as patients, providers and payers., (© 2023 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Background: Successful medical-dental integration is key to achieving children's health equity. In 2015, a community health center (CHC) in Boston, Massachusetts, implemented a model of interdisciplinary care in a nationwide pilot. Based on the Oral Health Delivery Framework, pediatricians were trained to assess dental caries risk and apply fluoride varnish. They were trained to offer education materials to patients, incorporate oral health assessment in pediatric practice, and document preventive dental care in the electronic health record. This study assessed the level of medical-dental integration achieved by the pilot and maintained over 2 years after program implementation., Methods: Deidentified data were provided by the CHC on all well-child visits during 2014 to 2018 for children 72 months or younger, including appointment dates, age, ethnicity, race, insurance status, and outcomes of interest (ie, whether a dental assessment was performed and whether fluoride varnish was applied). Outcomes were stratified by visit year to allow pilot (2015-2016) outcomes to be compared to pre-pilot (2014) and post-pilot (2017-2018) outcomes. Descriptive statistics were used to summarize the data., Results: Pediatricians performed fluoride varnish applications and dental assessments in 25% and 0% of visits, respectively, at baseline; in 50.2% and 49.4% of visits, respectively, at the pilot's end; and in 56.7% and 57.3% of visits, respectively, 2 years post-pilot., Conclusions: The proportion of well-child visits during which pediatricians integrated oral health preventive measures increased by roughly 25% to 50% from baseline (2014) to the end of the pilot (2016) and by at least 5% from 2016 to 2018. The success of this medical-dental integration pilot underscores the need for broader implementation of interprofessional education and practice to promote children's health equity., Competing Interests: The author(s) had no conflicts of interest to disclose., (Copyright 2022 American Medical Association. All Rights Reserved.)

