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The purpose of this study was to elicit ideas or concerns influencing dental hygiene educators' experiences of personal and professional burnout, burnout working with students, and teaching efficacy in an online/hybrid environment as a result of the COVID-19 pandemic.A qualitative, content-analysis study included a convenience sample of dental hygiene educators emails. An invitation to participate in an August 2021 or October 2021 focus group was sent via QualtricsFifty-three were invited to the August 2021 focus groups for a 26% (n = 14) response rate, and 116 were invited to the October 2021 focus groups for an 11% (n = 13) response rate. Contributing factors to experiences of burnout expressed were: (1) work-life balance (n = 59), including (a) overwork, (b) pressure to be available, and (c) lack of boundaries; (2) change (n = 34) involving (a) developing new protocols, (b) constant uncertainty, (c) COVID-19 requirements, and (d) new platforms; and (3) negative interactions (n = 32) with (a) students and (b) faculty.A lack of work-life balance from overwork, pressure to be available at all times, no boundaries with students, and an absence of a sense of connection for workplace vitality were contributors to burnout. Work-from-home flexibility, a work environment that supported wellness and mental well-being, and the ability to leave the workplace for periods of time were reported as helpful solutions to combatting burnout.

PURPOSE/OBJECTIVES The aim of this study is to report data on the lack of a proper patient handoff system in dentistry and dental education and to present a possible solution to integrate this into curriculum using the "entrustable professional activities" (EPAs) framework. METHODS Delphi participants from seven US dental schools provided feedback on a preliminary definition of handoff, a mnemonic and an assessment rubric. 2019 American Dental Education Association Commission on Change and Innovation in Dental Education (ADEA CCI) participants further evaluated the handoff EPA using the EQual rubric for EPA quality and structure. RESULTS Delphi participants identified points of transition in dentistry, selected the D-PASS as a mnemonic, and agreed with the evaluation rubric. The ADEA CCI participants agreed the handoff EPA describes work that is essential for the profession and suitable for entrustment. CONCLUSION The D-PASS rubric is an effective way to assess patient handoffs.

Purpose/objectives The purpose of this study was to define and develop a set of Entrustable Professional Activities (EPAs) for dental education using a modified Delphi consensus approach. EPAs define the core tasks that a graduating dentist needs to perform independently in practice. The EPA framework facilitates assessment of competencies as they manifest in the tasks and independence needed to be ready for practice. Methods Feedback was obtained from participants about a list of EPAs, with modifications made after each of the 3 rounds, using a modified Delphi approach. Phase 1 included attendees at the ADEA Fall 2017 meeting (n = 35) who participated in an EPA workshop primarily composed of academic deans. The Phase 2 "reactor panel" consisted of 10 dental schools' academic deans and other individuals with expertise and interest in dental curriculum and assessment (n = 31). Phase 3 participants were attendees at the ADEA CCI 2019 meeting (n = 91) who also participated in a 2-day EPA workshop. Results In phase 1, overall ratings for acceptability of the EPAs were satisfactory. In phase 2, the next iteration of EPAs was judged as satisfactory for inclusion in curriculum, match well with clinical practice and clarity. In phase 3, the EPAs were judged as satisfactory for being an "entrustable, essential, and important task of the profession." Qualitative feedback suggested wording, measurability, and specific focus of EPA statements is important. Conclusions A preliminary set of EPAs was designed for predoctoral dental education through a systematic, careful consensus building approach involving a diverse set of participants.

PURPOSE Advances in virtual reality technology for surgical simulation methods may improve diagnosis and treatment planning of complex orthognathic surgery cases. The objectives were to assess orthodontic residents' performance and attitudes when treatment planning orthognathic surgery cases using two-dimensional (2D) digital, three-dimensional (3D) digital, and virtual reality (VR) surgical simulations. METHODS The study had a mixed methods study design involving 20 graduate orthodontic residents. Their previous experiences, confidence, and competence with orthodontic diagnosis and surgical treatment planning were assessed with a baseline survey. Each resident completed 2D, 3D, and VR treatment planning and simulation tasks in a randomized order and recorded their diagnosis, objectives, treatment plan, and special surgical concerns for each case using a treatment planning worksheet. The worksheets were scored and quantitative data were analyzed. Attitudinal responses to the simulation experience were captured with a post-survey and interview. RESULTS The number of total prescribed surgical movements was greater for 3D and VR simulation methods (p = 0.001). There were no differences in the overall total written treatment plan analysis score among the three surgical simulation tasks. Participants took longer to complete the VR and 3D tasks (p

