Comparison of graduate-entry and direct school leaver student performance on an applied dental knowledge test

AIMS

To compare the academic performance of graduate-entry and direct school leavers in an undergraduate dental programme.

METHODS

This study examined the results of students in applied dental knowledge (ADK) progress tests conducted during two academic years. A mixed model analysis of variance (ANOVA) was conducted to compare the performance of graduate-entry and direct school leavers. ADK was treated as a repeated measures variable, and the outcome variable of interest was percentage score on the ADK.

RESULTS

The results show statistically significant main effects for ADK [F (1,113) = 61.58, P < 0.001, η²_p = 0.35], Cohort [F (1,113) = 88.57, P < 0.001, η²_p = 0.44] and Entry [F (1,113) = 11.31, P = 0.001, η²_p = 0.09]. That is, students do better on each subsequent test (main effect of ADK), students in later years of the programme perform better than those in earlier years (main effect of cohort), and graduate-entry students outperform direct school leavers.

CONCLUSIONS

This is the first study to explore the differences in the academic performance of graduate-entry and direct school leavers in an undergraduate dental programme. The results show that the academic performance of graduate students was better than the direct school leavers in years 2 and 3. Further research is required to compare the performance of students longitudinally across the entire duration of undergraduate dental programmes and evaluate whether this difference persists throughout.

Application of Rasch analysis in the development and psychometric evaluation of dental undergraduates preparedness assessment scale

AIMS

The aim of this study was to develop a valid and reliable scale to measure preparedness of new dental graduates.

METHODS

The scale development and validation was carried out using the Rasch measurement model. Following a pilot and pre-testing of the scale, a national study was undertaken with undergraduate students from all dental schools as well as foundation dentists in UK.

RESULTS

To examine the internal validity of the scale, we conducted a Rasch analysis. External validity of the scale was checked through validation with a range of stakeholders. An excellent fit to the Rasch model provided evidence of internal construct validity. The scale demonstrated invariance, ordered thresholds and lack of differential item functioning. Unidimensionality of the scale was confirmed by independent t-tests. The PSI value was 0.877, indicating a good degree of person separation and internal consistency. Test-retest reliability of the scale was also established.

CONCLUSIONS

The preparedness scale developed in this project reflects innovative research using a systematic approach and employment of modern psychometric methods. The scale can be used for assessment of the preparedness of undergraduate students by dental educators and potential employers as well as by the student for self-assessment.

Mathematical modeling and stability analysis of Pine Wilt Disease with optimal control

This paper presents and examine a mathematical system of equations which describes the dynamics of pine wilt disease (PWD). Firstly, we examine the model with constant controls. Here, we investigate the disease equilibria and calculate the basic reproduction number of the disease. Secondly, we incorporate time dependent controls into the model and then analyze the conditions that are necessary for the disease to be controlled optimally. Finally, the numerical results for the model are presented.

Academic performance of undergraduate dental students with learning disabilities

Aims To compare the academic performance of undergraduate dental students with known learning disabilities (LDs) to their peers.Methods This study analysed the results of students in applied dental knowledge (ADK) progress tests across four cohorts of dental students. A mixed model analysis of variance (ANOVA) was conducted to compare the performance of students with known disability to their peers. ADK test sitting was treated as a repeated measures variable, and the outcome variable of interest was percentage score on the ADK.Results Students' performance data on five ADK test sittings (ADK15, ADK16, ADK17, ADK18, and ADK19) by disability showed a significant main effect of test but no significant effect of disability or any interaction between disability and test.Conclusions This is the first study that explores the academic performance of dental students with a diagnosis of disability. The findings give reassurance to all stakeholders that, within the study population, students with LDs are not disadvantaged in knowledge-based assessments, demonstrating compliance with the legal obligations. Further research is required to explore how generalisable these findings are, as well as assess academic, clinical, and behavioural attributes of students with learning disabilities.