Background: Options for patients with ventricular tachycardia (VT) refractory to antiarrhythmic drugs and/or catheter ablation remain limited. Stereotactic radiotherapy has been described as a novel treatment option., Methods: Seven patients with recurrent refractory VT, deemed high risk for either first time or redo invasive catheter ablation, were treated across three UK centres with non-invasive cardiac stereotactic ablative radiotherapy (SABR). Prior catheter ablation data and non-invasive mapping were combined with cross-sectional imaging to generate radiotherapy plans with aim to deliver a single 25 Gy treatment. Shared planning and treatment guidelines and prospective peer review were used., Results: Acute suppression of VT was seen in all seven patients. For five patients with at least 6 months follow-up, overall reduction in VT burden was 85%. No high-grade radiotherapy treatment-related side effects were documented. Three deaths (two early, one late) occurred due to heart failure., Conclusions: Cardiac SABR showed reasonable VT suppression in a high-risk population where conventional treatment had failed., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This paper is aimed mainly at Human Factors and Ergonomics (HFE) practitioners. It addresses the sustainability of communities, since without them there is no real human future. It also fits current concerns about climate change and general sustainability. However, our understanding of the characteristics of sustainable communities is still insufficient, as is evidenced by the different perspectives extant in the HFE literature. This paper provides a further perspective based on systems ergonomics, intended both to extend our socio-technical understanding and to assist HFE practitioners in contributing to a broad approach by which to contribute to the never-ending renewal process for these communities. Without such an approach many communities will become unsustainable, with collapse as their end, as Tainter originally, icily, explained (Tainter 1988). The paper begins with a definition of a 'sustainable community', including its legal basis. Its sustainability goals are outlined, based mainly on principles of social justice, since without people there is no community. Then there is a discussion of the characteristics of sustainable communities, the classes of resources available to maintain sustainability, and some of the complexities and hindrances to this maintenance. The last sections link this conceptual landscape to HFE practice by outlining approaches and processes that move from the conceptual landscape in this paper to current practice., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Porcine epidemic diarrhea virus (PEDV) has had a negative economic impact on the global swine industry for decades since its first emergence in the 1970s in Europe. In 2013, PEDV emerged for the first time in the United States, causing immense economic losses to the swine industry. Efforts to protect U.S. swine herds from PEDV infection and limit PEDV transmission through vaccination had only limited success so far. Following the previous success in our virus-like particle (VLP) based vaccine in mouse model, in this study we determined the immunogenicity and protective efficacy of a VLP-based vaccine containing B-cell epitope 748 YSNIGVCK 755 from the spike protein of PEDV incorporated into the hepatitis B virus core capsid (HBcAg), in a comprehensive pregnant gilt vaccination and piglet challenge model. The results showed that the vaccine was able to induce significantly higher virus neutralization response in gilt milk, and provide alleviation of clinical signs for piglets experimentally infected with PEDV. Piglets from pregnant gilt that was vaccinated with the VLP vaccine had faster recovery from the clinical disease, less small intestinal lesions, and higher survival rate at 10 days post-challenge (DPC)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Effective preventive treatments for dental decay exist, but caries experience among preschoolers has not changed, with marked disparities in untreated decay. Despite near-universal use of SMS text messaging, there are no studies using text messages to improve the oral health of vulnerable children., Objective: This randomized controlled feasibility trial aimed to test the effects of oral health text messages (OHT) versus a control (child wellness text messages or CWT). OHT was hypothesized to outperform CWT on improving pediatric oral health behaviors and parent attitudes., Methods: Parents with a child aged <7 years were recruited at urban clinics during pediatric appointments (79% [41/52] below poverty line; 66% [36/55] black) and randomized to OHT (text messages on brushing, dental visits, bottle and sippy cups, healthy eating and sugary beverages, and fluoride) or CWT (text messages on reading, safety, physical activity and development, secondhand smoke, and stress) groups. Automated text messages based on Social Cognitive Theory were sent twice each day for 8-weeks. Groups were equivalent on the basis of the number of text messages sent, personalization, interactivity, and opportunity to earn electronic badges and unlock animated characters. Assessments were conducted at baseline and 8 weeks later. Data were analyzed with linear mixed-effects models., Results: A total of 55 participants were randomized (28 OHT and 27 CWT). Only one participant dropped out during the text message program and 47 (24 OHT and 23 CWT) completed follow up surveys. Response rates exceeded 68.78% (1040/1512) and overall program satisfaction was high (OHT mean 6.3; CWT mean 6.2; 1-7 scale range). Of the OHT group participants, 84% (21/25) would recommend the program to others. Overall program likeability scores were high (OHT mean 5.90; CWT mean 6.0; 1-7 scale range). Participants reported high perceived impact of the OHT program on brushing their child's teeth, motivation to address their child's oral health, and knowledge of their child's oral health needs (mean 4.7, 4.6, and 4.6, respectively; 1-5 scale range). At follow up, compared with CWT, OHT group participants were more likely to brush their children's teeth twice per day (odds ratio [OR] 1.37, 95% CI 0.28-6.50) and demonstrated improved attitudes regarding the use of fluoride (OR 3.82, 95% CI 0.9-16.8) and toward getting regular dental checkups for their child (OR 4.68, 95% CI 0.24-91.4). There were modest, but not significant, changes in motivation (F1,53=0.60; P=.45) and self-efficacy (F1,53=0.24; P=.63) to engage in oral health behaviors, favoring OHT (d=0.28 and d=0.16 for motivation and self-efficacy, respectively)., Conclusions: The OHT program demonstrated feasibility was well utilized and appealing to the target population and showed promise for efficacy., (©Belinda Borrelli, Michelle Henshaw, Romano Endrighi, William G Adams, Timothy Heeren, Rochelle K Rosen, Beth Bock, Scott Werntz. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 11.11.2019.)

Objectives: To evaluate a storytelling intervention targeting the oral health beliefs, knowledge, and behaviors of AIAN pregnant women and mothers., Methods: Fifty-three adult AIAN women from three tribal communities in Northern California participated. The intervention story delivered oral health messaging using a traditional storytelling format. The effect of the intervention on self-reported oral health behaviors, dental knowledge, and beliefs was assessed using a pretest-posttest design, with an additional six-month follow-up. Tests of repeated measures using Generalized Linear Models were conducted to assess changes in oral health knowledge, beliefs, and behaviors., Results: Knowledge and beliefs significantly increased as a result of the intervention and persisted after six months. A consistent, significant increase in positive oral health behaviors from baseline to six-months was also observed., Conclusions: The results of this intervention study suggest promise for traditional storytelling to increase oral health-related knowledge, beliefs, and behaviors among self-identified AIAN pregnant women and mothers., (© 2019 American Association of Public Health Dentistry.)