PURPOSE/OBJECTIVES Broken appointments are an important cause of waste in health care. Patients who fail to attend incur costs to providers, deny trainees learning opportunities, and impact their own health as well as that of other patients who are waiting for care. METHODS A total of 410,000 appointment records over 3 years were extracted from our electronic health record. We conducted exploratory data analysis and assessed correlations between appointment no-shows and other attributes of the appointment and the patient. The University of Michigan Medical School's Committee on Human Research reviewed the study and deemed that no Institutional Review Board oversight was necessary for this quality improvement project that was, retrospectively, turned into a study with previously de-identified data. RESULTS The patient's previous attendance record is the single most significant correlation with attendance. We found that patients who said they are "scared" of dental visits were 62% as likely to attend as someone reporting "no problem." Patients over 65 years of age have better attendance rates. There was a positive association between receiving email/text confirmation and attendance. A total of 94.9% of those emailed a reminder and 92.2% of those who were texted attended their appointment. CONCLUSION(S) We were able to identify relationships of several variables to failed and attended appointments that we were previously unknown to us. This knowledge enabled us to implement interventions to support better attendance at Dental Clinics at the University of Michigan, improving patient health, student training, and efficient use of resources.

The aim of this study was to investigate the reliability and validity of the Multiple Mini Interview (MMI) process and to assess its use as an admission tool to predict noncognitive traits associated with professional behavior during patient care in one cohort of dental students at a single U.S. dental school. Data were analyzed for the 95 candidates who matriculated and graduated as part of the 2017 graduating cohort at the University of Michigan School of Dentistry. All MMI interviewees for one cycle of admissions rotated through ten stations: two traditional interview question stations and eight scenario stations measuring domains that included four questions scored on a five-point Likert scale. Generalizability theory analysis showed the MMI to have good reliability (G Coefficient of 0.74). Station reliabilities (Cronbach's alpha) ranged from 0.88 to 0.92. MMI scores showed a positive significant correlation with students' scores on the Dental Admission Test and Perceptual Ability Test, D1 cumulative GPA, and D4 Patient Management grade. MMI scores positively correlated with professional behaviors relating to three domains-openness, conscientiousness, and emotional stability-thus demonstrating good predictive validity for measuring noncognitive traits associated with professionalism. This study found that the MMI was a reliable and valid tool that predicted key behavioral traits associated with professionalism in dental students.

Virtual reality patient (VR patient), a simulated patient module in a virtual reality environment allowing manipulation of the upper and lower jaws and chin in three planes of space, was developed to help students understand diagnosis and treatment planning of orthognathic surgical procedures. The objective was to compare student understanding in diagnosing and treatment planning complex orthognathic cases using the VR patient versus a conventional 2D prediction tracing method and to determine feasibility of utilizing VR methods. Thirty third year dental students were assigned randomly to an experimental (VR patient) or control (2D tracing) group. The dependent variables were a multiple choice question (MCQ) examination, baseline and exit surveys, and written case analysis of two cases. Student–teacher interactions were recorded for both length and type of interaction. Data were evaluated using descriptive and inferential statistics. The students’ performance on the MCQ examinations improved immediately following the educational intervention (p .928). Dental students were able to improve their understanding of diagnosis and treatment planning of orthognathic cases using both 2D prediction tracing and the VR patient methods. The method of scoring the written responses was reliable and reproducible and should be used for future full-scale studies.

By leveraging emerging technologies in augmented reality (AR) and virtual reality (VR), a Virtual Dental Library and AR virtual tooth identification test were developed at a U. S. dental school. The AR virtual tooth identification test is a vision- based AR application that uses three-dimensional models of extracted human teeth as test items. The aims of this study were to investigate the validity of the AR virtual tooth identification test and evaluate the users' experience with the virtual testing method. The AR virtual tooth identification test scores were compared with real tooth identification tests, scores on three quizzes, final exam, and final grade for the course to assess its validity. In addition, a survey was used to assess students' perceptions of the AR tool. In 2018, all 109 first-year dental students who had completed the dental anatomy course were invited to participate in the study. Of the 93 participants, 61 (56% of total students) were included in the correlation analysis (32 were excluded due to incomplete test answer sheets or missing criterion measures). All 93 could respond to the survey and provide comments. In the results, the AR virtual tooth identification test had a positive correlation with the real tooth identification test (r=0.410, p