Tethered balloon-born and ground-based measurements of black carbon and particulate profiles within the lower troposphere during the foggy period in Delhi, India

The ground and vertical profiles of particulate matter (PM) were mapped as part of a pilot study using a Tethered balloon within the lower troposphere (1000m) during the foggy episodes in the winter season of 2015-16 in New Delhi, India. Measurements of black carbon (BC) aerosol and PM <2.5 and 10μm (PM_2.5 & PM₁₀ respectively) concentrations and their associated particulate optical properties along with meteorological parameters were made. The mean concentrations of PM_2.5, PM₁₀, BC_370nm, and BC_880nm were observed to be 146.8±42.1, 245.4±65.4, 30.3±12.2, and 24.1±10.3μgm^-3, respectively. The mean value of PM_2.5 was ~12 times higher than the annual US-EPA air quality standard. The fraction of BC in PM_2.5 that contributed to absorption in the shorter visible wavelengths (BC_370nm) was ~21%. Compared to clear days, the ground level mass concentrations of PM_2.5 and BC_370nm particles were substantially increased (59% and 24%, respectively) during the foggy episode. The aerosol light extinction coefficient (σ_ext) value was much higher (mean: 610Mm^-1) during the lower visibility (foggy) condition. Higher concentrations of PM_2.5 (89μgm^-3) and longer visible wavelength absorbing BC_880nm (25.7μgm^-3) particles were observed up to 200m. The BC_880nm and PM_2.5 aerosol concentrations near boundary layer (1km) were significantly higher (~1.9 and 12μgm^-3), respectively. The BC (i.e BC_tot) aerosol direct radiative forcing (DRF) values were estimated at the top of the atmosphere (TOA), surface (SFC), and atmosphere (ATM) and its resultant forcing were - 75.5Wm^-2 at SFC indicating the cooling effect at the surface. A positive value (20.9Wm^-2) of BC aerosol DRF at TOA indicated the warming effect at the top of the atmosphere over the study region. The net DRF value due to BC aerosol was positive (96.4Wm^-2) indicating a net warming effect in the atmosphere. The contribution of fossil and biomass fuels to the observed BC aerosol DRF values was ~78% and ~22%, respectively. The higher mean atmospheric heating rate (2.71Kday^-1) by BC aerosol in the winter season would probably strengthen the temperature inversion leading to poor dispersion and affecting the formation of clouds. Serious detrimental impacts on regional climate due to the high concentrations of BC and PM (especially PM_2.5) aerosol are likely based on this study and suggest the need for immediate, stringent measures to improve the regional air quality in the northern India.

Progress testing in undergraduate dental education: the Peninsula experience and future opportunities

BACKGROUND

Progress testing is well established as a longitudinal form of assessment in undergraduate medical programmes to measure growth in knowledge. Peninsula Dental School is the first school to use progress testing and remains the only one to do so.

AIMS

To share the experience of developing progress testing in an undergraduate dental programme as a major summative assessment tool at a newly established dental school in the United Kingdom.

METHODS

Data were collected for progress tests conducted from 2007 to 14. The tests were formative in the first 2 years of the programme and summative in subsequent years. Each test was based on 100 single best answer multiple-choice items with an appropriate vignette. The students chose their answer from 5 options. A score 1 mark is awarded for each correct answer, minus 0.25 for an incorrect answer and 0 for 'don't know' (DK). The standard setting for each sitting was carried out using Angoff and Hofstee methods.

RESULTS

There were two tests per year with each cohort undertaking eight tests in their 4 years of study providing a total 14 test occasions. The reliability of each test for each student cohort tests was measured using Cronbach's alpha. The average reliability over 42 test/cohort combinations was 0.753 (±SD 0.08). Data analyses show growth in knowledge of dental students across successive years with the largest increase in knowledge observed between tests 1 and 5 and concomitant reduction in DK responses.

CONCLUSION

This is the first study to report the establishment and use of progress testing as the principle form of written summative testing in an undergraduate dental curriculum. Progress testing is a valid and reliable tool to assess growth in knowledge longitudinally over the duration of a dental programme. Although a labour-intensive process, progress testing merits more widespread use in dental programmes.

Provider-reported acceptance and use of the Centers for Disease Control and Prevention messages and materials to support HPV vaccine recommendation for adolescent males

PURPOSE

We evaluated Florida-based physicians' awareness and use of the Centers for Disease Control and Prevention's (CDC) "You are the Key" campaign website, including messages to support physicians' human papillomavirus (HPV) vaccine recommendations.