Background and Aims: The association between racial differences in myocardial deformation and cardiometabolic risk factors is unknown in obese children. Our objective was to: 1) investigate for racial differences in myocardial deformation between white and black obese children and 2) identify biomarkers associated with these observed racial differences. We hypothesized that decreased myocardial deformation observed in black obese children could be accounted for by the differences in the markers of metabolic syndrome between the groups., Methods and Results: Obese children were recruited prospectively. All clinical and laboratory tests for the metabolic syndrome were conducted during a single assessment using a standardized protocol. Speckle-tracking echocardiography was performed to obtain longitudinal and circumferential measures of deformation. 310 patients were included in the analysis; 158 (51%) white and 152 (49%) black. The median age was 11.3 years (IQR 5.9). Blacks demonstrated worse longitudinal strain (-14.7 ± 2.7% vs. -15.4 ± 2.9%, p = 0.04). There was no difference in circumferential strain between the groups. Multivariable linear regression showed a significant relationship between longitudinal strain and hsCRP (β = 0.16, p = 0.03) and HOMA-IR (β = 0.15, p = 0.04); there was no independent association between longitudinal strain and race., Conclusion: Black subjects demonstrated worse longitudinal strain than whites. Only hsCRP and HOMA-IR levels, not race, had an independent association with longitudinal strain, suggesting that the observed racial differences in longitudinal strain may be secondary to differences in inflammation and insulin resistance between the groups., (Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Introduction: We conducted a qualitative analysis to evaluate the acceptability of using storytelling as a way to communicate oral health messages regarding early childhood caries (ECC) prevention in the American Indian and Alaska Native (AIAN) population., Methods: A traditional story was developed and pilot tested among AIAN mothers residing in 3 tribal locations in northern California. Evaluations of the story content and acceptability followed a multistep process consisting of initial feedback from 4 key informants, a focus group of 7 AIAN mothers, and feedback from the Community Advisory Board. Upon story approval, 9 additional focus group sessions (N = 53 participants) were held with AIAN mothers following an oral telling of the story., Results: Participants reported that the story was culturally appropriate and used relatable characters. Messages about oral health were considered to be valuable. Concerns arose about the oral-only delivery of the story, story content, length, story messages that conflicted with normative community values, and the intent to target audiences. Feedback by focus group participants raised some doubts about the relevance and frequency of storytelling in AIAN communities today., Conclusion: AIAN communities value the need for oral health messaging for community members. However, the acceptability of storytelling as a method for the messaging raises concerns, because the influence of modern technology and digital communications may weaken the acceptability of the oral tradition. Careful attention must be made to the delivery mode, content, and targeting with continual iterative feedback from community members to make these messages engaging, appropriate, relatable, and inclusive.

Background: Several jurisdictions mandate the presence of an independent support person during police interviews with vulnerable people. The current study investigated police officers' experiences and perceptions of these volunteers during interviews with people with intellectual disability(ies) (ID)., Methods: The sample comprised 229 police officers who attended a mandatory firearms training course in Melbourne, Australia, in 2010., Results: Participants commonly reported utilizing independent support persons and displayed a fair understanding of their role. Overall, volunteers were engaged more frequently than family/friends; police considered the volunteers to be more impartial during interviews, whereas family/friends provided a greater level of emotional support to interviewees., Conclusions: Independent support persons need to demonstrate two quite different types of support to people with intellectual disability(ies) during police interviews; these require quite different skill sets and suggest the need for more tailored training and support for these volunteers. Implications for future research and policy are discussed., (© 2016 John Wiley & Sons Ltd.)