The purpose of this study was to assess the impact of the Covid-19 pandemic on dental hygiene (DH) educators' perception of personal and professional burnout and efficacy in the online/hybrid learning environment.A cross-sectional study of DH faculty members from 327 United States entry level DH programs was invited to participate in this study. A 36 item survey was disseminated in QualtricsThe survey had an institutional response rate of 46%. Personal burnout scores had a significantly higher mean as compared to work-related and burnout working with students' scores. A majority (66%) of respondents reported often feeling tired. Only personal burnout scores had a significant negative correlation with teaching efficacy scores. Administrators/program directors and full-time faculty had significantly higher mean personal and work-related burnout scores as compared to part-time/adjunct clinical faculty. There were no significant differences in teaching efficacy scores by faculty position and institutional setting.COVID-19 had significant impact on full-time DH educators' personal and professional burnout levels. Full-time administrators/program directors/DH educators reported higher levels of personal burnout. It seems that personal burnout has a negative relationship with teaching efficacy. Faculty position rather than institution impacted personal burnout. Despite personal and professional burnout, DH faculty reported low-levels of burnout related to working with students.

The Ten Item Personality Inventory (TIPI) is a widely used instrument based on a personality framework measuring five dimensions: Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Openness to Experiences. The aim of this study was to establish a scale to assess dental students' professionalism by adding to the TIPI's five dimensions a set of descriptors that define professional behavior in dental students. The resulting Patient Management and Professionalism Scale (PMPS) was then tested with a cohort of graduating students at the University of Michigan School of Dentistry. To develop the scale, one clinic director and a patient care coordinator from four clinics wrote descriptive statements for each of the five dimensions based on their observations of dental students in the context of their clinical experiences. These descriptors were compiled into a single scale. The PMPS demonstrated good scale reliability and interrater agreement and correlated significantly with students' patient management grade scores and cumulative GPA at the end of their fourth year. Exploratory factor analysis showed the presence of a single factor (professionalism) with all five dimensions loading highly on this factor, accounting for 66% of variance in scores. While a useful standardized measure to assess professionalism in dental students, the PMPS also has a flexible format that makes it easy for other schools to use.

Interdisciplinary education (IDE) during dental residencies can help produce dentists who work more efficiently to provide continuous and reliable patient care. The aim of this study was to assess the extent and type of interdisciplinary education in dental residency programs at U.S. dental schools. A 24-item survey addressing didactic courses and patient care was sent to academic and/or clinical deans at 65 U.S. dental schools in fall 2016; they were asked to forward the survey to the appropriate person in their school. The questions addressed IDE characteristics such as the academic home for IDE, focus areas, defined outcomes, program objectives, and perceived institutional barriers. Of the 65 schools invited to participate, 31 responded to the survey for an overall response rate of 48%. Of those schools, 23 (74%) reported having IDE for their advanced/postgraduate students. Among the schools with IDE, their IDE learning experiences primarily involved residents in different disciplines participating in clinical case group projects and small group workshops, and 77% of IDE faculty taught in department-specific clinical spaces as opposed to teaching together in a single clinic. The respondents identified barriers to implementing IDE such as a lack of clearly defined competencies, logistical challenges including academic calendars and scheduling, and faculty resistance. Also, 43% reported that their institutions did not have a program to support IDE faculty development. At the time of this survey, most of the respondents did not have a clearly defined IDE model consisting of competencies, defined assessments, and milestones.

INTRODUCTION There has been a recent demand in dental education for distance learning and the use of virtual assessment tools that can leverage technology to potentially replace physical testing facilities. However, virtual tools that evaluate student learning should be validated prior to adoption. The aim of this study was to investigate the effectiveness, efficiency and user satisfaction of a 3D tooth identification test for a dental anatomy course that can be given remotely. MATERIALS AND METHODS First-year dental students (n = 41) enrolled in a dental anatomy course took both traditional in-person practical and virtual 3D tooth identification tests consisting of 25 test items. The test scores, average test durations, faculty time commitment and user perception were collected and analysed. Pearson product-moment correlation coefficients (p