METHODS

Using closed-ended and free-text survey items, physicians' (n=355) practices related to HPV vaccination recommendations for males and use of the CDC's materials were assessed. Descriptive statistics were calculated for closed-ended questions, and thematic analysis was conducted on free-text responses.

RESULTS

Over half of physicians were aware of the CDC's website (n=186; 57.9%); of those aware, fewer than half reported using the website (n=86; 46.2%). Slightly more than half reported awareness of the CDC's messages (n=178; 55.3%); however, less than one-third of those aware reported using them (n=56; 31.5%). Physicians' comments on the CDC's messages were favorable; 78.6-93.2% said they would use a message in clinic.

CONCLUSION

Additional research is needed to identify the best mechanisms for resource dissemination and to understand why physicians do not use these messages, despite favorable attitudes.

Transition of new dental graduates into practice: a qualitative study

AIMS

The aims of this study were to explore the transition of new dental graduates to gain a deeper understanding of the merits and challenges of a mentored year for new graduates in general dental practice settings.

METHODS

The study was conducted in the south-west region of England. Qualitative methods were used to engage a range of stakeholders in dental education including dental students, academics, general dental practitioners, new graduates, specialists and representatives of the postgraduate dental deanery. Purposive sampling was employed, and after ethical approval, participants were contacted through professional channels. All interview transcripts were transcribed verbatim. The data were imported into NVivo 10 (QSR International Pty Ltd) and analysed thematically.

RESULTS

Sixteen participants representing a variety of stakeholder groups were interviewed. The participants shared their perceptions and experiences regarding the transition new dental graduates into dental practice. The challenges and benefits are discussed along with strategies to facilitate a smooth transition.

CONCLUSIONS

This study provides an insight into experience of a mentored year for new dental graduates in general practice settings. Foundation training provides a structured introduction into general practice and serves as a safety net before new graduates gain further independence in clinical practice.

The Killer Will Remain Free: On Pat Parker and the Poetics of Madness

Poet and scholar Kazim Ali reads Pat Parker's Movement in Black intimately, one poet to another, uncovering the shadow-fact of the lives of most people of color: not only the anger that is somehow sublimated into every part of our lives but also the issue that carrying this feeling around has on our mental health itself-that "anger" and "madness" might have sources in one another. Ali concludes that Parker offers a brutal and clear-eyed and ultimately hopeful assessment of the conditions that were faced at the time, and even now, by communities of color.

Estimating tuberculosis burden and case detection in Pakistan

BACKGROUND

The National Tuberculosis Control Programme (NTP) in Pakistan has officially achieved a tuberculosis (TB) case detection rate of 64% in 2011, with an estimated incidence rate of 230 per 100 000 population, but is likely to be missing an unknown number of patients, particularly in the private sector.

SETTING

All public and private sector providers in 12 randomly selected districts of Pakistan were included.

OBJECTIVE

To estimate TB incidence and TB notification rates in Pakistan in 2012.

DESIGN

A surveillance system was established among all eligible non-NTP providers in selected districts from January to March 2012. Record linkage and capture-recapture analysis was conducted.

RESULTS

Of 8346 TB cases identified after record linkage, 6061 were registered with the NTP. The estimated number of unobserved TB cases was 10 030 (95%CI 7800-12 910), which meant that the proportion of notified cases was 32% (95%CI 17-49). The calculated annual incidence was 878 000 cases (95%CI 573 000-1 675 000), corresponding to a rate of 497/100 000 (95%CI 324-948) annually in the population.

CONCLUSION

The study estimated that the proportion of cases notified to the NTP was low, with actual incidence rates being higher than official estimates. TB surveillance should be strengthened to reduce under-reporting.

Management of impacted wisdom teeth: teaching of undergraduate students in UK dental schools

INTRODUCTION

Wisdom tooth removal is one of the most common oral surgical procedures performed across the world. The aim of this study was to gauge the teaching and training of impacted wisdom teeth in undergraduate dental programmes across the UK. The objectives were to identify consistencies and variations in theoretical instructions and clinical training as well as approaches to management of impacted wisdom teeth.