Technological advances have dramatically increased the ability to access, distribute and produce child exploitation material (CEM) online, resulting in increased numbers of individuals being charged with CEM offences. This study examined the demographic, mental health, and offending characteristics of CEM offenders (n = 456) in comparison to child contact sexual offenders (n = 493) and offenders with a history of both CEM and contact offences (dual offenders, n = 256). A robust data linkage methodology was employed to link records from statewide corrections services with policing and mental health records in Victoria, Australia. The results indicated that CEM offenders differed from both contact and dual offenders, and that the groups were primarily differentiated based on two factors: antisocial orientation and sexual deviance. CEM offenders demonstrated high rates of sexual deviance but low rates of antisociality, contact offenders exhibited the opposite pattern, and dual offenders had both high sexual deviance and antisociality. The findings suggest that existing sexual offender assessment and treatment frameworks are unlikely to be suitable for exclusive CEM offenders. The implications for future research are discussed., (Copyright © 2018 John Wiley & Sons, Ltd.)

Objectives: To identify successful strategies for retention of participants in multiyear, community-based randomized controlled trials (RCTs) aiming to reduce early childhood caries in health disparities populations from diverse racial/ethnic backgrounds and across diverse geographic settings., Methods: Four RCTs conducted by the Early Childhood Caries Collaborating Centers (EC4), an initiative of the National Institute of Dental and Craniofacial Research, systematically collected information on the success of various strategies implemented to promote participant retention in each RCT. The observational findings from this case series of four RCTs were tabulated and the strategies rated by study staff., Results: Participant retention at 12 months of follow-up ranged from 52.8 percent to 91.7 percent, and at 24 months ranged from 53.6 percent to 85.9, across the four RCTs. For the three RCTs that had a 36-month follow-up, retention ranged from 53.6 percent to 85.1 percent. Effectiveness of different participant retention strategies varied widely across the RCTs., Conclusions: Findings from this case series study may help to guide the design of future RCTs to maximize retention of study participants and yield needed data on effective interventions to reduce oral health disparities., (© 2016 American Association of Public Health Dentistry.)

Objectives: To assess the oral health beliefs, knowledge, and behaviors related to early childhood caries (ECC) risk in a convenience sample of American Indian and Alaska Native (AIAN) mothers residing in rural Northern California communities., Methods: Fifty-three mothers of young children were recruited from three tribal communities in Northern California with the assistance of the California Rural Indian Health Board, Inc. and its California Tribal Epidemiology Center and Dental Support Center. Trained study staff administered questionnaires to obtain basic socio-demographic information, to survey participants on their oral health beliefs, knowledge, and behaviors as related to ECC risk, and to identify possible barriers to their accessing professional oral health care. Analyses of covariance were used to explore associations between socio-demographic indicators and oral health behaviors, after controlling for knowledge, beliefs and barriers to care., Results: Overall, 53 percent of participants reported their oral health as "fair" or "poor." Mothers' education (high) and being employed were positively associated with better oral health behavior scores. Additionally, 72 percent of mothers reported having one or more barriers to oral health care including access. There was a significant relation (P = 0.03) between high number of reported barriers to oral health care and low oral health behavior scores., Conclusions: Despite generally high-level oral health knowledge, perceptions of self and child oral health remains low in this sample of AIAN mothers. Factors identified as being associated with oral health behaviors in this sample were similar to those found in other health disparities populations., (© 2017 American Association of Public Health Dentistry.)

This article reviews the current literature pertaining to those who engage in child pornography offending. The basic characteristics of online child pornography offenders (CPOs) and related typologies are briefly presented prior to reviewing the comparative literature pertaining to CPOs and child contact sexual offenders. In general, CPOs have been found to be relatively high functioning and generally pro-social individuals with less extensive and diverse offending histories than contact offenders. CPOs also display high levels of sexual pre-occupation, deviant sexual interests, and deficits in interpersonal and affective domains that surpass those of contact offenders. Although further research is required to replicate and clarify preliminary findings, the available evidence indicates that existing sexual offender risk assessment tools and treatment programs are not suitable for use with CPOs, and thus require revision and empirical evaluation prior to widespread use among this population. The article concludes with implications for clinical practice and directions for future research.