The aim of this study was to assess the culture and climate for diversity and inclusion and the humanistic learning environment for students, faculty, and staff at the University of Michigan School of Dentistry. From July 2014 to June 2015, two committees of 16 faculty members, staff members, and students, in partnership with trained program evaluators, used a participatory program evaluation (PPE) process to conduct the assessment using key informant interviews, surveys, and focus groups. The topics addressed were humanistic environment, learning environment, diversity and inclusion, microaggressions and bullying, and activities and space. All staff members, all faculty members (both full- and part-time), and all students in all four years were invited to participate in the parallel but distinctive versions of the survey from November 10 to 25, 2014. Response rates for each group were as follows: 50% (318/642) for students, 68% (217/320) for staff, and 40% (147/366) for faculty; numbers responding to individual items varied. Among the respondents, the majority (76% faculty, 67% staff, 80% students) agreed that the environment fostered learning and personal growth and that a humanistic environment was important (97% faculty, 95% staff, 94% students). Many reported having experienced/witnessed a micro-aggression or bullying. Many also reported having "ever had" dissatisfaction with the learning environment (44% faculty, 39% staff, 68% students). The students sought better relationships with the faculty; the staff and faculty members sought opportunities for professional development and mentoring. Recommendations included cultural sensitivity training, courses for interpersonal skills, leadership and team-building efforts, addressing microaggressions and bullying, creating opportunities for collaboration, and increasing diversity of faculty, staff, and students. These recommendations were incorporated into the school's strategic plan. In this study, a utilization-focused PPE process using mixed methods was effective for evaluating the dental school's climate for diversity and inclusion, as well as the learning environment for faculty, staff, and students.

Multisource assessment (MSA) uses multiple assessors to provide feedback. Little is known about the validity of using MSA feedback for improving students' ability to self-assess in a preclinical environment. Therefore, the aim of this study was to measure the validity of using a defined reflective process involving an MSA tool for building skill in dental students' self-evaluation of caries excavation on extracted teeth. As part of this process, 104 first-year students at one U.S. dental school used a self-generated study plan (SGSP) for structured reflection on MSA feedback during the 2013-14 academic year. Interrater agreement, determined through calculation of percentage-agreements in scoring, was measured among three assessor groups (self-, peer, and expert assessors) in formative assessment and between two assessor groups (self- and expert assessors) in summative assessment two weeks apart, allowing for reflective practice and completion of an SGSP between assessments. Validity for improving self-assessment was determined by measuring significance in positive shifts of agreement between self- and expert assessors. The results showed that interrater agreement between the self- and expert assessors increased significantly: from a 28% agreement in formative assessment to a 60% agreement in summative assessment. Significance in percentage shifts between assessments was demonstrated with a McNemar score of 0.26 (p

The aim of this study was to explore dental and dental hygiene students' and faculty members' perceptions of student evaluations of teaching (SET) and determine whether dental vs. dental hygiene student, beginning vs. advanced student, and faculty vs. student responses differed. Perceived benefits, challenges, and suggestions for conducting SETs optimally were also assessed. Survey data were collected from 329 dental students (D1: 108; D2: 91; D3&4: 130) and 68 dental hygiene students (DH2: 26; DH3: 19; DH4: 23) (overall response rates 76%/92%) and 56 dental and eight dental hygiene faculty members (response rates 41%/100%). Faculty respondents were more positive about SETs than students (five-point scale with 1=disagree: 3.85 vs. 3.39; p

The aim of this study was to examine students' perceptions of the value of a standardized patient instructor conflict resolution program designed to strengthen their communication and confidence during difficult patient conversations. Three cohorts of students at one dental school were part of the study: the dental class of 2013, the dental class of 2014, and the dental hygiene class of 2013. The same groups of students completed surveys immediately following the program and one, two, or three years afterwards. Response rates for the survey immediately after the program were 98 percent (n=99) of the dental class of 2013, 97 percent (n=103) of the dental class of 2014, and 100 percent (n=25) of the dental hygiene class of 2013. Response rates for the subsequent survey were 41.5 percent (n=42) of the dental class of 2013, 74.5 percent (n=79) of the dental class of 2014, and 100 percent (n=25) of the dental hygiene class of 2013. In the results, all students reported a high level of satisfaction in their immediate assessment of the program and its ability to prepare them for conflict situations. They also reported a high level of satisfaction in their retrospective self-assessment of conflict resolution skills. However, their assessment of the program's value and applicability appeared to have diminished over time. This study suggests that the program should continue being a part of both dental and dental hygiene curricula, with more training and guided experiences in self-assessment and perhaps supplemental experiences added.