METHODS

This was a cross-sectional survey utilising an online questionnaire. A purposefully designed pro forma with open- as well as closed-ended questions was used. The questionnaire was hosted online on the school's blackboard academic suite (Emily). Prior to conducting the study, approval was gained from the Research and Ethics Committee, and all the ethical principles pertaining to data protection were strictly followed. E-mail invitations were sent to oral surgery leads in all dental schools in the UK. The participants were provided with an information sheet, and an informed consent was obtained. The participants were invited by e-mail to complete the questionnaire online voluntarily.

RESULTS

A total of 16 dental schools offering an undergraduate course in dentistry in the UK, 13 responded positively. (response rate = 81.25%). In majority of dental schools, this subject is taught in the 4th and 5th years. A pre-clinical competency on phantom heads is a requirement in six schools, whilst only one school requires the students to pass a clinical competency. The clinical exposure of students to wisdom tooth surgery is quite variable. Although the dental schools are fairly consistent in their teaching with regard to the indications for surgical intervention, diagnostic/treatment modalities as well as the post-operative care, interesting variations were also observed.

CONCLUSIONS

This study, perhaps the first of its kind, provides useful insights into management of impacted wisdom teeth, as taught in the undergraduate dental programmes across the UK.

Use of peer assessment in tooth extraction competency

INTRODUCTION

Peer assessment is a widely recognised practice in higher education and is being increasingly utilised in healthcare education. It offers multiple advantages and may play a useful role in enhancing students' learning experience. This study was carried out to evaluate the utility of peer assessment in tooth extraction competency in simulated dental learning environment (SDLE).

METHODS

Year 2 dental students were invited to participate in a formative, peer assessment exercise on forceps tooth extraction in SDLE. The ratings made by peers in the formative assessment were compared with the ratings made by academic supervisors in an equivalent summative assessment.

RESULTS

One hundred and twenty-two students participated in both the formative and summative assessments. Descriptive statistics demonstrated that the majority of students were given the same rating in both assessments. However, there were a number of students who were rated as 'Competent' in one assessment and 'Not Competent' in the other assessment. Spearman's Rho correlations showed that there were weak relationships between the formative and summative assessments. There was also weak inter-rater reliability for the ratings of the peers and academic supervisors, as measured by the intraclass correlation coefficient. Feedback from the students and academic supervisors showed unanimously positive perceptions about the peer assessment experience, and they expressed the desire for incorporating peer assessment in other competencies.

CONCLUSIONS

This study shows mixed results with regard to the value of the peer assessment. Given the potential utility of peer assessment as a tool to augment and enrich students' learning experience, further work needs to be done to evaluate the use of peer assessment in operative competencies in dentistry.

Lipid profile and glycosylated hemoglobin status of gestational diabetic patients and healthy pregnant women

AIM

Lipid profile and glycosylated hemoglobin level changes in gestational diabetes. The extent to which this alteration takes place is still not clearly documented.

MATERIALS AND METHODS

To add a clear answer to this question, lipid profile parameters, and glycosylated hemoglobin status were determined in patients with gestational diabetes mellitus and compared to healthy pregnant women (controls).

RESULTS

Fasting plasma glucose levels, plasma glucose levels 1 hour, and plasma glucose levels 2 hours after 75 gm oral glucose administration (oral glucose tolerance test) were significantly higher in patients with gestational diabetes as compared to controls. Glycosylated hemoglobin was significantly higher in gestational diabetes than in controls. It was observed that there was a significant increase in serum cholesterol and serum triglyceride level in cases with gestational diabetes when compared to healthy pregnant women.

CONCLUSION

The results of our study suggest that abnormal glucose levels, glycosylated hemoglobin, serum cholesterol, and serum triglycerides play an important role in pathophysiology of gestational diabetes, and therefore, extensive studies are required. Early diagnosis of gestational diabetes will decrease adverse neonatal and maternal outcomes.

