The six-domain well-being framework in oral health sciences: A pathway from theory to practice

OBJECTIVES

Well-being is a complex and multifaceted construct that has gained popularity in oral health sciences education. Maintaining students' well-being is essential for their academic performance and quality of life. While many definitions and frameworks of well-being exist, their applicability to oral health sciences education remains unknown. This study aimed to evaluate the applicability of the Feeney and Collins's framework of well-being to oral health sciences education by exploring students' perceptions and experiences in the University of British Columbia METHODS: An Interpretive Description approach was used to conduct semi-structured interviews with dental and dental hygiene students. Interviews were transcribed, and transcripts were coded and analyzed with guidance from Feeney and Collins's well-being and thriving framework using content analysis. Domains were inductively developed within and beyond the organizing categories of the chosen framework.

RESULTS

Thirty-one oral health sciences students participated in the study. Study data can largely be explained by the five well-being domains suggested by Feeney and Collins: physical, psychological, eudaimonic, subjective, and social. Spirituality and gratitude emerged as an additional domain that contributes to students' well-being. Interdomain relationships were observed. The social domain seemed to contribute to all other well-being domains; while the subjective domain seemed to be shaped by all other domains CONCLUSIONS: Feeney and Collins's framework seemed to be useful to understand and conceptualize well-being in oral health sciences education but needed to be expanded to include spirituality and gratitude. Further evidence is needed to explore the applicability of this framework in other health professional education disciplines.

Access to Multidisciplinary Care for Pediatric Weight Management: Exploring Perspectives of the Health Care Team within Canada and the United States

Background: In Canada and the United States, most families referred for pediatric weight management services do not start treatment. Of families who initiate care, many discontinue before the program ends. Parents and youth have reported difficulties in accessing services as an important barrier to starting or completing programming. The purpose of this study was to understand barriers and identify potential solutions related to access to care from the perspective of health care team members from Canada and the United States. Methods: Qualitative description method guided the study design. Participants were health care team members, purposefully recruited through Canadian and US-based pediatric weight management program registries. Telephone interviews were conducted with participants between February and May 2017. Interviews were transcribed verbatim and analyzed using content analysis. Results: Eighteen individuals from 16 sites participated (n = 8 Canada, n = 8 United States). Access barriers and potential solutions were related to: (1) referral and eligibility, (2) wait lists and program capacity, (3) logistics and costs, and (4) stigma and weight bias. Barriers were similar between Canadian and US sites, with the exception of cost-related barriers. Conclusions: Health care providers from Canada and the United States reported multiple societal, organizational, service, and family-level barriers to accessing multidisciplinary pediatric weight management care. Proposed solutions suggest that service providers can play a key role alongside families to improve access to appropriate care. Further research is needed to demonstrate the feasibility and effectiveness of proposed solutions.

Variation among Pathologists in the Histologic Grading of Canine Cutaneous Mast Cell Tumors with Uniform Use of a Single Grading Reference

Ten veterinary pathologists independently assigned histologic grades to the same 60 canine cutaneous mast cell tumors using the Patnaik classifications. The degree of agreement in grading among the pathologists was compared with the degree of agreement among the same pathologists in a previous study, in which each pathologist used the reference for grading that he/she uses routinely. Mean agreement improved significantly from 50.3% to 62.1% with uniform use of the Patnaik classifications ( P = 0.00001), suggesting that there is value in uniform application of a single grading scheme for canine cutaneous mast cell tumors. Agreement among pathologists was still not 100%, suggesting that a more objective grading scheme should be developed and that other histologic indicators of prognosis should be investigated.

Should I stay or should I go? Understanding families' decisions regarding initiating, continuing, and terminating health services for managing pediatric obesity: the protocol for a multi-center, qualitative study

BACKGROUND

At least two million Canadian children meet established criteria for weight management. Due to the adverse health consequences of obesity, most pediatric weight management research has examined the efficacy and effectiveness of interventions to improve lifestyle behaviors, reduce co-morbidities, and enable weight management. However, little information is available on families' decisions to initiate, continue, and terminate weight management care. This is an important knowledge gap since a substantial number of families fail to initiate care after being referred for weight management while many families who initiate care discontinue it after a brief period of time. This research aims to understand the interplay between individual, family, environmental, and systemic factors that influence families' decisions regarding the management of pediatric obesity.