Understanding the dynamics of mental health stigma through existing frameworks, especially in minorities with higher stigma, is problematic. There is a need to reconceptualize stigma, particularly in highly traumatized groups. The current study examines the validity of a new development-based trauma framework that conceptualizes stigma as a type III chronic trauma that contributes to negative mental health effects. This framework proposes that public stigma is a unique chronic traumatic stress that mediates the effects of similar trauma types in mental health patients. To test this proposition, this study explores the relationships between internalized stigma of mental illness (ISMI), different trauma types, and posttrauma spectrum disorders. ISMI, posttraumatic stress disorder, other posttrauma spectrum disorders, and cumulative trauma measures were administered to a sample of 399 mental health patients that included Arab (82%), Muslim (84%), and refugee (31%), as well as American patients (18%). Age in the sample ranged from 18 to 76 years ( M = 39.66, SD = 11.45), with 53.5% males. Hierarchical multiple regression, t tests, and path analyses were conducted. Results indicated that ISMI predicted posttraumatic stress disorder and other posttrauma spectrum disorders after controlling for cumulative trauma. ISMI was associated with other chronic collective identity traumas. While Arab Americans, Muslims, and refugees had higher ISMI scores than other Americans, the elevated chronic trauma levels of these groups were significant predictors of these differences. The results provide evidence to support ISMI traumatology model. Implications of the results for treating victims of ISMI, especially Arab Americans, Muslims and refugees are discussed.

The solid-state potentiometric sensor responses of high surface area nanocomposite and low surface area gold sensing electrodes were compared. The composite nature of the high surface area gold and stabilized zirconia electrode preserved average gold particle size of 62 nm after calcination and sintering. The electrochemical sensor response of up to 300 ppm CO, NO 2 or NO gas in the presence of 3% O 2 (balance N 2 ) was measured. Sensors using the low surface area Au electrodes had a larger sensitivity to all test gases, more than twice the sensitivity to CO and NO 2 , than the high surface area nanostructured composite electrode. The superior heterogeneous catalytic activity of the nanostructured Au electrode, as determined through temperature programmed reaction, is believed to reduce the charge transfer potentiometric sensitivity to the test gases. In comparison, the low surface area Au sensing electrode did not favor heterogeneous catalysis of CO or NO 2 at 500 °C, the temperature of sensor operation.

AA is defined in the psychoanalytic literature as fear of impending psychic or physical destruction that is triggered by personal survival threats. Little or no attention in the psychoanalytic literature was given to collective or group survival threats. We developed a short measure for AA that includes both kinds of survival threats. We used a clinical sample of 399 mental health clients and measures for cumulative trauma, PTSD, cumulative trauma related disorders, depression and anxiety. We conducted confirmatory factor analysis, multiple regressions, and path analysis. The developed short measure has good reliability, strong divergent and predictive validity and generally fit the theoretical assumptions that underlie the construct. The measure can be useful in clinical screening, and in psychological and political research, especially with the multiply traumatized. Subsequent research that utilized the measure replicated the findings.

Since 2006, the University of Michigan School of Dentistry has used a 13-point measure of overall competence instrument to assess fourth-year dental students' end-rotation performance at community clinics. The aim of this study was to assess the reliability and validity of this instrument used by preceptors to rate students' overall competence during community-based dental education experiences. The measure was analyzed using performance ratings for all fourth-year DDS students in the graduating classes of 2012 and 2013 (combined n=201). The results were that interrater agreement was satisfactory and the measure scored high for internal consistency; also, the measure loaded highly on a single overall competence factor. Ratings on this measure did not correlate with students' final cumulative dental school GPA, but showed a significant positive correlation with their fourth-year fall patient management grades (which signify students' conscientiousness in managing patients and their families in a professional and ethical manner). There were differences in grading systems between the 2012 cohort (which used a pass/fail system) and the 2013 cohort (which used a letter grade system) and the mean ratings they received (higher for the 2013 cohort). Overall, the study found that the 13-point measure demonstrated excellent reliability and validity, suggesting it is useful in determining a student's clinical competence in these settings.

NO x adsorption behavior on LaFeO 3 (LFO) and LaMnO 3+ δ (LMO) was characterized using temperature controlled methods and mass spectrometry. Temperature program desorption revealed decomposition of complex surface species formation when NO or NO 2 was adsorbed on LFO and LMO. LFO exhibited higher adsorption capacity for NO x species than LMO and was shown to be more active for NO x surface conversion. Both effects were attributed to the different B-site cations, with iron in LFO in the 3+ valence state, and manganese in LMO in the 3+ and 4+ valence states. Results from diffuse reflectance infrared spectroscopy were used to identify specific nitrite and nitrate species that are formed on the surfaces of LFO and LMO at room temperature. Temperature programmed reaction revealed a complex NO 2 decomposition mechanism to NO and O 2 for LFO and LMO in which the formation of nitrite and nitrate species serve as intermediates below ∼600 °C. NO x sensing mechanisms were considered and predicted based on the types and quantities of surface species formed.