Assessments of population exposure to environmental pollutants using air quality measurements during Commonwealth Games-2010

During the "Commonwealth Games" 2010 (CWG-2010) in Delhi, the Indian government has implemented an ambitious project "System of Air quality Forecasting And Research (SAFAR)" for monitoring and forecasting air-quality scenario. Using high-precision spatio-temporal measurements of criteria pollutants from the SAFAR network, the number of cases are estimated for total, cardiovascular and respiratory mortalities and hospital admissions. In a thinly populated airport area, the excess number of cases for total mortality show ∼10 for PM2.5 and 25 for PM10, whereas, ∼110 for PM2.5 and ∼300 for PM10 in most populous Delhi University (DU) area. Cardiovascular mortality in airport area show ∼5 and <10 for PM2.5 and PM10, respectively, but, in DU area show ∼55 for PM2.5 and ∼140 for PM10. In DU locality, respiratory mortality shows ∼7 and ∼20 for PM2.5 and PM10 and, hospital admissions show ∼11 and ∼30 for PM2.5 and PM10, respectively. In airport area, excess cases of respiratory mortality and hospital admission tends to one for exposure to PM2.5 or PM10 levels indicating effective exposure is the key factor for health hazards. As public health gains, low air pollution levels were observed before the CWG due to effective washout by monsoonal rain and during CWG under policy-induced air quality measures could increase the life expectancy as against to post-CWG period. These results are important for the megacities in developing world as the SAFAR project is internationally recognized by the Global Urban Research Meteorology and Environment of the World Meteorological Organization.

Evaluating population exposure to environmental pollutants during Deepavali fireworks displays using air quality measurements of the SAFAR network

Indian government has implemented a state of art project "System of Air quality Forecasting And Research (SAFAR)" for assessing the air-quality scenario in Delhi during "Commonwealth Games-2010" which is operational in Delhi. Using a high resolution data of the SAFAR network, we estimate the excess numbers of cases for total, cardiovascular and respiratory mortalities and hospital admissions with the air-quality response to population attributable-risks due to emissions from fireworks displays (Deepavali-2010). The ratios of numbers of excess cases for fireworks displays (Deepavali) to those of non-Deepavali period (CWG-2010) vary from 1.75 to 3.5 for PM(2.5) and from 3 to 8 for PM(10) at monitoring stations in study area except in an airport. These ratios approach to 1 for PM(2.5) or PM(10) in airport area which can be attributed to restrictions on fireworks displays and eventually a very low population exposure. The numbers of excess cases for PM(2.5) and PM(10) during extreme emissions by fireworks displays are about 2-fold to those of non-Deepavali period. The SAFAR is recognized by the Global Urban Research Meteorology and Environment of the World Meteorological Organization and thus results would likely to provide episodic limits for developing countries in common line with the air-quality standards set for developed world for pollutant levels due to emissions from the fireworks displays when population of country celebrates traditional festivals collectively.

Minimized perfusion circuits: an alternative in the surgical treatment of Jehovah’s Witnesses

Objectives:

Jehovah’s Witnesses present a challenge to cardiac surgeons, as quality of care is not only defined by mortality and morbidity, but also by the avoidance of blood transfusions. Over the last years, minimized perfusion circuits (MPC) have contributed substantially to the achievement of this goal in our clinic. Presented is a retrospective analysis of our experience.

Methods:

Twenty-nine Jehovah’s Witnesses, aged 69 ± 10 years, have undergone cardiac surgery with a MPC in our institution since 2005. The ROCsafe (Reservoir Optional Circuit) MPC was used in most of these patients (n=27) as it offers the unique possibility of a speedy integration of a reservoir in the event of a major air leak, thereby, negligating any safety concerns.

Results:

There was no in-hospital or 30-day postoperative mortality. Mean ICU stay was 1.6 ± 2 days with a mean intubation time of 11.3 ± 9.1 hrs. Postoperative complications included one myocardial infarction with accompanying low cardiac output, one stroke, one transient delirium, one idiopathic thrombocytopenia and three re-operations (one sternal infection, one postoperative bleeding and one delayed tamponade). The mean postoperative hospital stay was 9.9 ± 2.3 days. Mean decrease in hemoglobin was 2.1 ± 1.3 g/dl during cardiopulmonary bypass and 3.4 ±1.4 g/dl at discharge. The lowest postoperative hemoglobin level was 9.3 ±1.8 (Range 6-12.9).

Conclusions:

These encouraging results emphasize the role MPCs can play in optimizing the quality of patient care. We hope that this report can serve as a stimulus for similar experiences.