Purpose: Despite the prevalence of oral disease, the subject of oral health historically has been absent from medical education. We have developed an interprofessional curriculum in collaboration with our school of dentistry to teach oral health in the primary care setting to physician assistant (PA) students. The goal was to create and assess the impact of a curricular model that would be adaptable to various academic settings., Methods: A blend of classroom, clinical skills lab, observations in the dental clinic, and observed structured clinical examinations was used to teach oral health to first-year (didactic year) PA students. The objectives were created in collaboration between the medical and dental faculties and included topics on general oral health, oral cancer, geriatrics, pediatrics, and fluoride varnish., Results: A total of 12 hours of instructional time was delivered to 23 students over 3 semesters from 2014 to 2015. Pretesting and posttesting demonstrated long-term knowledge retention that was 14% better than baseline at 8 months (P < .001). Student surveys demonstrated that satisfaction levels were high and that the students felt better prepared and motivated to incorporate oral health into their practice of medicine. Analyses of students' write-ups of the history and the physical examination demonstrated that the students incorporated oral health concepts., Conclusions: A significant impact on trainees can occur after a short, focused amount of instructional time in oral health. Students demonstrate enthusiasm and begin using oral health skills early on. A focused interprofessional oral health curriculum can likely be successfully integrated into various academic settings with a positive effect on learning and improved patient care.

Introduction: Fluoride varnish is an effective prevention intervention for caries in young children. Its routine use in clinical care is supported by meta-analyses and recommended by clinical guidelines, including the US Preventive Services Task Force (B rating). This report is the first prospective systematic assessment of adverse events related to fluoride varnish treatment in young children., Methods: We determined the incidence of adverse events related to fluoride varnish treatment in 3 clinical trials on the prevention of early childhood caries, conducted under the auspices of the Early Childhood Caries Collaborating Centers, an initiative sponsored by the National Institute of Dental and Craniofacial Research. Each trial incorporated use of fluoride varnish in its protocol and systematically queried all children's parents or legal guardians about the occurrence of acute adverse events after each fluoride varnish treatment., Results: A total of 2,424 community-dwelling, dentate children aged 0 to 5 years were enrolled and followed for up to 3 years. These children received a cumulative total of 10,249 fluoride varnish treatments. On average, each child received 4.2 fluoride varnish treatments. We found zero fluoride varnish-related adverse events., Conclusion: Fluoride varnish was not associated with treatment-related adverse events in young children. Our findings support its safety as an effective prevention intervention for caries in young children.

This paper briefly explores the expected impact of the 'Global Drivers' (such as population demographics, food security; energy security; community security and safety), and the role of sustainability engineering in mitigating the potential effects of these Global Drivers. The message of the paper is that sustainability requires a significant input from Ergonomics/Human Factors, but the profession needs some expansion in its thinking in order to make this contribution. Creating a future sustainable world in which people experience an acceptable way of life will not happen without a large input from manufacturing industry into all the Global Drivers, both in delivering products that meet sustainability criteria (such as durability, reliability, minimised material requirement and low energy consumption), and in developing sustainable processes to deliver products for sustainability (such as minimum waste, minimum emissions and low energy consumption). Appropriate changes are already being implemented in manufacturing industry, including new business models, new jobs and new skills. Considerable high-level planning around the world is in progress and is bringing about these changes; for example, there is the US 'Advanced Manufacturing National Program' (AMNP)', the German 'Industrie 4.0' plan, the French plan 'la nouvelle France industrielle' and the UK Foresight publications on the 'Future of Manufacturing'. All of these activities recognise the central part that humans will continue to play in the new manufacturing paradigms; however, they do not discuss many of the issues that systems ergonomics professionals acknowledge. This paper discusses a number of these issues, highlighting the need for some new thinking and knowledge capture by systems ergonomics professionals. Among these are ethical issues, job content and skills issues. Towards the end, there is a summary of knowledge extensions considered necessary in order that systems ergonomists can be fully effective in this new environment, together with suggestions for the means to acquire and disseminate the knowledge extensions., (Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.)