Two studies compared the effects of cumulative trauma (CT) with those of cumulative negative (CNTA) and cumulative positive tertiary appraisals (CPTA). The first study was conducted with an adult clinical population in the U.S. (N = 399), while the second study was conducted with adolescent students in Gaza (N = 422). Among the effects found were that path analysis with comulative trauma, positive tertiary appraisal, and cumulative negative tertiary appraisals as independent variables and mental health measures as dependent variables, in both samples, found that CNTA and CPTA had direct positive and direct negative effects, respectively, on PTSD, depression, and anxiety. However, CT, independent from appraisals, had direct effects in producing the more complicated symptom clusters of cumulative trauma disorders.

The effects of discrimination and the post-9/11 backlash on Iraqi refugees have not yet been fully examined. The present study aimed to adapt a scale of the perceived backlash (BTS; a modified version of the Race Related Stressors Scale), and measure its relationships with Cumulative Trauma Dose (CTD), Post-traumatic Stress Disorder (PTSD), and health. The BTS was found to have high reliability; and construct, convergent, divergent, and predictive validities. The BTS predicted PTSD and poor health after controlling for the cumulative effects of other reported life traumas. The BTS correlated significantly with neurological, respiratory, digestive and blood disorders, and non-life-threatening illnesses. The results provided evidence for the validity of the trauma model of backlash and discrimination and its importance in the treatment of Iraqi refugees.

Research on forgiveness on the interpersonal level has found evidence of its positive health and mental health effects. However, there is no research on the health and mental health benefits of forgiveness in political conflicts. The removal of the dictator and the war in Iraq has provided researchers with opportunities to answer some questions about the effects of forgiveness in political conflicts. This study used a modified measure of forgiveness and measures of posttraumatic stress disorder (PTSD), cumulative trauma disorder (complex PTSD), health, and religiosity with a sample of 501 Iraqi refugees in Wayne County, Michigan. Results indicated that forgiveness of the collaborators has some positive mental health benefits and is associated with religiosity, whereas not forgiving them has serious health and mental health consequences. However, counter to predictions, un-forgiveness of the dictator was found to be associated with positive health and mental health. Health mediated the effects of un-forgiv...

Teachers were trained to use reinforcement and induction to increase prosocial behavior in a sample of 98 children in Head Start-affiliated preschools, using a peer coaching model. There was one control group and three intervention groups: reinforcement-only, induction-only, and reinforcement-and-induction. Results indicated that the intervention groups showed a significant increase in total classroom prosocial behavior compared to the control group. The induction-only group increased dramatically in affection. The reinforcement-only group increased more in helping, sharing, and cooperation than in affection and comforting. Teacher behaviors in the classroom did not reflect conclusively that they were using the intervention strategies, possibly due to inadequate measurement.

The focus of this study was to explore the effects of watching or listening to news about the war in Iraq on the physical and mental health in a sample of 501 Iraqi refugees. We used measures of media exposure, families and friends killed in the war, cumulative trauma, torture, post-traumatic stress disorder (PTSD), cumulative trauma disorders, and health. Data indicates media exposure to war news was highly predictive of PTSD and poor health after controlling for the effects of previous cumulative traumas and demographics. The effect of media exposure was comparable in its physical and mental health effects to the war-related death or injury of family members and friends, and stronger than other previous traumas. We used mass communication, globalization, secondary trauma, identity trauma, taxonomy of trauma, and cognitive and value processing theories to interpret the results. Results suggest that war media exposure is a Type III collective identity secondary trauma for Iraqis, which is the most damagin...

This study presents a new short scale for measuring cumulative trauma dose, types, and profiles that is based on the APA (American Psychological Association) trauma Group (currently division 56) definition of trauma and a new, two-way development-based taxonomy of trauma. The new measure was tested using a sample of 501 Iraqi refugees who are one of the most traumatized groups. The following six salient factors were found: collective identity, family, personal identity, interdependence or secondary, man-made or nature-made survival, and abandonment types of traumas. The study provided evidence of adequate reliability; construct, convergent, divergent and predictive validity of the new scale and provided partial confirmation of the validity of the development-based taxonomy of traumas. A new method was introduced to measure trauma types and profiles and their differential association with different symptom configurations and health disorders. The newly developed measure can be used in clinical trauma-infor...