METHODS/DESIGN

Individual interviews will be conducted with children and youth with obesity (n = 100) and their parents (n = 100) for a total number of 200 interviews with 100 families. Families will be recruited from four Canadian multi-disciplinary pediatric weight management centers in Vancouver, Edmonton, Hamilton, and Montreal. Participants will be purposefully-sampled into the following groups: (i) Non-Initiators (5 families/site): referred for weight management within the past 6 months and did not follow-up the referral; (ii) Initiators (10 families/site): referred for weight management within the past 6 months and did follow-up the referral with at least one clinic appointment; and (iii) Continuers (10 families/site): participated in a formal weight management intervention within the past 12 months and did continue with follow-up care for at least 6 months. Interviews will be digitally recorded and analyzed using an ecological framework, which will enable a multi-level evaluation of proximal and distal factors that underlie families' decisions regarding initiation, continuation, and termination of care. Demographic and anthropometric/clinical data will also be collected.

DISCUSSION

A better understanding of family involvement in pediatric weight management care will help to improve existing health services in this area. Study data will be used in future research to develop a validated survey that clinicians working in pediatric obesity management can use to understand and enhance their own health services delivery.

Nanomechanics of biologically inspired helical silica nanostructures

Diatoms are unicellular algae that exhibit highly intricate, silicified cell walls called frustules. Frustules consist of hierarchical nanostructures composed of amorphous silica and organic protein. Earlier work has suggested diatoms as inspiration for novel molecular sieves, resins, and optical coatings because of their unique mechanical, structural, and optical properties. Here the present authors report studies of the mechanics of helical silica structures inspired by the geometry found in diatom frustules consisting of both crystalline and amorphous silica. Molecular dynamics simulations are reported with the reactive force field ReaxFF, which is a powerful model to describe interatomic interactions derived directly from first principles quantum mechanics. It is found that introducing a helical nanostructural geometry gives the typically brittle silica a highly ductile, yet softer, mechanical behaviour: extensions of 100 per cent to roughly 300 per cent are observed for varying helical geometries. The present authors show that hydroxide termination markedly affects the mechanical properties of the silica, lowering both the Young’s modulus and the ultimate strength of the structures. The results reported here demonstrate the potential to drastically alter, and possibly improve, the properties of an inherently brittle material by confining structural features to the nanoscale and by altering its hierarchical geometry without introducing any additional material components, solely relying on geometrical changes.

Preterm infants' responses to taste/smell and tactile stimulation during an apneic episode

A nonprobability sample of 14 nonventilated preterm infants, with a mean postconceptional age of 33.9 weeks, was examined to determine their responses to two interventions during apnea. The interventions included a traditional tactile stimulation of moderate shaking applied to the infant's leg and an experimental oral intervention consisting of taste, smell, and oral tactile stimulation. Infants served as their own control. Each infant received four randomly assigned trials (two of each intervention) when they experienced an apneic episode. The time interval for reinitiation of respiratory effort was significantly shorter after infants received the experimental stimulation (p = 0.0101). Behavioral state changed to alertness when the infants received the traditional tactile intervention yet remained unchanged when the experimental stimulation was administered during apnea (p = 0.0202).

Kinetics of inulin penetration in cortex and medullary kidney slices

The inulin space of dog kidney slices obtained from cortex and outer and inner medulla was evaluated by incubating the tissue at different time intervals in inulin Ringer. When the kidney was cut normal to the major axis of Henle's loops and collecting ducts, inulin uptake appeared to follow a single exponential time function in each renal region.When the organ was cut parallel to the major axis of Henle's loops the inulin space was greater and inulin uptake appeared to follow two exponential functions of time in each of the three renal regions. This would indicate that the plane of section can influence the apparent size of the extracellular space of kidney slices, as measured by the distribution of inulin.