Academic environment in a newly established dental school with an enquiry-based curriculum: perceptions of students from the inaugural cohorts

INTRODUCTION

Established in 2007, Peninsula Dental School offers a highly innovative, enquiry-based, student-led, patient-centred curriculum. It is one of the first dental schools in UK to be based exclusively in a primary care setting. This study was carried out to evaluate the academic environment at Peninsula Dental School and to identify differences between expectations of new entrants and perceptions of senior cohorts.

METHODS

This was a cross-sectional survey utilising an online questionnaire based on Dundee Ready Educational Environment Measure (DREEM). The subjects were 234 dental students from all years in this enquiry-based Bachelor of Dental Surgery programme.

RESULTS

The response rate to the questionnaire was 56.42% with an equal gender distribution of the participants. The overall mean DREEM score of the four cohorts was 143.58 (SD ± 20.84), and the mean score for individual items was 2.87 (SD ± 0.41). The reliability of the DREEM data as a whole was strong (α = 0.93). The difference in questionnaire means for the new entrants and the senior cohorts was not significant (P > 0.05). The ANOVA results showed that there were no significant effects of age, gender or ethnicity on the mean DREEM scores. The MANOVA results showed a significant effect of ethnicity with regard to perceptions of teachers and atmosphere.

CONCLUSIONS

An enquiry-based, student-centred curriculum at the Peninsula Dental School provides a positive academic environment for the students.

Mössbauer investigations of crystalline and quasicrystalline Al3(Mn, Fe) compounds

(57)Fe Mössbauer and magnetic measurements are reported on Taylor phase compounds T-Al(3)(Mn,Fe), which can be seen as complex metallic alloys. The orthorhombic unit cell contains 156 atoms. These investigations are further extended to Al(71)Mn(19)Fe(10) crystallizing as a decagonal quasicrystal. Common to both structures are layers, which are oriented perpendicular to the b axis in the crystalline or to the periodic axis in the quasicrystalline compound, allowing the formation of characteristic building blocks. At low temperatures for all samples spin glass behavior is observed with freezing temperatures T(f) increasing with Fe content. Above T(f) the (57)Fe Mössbauer spectra were analyzed by a superposition of two subspectra with intensity ratio around 75:25, which can be allocated to Fe substituted on Mn sites surrounded either by Al and Mn or solely by Al with Mn only at the edge of the nearest neighbor shell. For both subspectra quadrupole splitting and center shift do not change significantly with Fe content and with structure. Below T(f) broad hyperfine field distributions with non-vanishing contributions at zero hyperfine field are present. Magnetic and electrostatic hyperfine interactions are governed by length scales which are determined by the very similar interatomic configurations forming the T-Al(3)Mn phase as well as the decagonal compound. The presence of long range atomic order is of less importance.

Comparative analysis of Shwachman-Diamond syndrome to other inherited bone marrow failure syndromes and genotype-phenotype correlation

Our knowledge of the phenotypes of inherited bone marrow failure syndromes (IBMFSs) derives from case reports or case series in which only one IBMFS was studied. However, the substantial phenotypic overlap necessitates comparative analysis between the IBMFSs. Shwachman-Diamond syndrome (SDS) is an IBMFS that the appreciation of what comprises its clinical phenotype is still evolving. In this analysis we used data on 125 patients from the Canadian Inherited Marrow Failure Study (CIMFS), which is a prospective multicenter population-based study. Thirty-four cases of SDS patients were analyzed and compared to other patients with the four most common IBMFSs on the CIMFS: Diamond Blackfan anemia, Fanconi anemia (FA), Kostmann/severe congenital neutropenia and dyskeratosis congenita (DC). The diagnosis of SDS, FA and DC was often delayed relative to symptoms onset; indicating a major need for improving tools to establish a rapid diagnosis. We identified multiple phenotypic differences between SDS and other IBMFSs, including several novel differences. SBDS biallelic mutations were less frequent than in previous reports (81%). Importantly, compared to patients with biallelic mutations, patients with wild type SBDS had more severe hematological disease but milder pancreatic disease. In conclusion, comprehensive study of the IBMFSs can provide useful comparative data between the disorders. SBDS-negative SDS patients may have more severe hematological failure and milder pancreatic disease.