The aim of this study was to explore dental and dental hygiene students' and faculty members' perceptions of student evaluations of teaching (SET) and determine whether dental vs. dental hygiene student, beginning vs. advanced student, and faculty vs. student responses differed. Perceived benefits, challenges, and suggestions for conducting SETs optimally were also assessed. Survey data were collected from 329 dental students (D1: 108; D2: 91; D34: 130) and 68 dental hygiene students (DH2: 26; DH3: 19; DH4: 23) (overall response rates 76%/92%) and 56 dental and eight dental hygiene faculty members (response rates 41%/100%). Faculty respondents were more positive about SETs than students (five-point scale with 1=disagree: 3.85 vs. 3.39; p0.001), with seniors being the least positive (mean 2.42). Respondents agreed that all students should complete SETs (3.87 vs. 3.61; p=0.068), with faculty agreeing more strongly than students that all courses should be evaluated (4.32/4.04; p=0.046). Students agreed more strongly than faculty that SETs should occur during regular class time (3.97/3.44; p0.001) and are too long (3.47/3.09; p=0.010) and that results should be shared with students (4.03/3.57; p=0.002). Open-ended responses showed that students perceived more benefits of SETs for faculty members than for students and that the most frequently mentioned problem was that SETs do not result in changes. Faculty members were generally more positive than students (especially seniors) about SETs. These findings suggest that, according to these respondents, SETs should be completed by all students for all courses, be short, provide opportunities for open-ended comments, and be administered in class to improve response rate. In addition, SET results and how SETs are used to improve courses should be shared with students.

The study explored the psychometric properties of the Arabic version of the ISMI measure on an Arab sub-sample ( N = 330) in a health clinic that served mostly refugees in Michigan, USA. Study measures included the ISMI, PTSD, depression, anxiety, CTD (Cumulative Trauma Disorders), and traumatic stress measures. Data analysis included factor analysis, correlation, and multiple regression analysis. The Arabic form of the measure was found to have robust psychometric qualities, with high reliability construct and predictive validity. Factor analysis identified a general stigma factor and different levels of stigma resistance factors. General stigma was significantly associated with and predicted post-trauma symptoms of depression, anxiety, PTSD and CTD (complex PTSD), while tough stigma resistance was associated negatively with PTSD and depression and positively with positive appraisal of traumatic events.

The goal of this study was to examine whether the retributive justice enacted by the elimination of the oppressive regime in Iraq has positive mental health effects on Iraqi refugees. The study was conducted on a sample of 501 Iraqi refugees. Data was collected with measures for retributive justice, post-traumatic stress disorder (PTSD), cumulative trauma disorder (CTD), cumulative trauma, futuristic orientation, sociocultural adjustment, post-traumatic growth, social support, and other measures. Multiple regression and path analyses found that the variable regaining self-control and executive functions was the most predictive of the positive mental health gains. However, improvements in PTSD symptoms were not observed, possibly because of previous traumas or the ongoing trauma of discrimination and the war in Iraq.

We investigate the formation of nanoparticles of Au in SiO(2) by multiple ion implantation steps and intermediate anneals to isolate nucleation and growth, thereby producing a narrow particle size distribution. We discuss the effects of varying the initial nucleation dose and the growth temperature and establish guidelines for synthesizing nanoparticles with improved size uniformity. By this method, we have obtained a standard deviation of 16% on an average diameter of 1.68 nm, compared to 28% when no attempt is made to isolate nucleation and growth.

Turmeric is a yellow coloring spice widely used in the preparation of food. Curcumin is the active principle isolated from turmeric, exhibits antimutagenic and anticarcinogenic activity [Food Chem. Toxicol. 25 (1987) 545; J. Nutr., Growth Cancer 4 (1987) 83; J. Am. Nutr. Coll. 11 (1992) 192.]. Presently, curcumin is undergoing clinical trials for the prevention of cancer, at the NCI, Bethesda, USA. During boiling, broiling, frying and baking food proteins and carbohydrates pyrolyses to form Maillard reaction products, some of which are mutagenic/carcinogenic. We have tested the effect of turmeric extract and curcumin on the formation of mutagenic products in an in vitro model system. Glycine, 35 mM, creatinine, 70 mM and glucose, 70 mM were refluxed for 2 h at 150 °C with or without turmeric extract and curcumin. Turmeric extract and curcumin exhibited dose-dependent inhibition of formation of mutagenic pyrolysates as detected by TA98 with S9 mix. In another set of experiments, lysine, 1 M and glucose, 1 M was refluxed for 150 min at 100 °C with or without turmeric extract and curcumin. Mutagenic activity of reaction product was measured with TA100 without S9 mix. Both the test substances exhibited dose-dependent inhibition of mutagenicity of pyrolysed products. Moreover, turmeric extract and curcumin also inhibited the mutagenicity of lysine+glucose pyrolysed products. Some of the Maillard reaction products (pyrolysates) are known mutagens/carcinogens; they play an important role in the development and progression of diabetes and age-related degenerative diseases; they also destroy important essential amino acids. Spice turmeric, an important ingredient in the food preparation, blocks the formation of hazardous Maillard reaction products and its mutagenic activity.