Background: Four trials of interventions designed to prevent early childhood caries are using community-engagement strategies to improve recruitment of low-income, racial/ethnic minority participants. The trials are being implemented by 3 centers funded by the National Institute of Dental and Craniofacial Research and known as the Early Childhood Caries Collaborating Centers (EC4): the Center for Native Oral Health Research at the University of Colorado, the Center to Address Disparities in Children's Oral Health at the University of California San Francisco, and the Center for Research to Evaluate and Eliminate Dental Disparities at Boston University., Community Context: The community contexts for the EC4 trials include urban public housing developments, Hispanic communities near the US-Mexican border, and rural American Indian reservations. These communities have a high prevalence of early childhood caries, suggesting the need for effective, culturally acceptable interventions., Methods: Each center's intervention(s) used community-based participatory research approaches, identified community partners, engaged the community through various means, and developed communication strategies to enhance recruitment., Outcome: All 3 centers have completed recruitment. Each center implemented several new strategies and approaches to enhance recruitment efforts, such as introducing new communication techniques, using media such as radio and newspapers to spread awareness about the studies, and hosting community gatherings., Interpretation: Using multiple strategies that build trust in the community, are sensitive to cultural norms, and are adaptable to the community environment can enhance recruitment in underserved communities.

This study investigated the impact of English health literacy and spoken proficiency and acculturation on preventive dental care use among Somali refugees in Massachusetts. 439 adult Somalis in the US ≤10 years were interviewed. English functional health literacy, dental word recognition, and spoken proficiency were measured using STOFHLA, REALD, and BEST Plus. Logistic regression tested associations of language measures with preventive dental care use. Without controlling for acculturation, participants with higher health literacy were 2.0 times more likely to have had preventive care (P = 0.02). Subjects with higher word recognition were 1.8 times as likely to have had preventive care (P = 0.04). Controlling for acculturation, these were no longer significant, and spoken proficiency was not associated with increased preventive care use. English health literacy and spoken proficiency were not associated with preventive dental care. Other factors, like acculturation, were more predictive of care use than language skills.

Tooth loss in adults diminishes quality of daily life, affecting eating, speaking, appearance, and social interactions. Tooth loss is linked to severe periodontitis and caries; and to risk of stroke, cardiovascular disease, rheumatoid arthritis, and dementia. At the national (USA) level, poverty and African-American race have been linked to lower utilization of dental services, suggesting that the 7.5 million residents of publicly supported housing may be at risk of tooth loss and poor overall oral health. We assessed whether residence in publicly supported housing in Boston was associated with four oral health-related indicators. Compared to residents of nonpublicly supported housing, after adjusting for covariates residents of both public housing developments (PHDs) and rental assistance units (RAUs) had significantly lower odds of having had a dental cleaning in the past year (PHD, OR = 0.64 (95 % CI, 0.44-0.93); RAU, OR = 0.67 (95 % CI, 0.45-0.99))-despite parity in having had a past year dental visit. Further, residents of RAUs had double the odds of having had six or more teeth removed (OR = 2.20 (95 % CI, 1.39-3.50)). Associations of race/ethnicity and housing type with dental insurance were interrelated. Unadjusted results document a deficit in oral health-related indicators among public housing residents, taken as a group, giving a clear picture of an oral health care gap and identifying a defined real-world population that could benefit from services. Existing public housing infrastructure could provide both a venue and a foundation for interventions to reduce oral health disparities on a broad scale.

Objectives: We assessed the impact of health literacy and acculturation on oral health status of Somali refugees in Massachusetts., Methods: Between December 2009 and June 2011, we surveyed 439 adult Somalis who had lived in the United States 10 years or less. Assessments included oral examinations with decayed, missing, and filled teeth (DMFT) counts and measurement of spoken English and health literacy. We tested associations with generalized linear regression models., Results: Participants had means of 1.4 decayed, 2.8 missing, and 1.3 filled teeth. Among participants who had been in the United States 0 to 4 years, lower health literacy scores correlated with lower DMFT (rate ratio [RR] = 0.78; P = .016). Among participants who had been in the country 5 to 10 years, lower literacy scores correlated with higher DMFT (RR = 1.37; P = .012). Literacy was not significantly associated with decayed teeth. Lower literacy scores correlated marginally with lower risk of periodontal disease (odds ratio = 0.22; P = .047)., Conclusions: Worsening oral health of Somali refugees over time may be linked to less access to preventive care and less utilization of beneficial oral hygiene practices.