This article describes a survey of itinerant early childhood special education teachers in one state. Itinerant teachers address the Individualized Education Program (IEP) goals and objectives of children who receive special education services in their homes or in a community-based program. Itinerant teachers who responded to this survey identified a range of strategies they use as part of their jobs. Most of the strategies identified as frequently used involve providing direct services to children. Teachers reported infrequent implementation of indirect services such as modeling intervention techniques and writing intervention plans for general education teachers or parents. Itinerant teachers reported being satisfied with their job and were generally welcomed in classrooms and homes.

A novel concept for adjusting grip force in voluntary-opening prehensors is introduced. The vector mechanism allows the user to rotate a stiff elastic band within the prehensor to change grip force substantially with very low energy input. Two prototype vector prehensors are described: one modeled after a split hooka, the other modeled after a TRS Grip IIIb. The performances of the prototypes are evaluated and compared with those of commercially available prehensors primarily through laboratory testing. The vector prehensors allow grip force to be adjusted quickly and easily among 13 settings ranging from ½ to 20 lbs. This added capability was achieved without adding significant weight or bulk to the device. Preliminary field tests demonstrated the practical feasibility of the device, but a clinical evaluation has not been performed.

This project developed a robust, tunable, hierarchical nanoceramics materials platform for industrial process sensors in harsh-environments. Control of material structure at multiple length scales from nano to macro increased the sensing response of the materials to combustion gases. These materials operated at relatively high temperatures, enabling detection close to the source of combustion. It is anticipated that these materials can form the basis for a new class of sensors enabling widespread use of efficient combustion processes with closed loop feedback control in the energy-intensive industries. The first phase of the project focused on materials selection and process development, leading to hierarchical nanoceramics that were evaluated for sensing performance. The second phase focused on optimizing the materials processes and microstructures, followed by validation of performance of a prototype sensor in a laboratory combustion environment. The objectives of this project were achieved by: (1) synthesizing and optimizing hierarchical nanostructures; (2) synthesizing and optimizing sensing nanomaterials; (3) integrating sensing functionality into hierarchical nanostructures; (4) demonstrating material performance in a sensing element; and (5) validating material performance in a simulated service environment. The project developed hierarchical nanoceramic electrodes for mixed potential zirconia gas sensors with increased surface area and demonstrated tailored electrocatalytic activity operable at high temperatures enabling detection of products of combustion such as NOx close to the source of combustion. Methods were developed for synthesis of hierarchical nanostructures with high, stable surface area, integrated catalytic functionality within the structures for gas sensing, and demonstrated materials performance in harsh lab and combustion gas environments.

Arab-American Muslim adolescents in immigrant families face a number of challenges that put them at risk for behavior problems. This study of Arab-American Muslim Adolescents and their relatively recent immigrant mothers tested a longitudinal family-level model of adolescent behavior problems. Mother-adolescent dyads (N = 530) completed measures of maternal and adolescent stressors, active and avoidance coping, and social support; maternal distress; quality of mother–child relationship; and adolescent behavior problems at Time 1 and approximately 18 months later. The youth were between the ages of 11 and 15 years at Time 1 and 48.7% were girls. Longitudinal analyses were conducted using latent change modeling with change scores from Time 1 and Time 2 data. Social support facilitated active coping for both mothers and adolescents. Although maternal avoidance coping mediated maternal stressors and its effect on maternal distress, maternal stressors and maternal distress were not related to adolescent behavior problems. The only factor mitigating the effects of adolescent stressors on adolescent behavior problems was the quality of the mother–child relationship. These findings suggest that adolescents are insulated from maternal stress and distress as long as there is a good mother–child relationship.