Telomere Length, Proviral Load and Neurologic Impairment in HTLV-1 and HTLV-2-Infected Subjects.

Short or damaged telomeres have been implicated in degenerative conditions. We hypothesized that analysis of telomere length (TL) in human T-cell lymphotropic virus (HTLV) infection and HTLV-associated neuropathy might provide clues to the etiology of HTLV-associated disease and viral dynamics. A subset of 45 human T-cell lymphotropic virus type 1 (HTLV-1), 45 human T-cell lymphotropic virus type 2 (HTLV-2), and 45 seronegative subjects was selected from the larger HTLV Outcomes Study (HOST) cohort, matched on age, sex and race/ethnicity. Telomere-to-single-copy gene (T/S) ratio (a measure of TL) and HTLV-1 and HTLV-2 proviral loads were measured in peripheral blood mononuclear cells (PBMCs) using quantitative PCR (qPCR). Vibration sensation measured by tuning fork during neurologic examinations performed as part of the HOST study allowed for an assessment of peripheral neuropathy. TL was compared between groups using t-tests, linear and logistic regression. Mean T/S ratio was 1.02 ± 0.16 in HTLV-1, 1.03 ± 0.17 in HTLV-2 and 0.99 ± 0.18 in HTLV seronegative subjects (p = 0.322). TL was not associated with HTLV-1 or -2 proviral load. Shorter TL was significantly associated with impaired vibration sense in the HTLV-2 positive group only. Overall, we found no evidence that telomere length was affected by chronic HTLV-1 and HTLV-2 infection. That TL was only associated with peripheral neuropathy in the HTLV-2-positive group is intriguing, but should be interpreted cautiously. Studies with larger sample size and telomere length measurement in lymphocyte subsets may clarify the relationship between TL and HTLV-infection

Interventions for the Reduction of Dental Anxiety and Corresponding Behavioral Deficits in Children with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) can greatly inhibit a child\u27s communication and social interaction skills, impacting their comfort during dental hygiene treatment and services. Children with ASD may exhibit sensory sensitivities, fear of the unfamiliar and lack of socio-cognitive understanding, leading to anxiety and corresponding behavioral deficits. Since the prevalence rates for ASD have risen significantly in the past decade, increased emphasis has been placed on educational and behavior guidance techniques, which can be helpful for children with ASD because of their increased capabilities in visual-processing. The purpose of this literature review is to summarize the interventions available to reduce dental anxiety in children with ASD, and to determine which strategies are best suited for implementation by the dental hygienist. Advancements in technology and socio-behavioral interventions were assessed for appropriate use, efficacy and engagement in the target population. Interventions were categorized into the following groups: picture cards, video technologies and mobile applications

Mass Fatality Incidents and the Role of the Dental Hygienist: Are We Prepared?

Dental hygienists can fill critical roles during mass fatality incidents in the area of disaster victim identification, providing much needed support to forensic odontologists. The purpose of this paper is to bring awareness that research is needed to assess current dental hygiene programs, continuing education opportunities and the type of approach being used to develop and implement pedagogy in the forensic specialty area, specifically mass fatality preparedness and response for the dental hygienist. Because of the threat of terrorism in the U.S. and natural disasters like hurricanes, the need to prepare dental professionals in disaster response and fatality management is real. The authors\u27 recommendations are to incorporate training in the areas of risk management and infection control in the mortuary setting, antemortem and postmortem records comparison, safe usage of portable radiographic equipment, and proper radiographic technique for the deceased victim. Disaster victim identification training in these areas is necessary for the accurate, efficient and dignified identification of disaster victims while minimizing errors and increasing responder safety. The dental hygiene professional can assist disaster mortuary response efforts in a way that leverages multidisciplinary teams, if effective training programs are implemented

Influences of Training and Personal Experiences on Counselor Trainees\u27 GLBT Ally Development: A Case Stud

The goal of this multiple case study was to investigate straight counseling students’ perceptions of their preparation to work with GLBT clients. For this study, semi - structured interviews were conducted with six straight counselor education students from two universities. Pattern matching analysis revealed that students with significant exposure to GLBT individuals, as well as those who believed their training provided adequate preparation for GLBT counseling, were more likely to adopt a GLBT - affirmative identity and to experience greater self - efficacy about counseling with GLBT individuals. In addition, thematic analysis revealed seven themes of participants’ experiences that fell into four categories. Ideas for counselor educators to incorporate experiential learning into their programs are offered

Assessment of Mass Fatality Preparedness and Response Content in Dental Hygiene Education

When mass fatality incidents (MFIs) occur, they can quickly overwhelm local, state, and government agencies, resources, and personnel. It is important to have a rapid and effective response with skilled, multidisciplinary victim identification teams since specific skill sets are necessary to participate in mass fatality preparedness and response. The aims of this study were to determine the extent of formal education related to mass fatality preparedness and response training in U.S. dental hygiene programs and to assess program directors\u27 perceptions of the need for such training. A 23-item cross-sectional survey was emailed to 319 U.S. dental hygiene programs in 2015. Survey questions addressed if the program offered mass fatality preparedness and response training to its students and how much training was given, as well as collecting respondents\u27 demographics and opinions regarding education and training. An overall response rate of 36% was obtained, with 111 program chairs completing the survey. The results showed that only a small percentage of responding programs incorporated coursework related to mass fatality and preparedness in their curricula. Of the responding programs, 84% had no formal instruction on the role of a dental hygienist in MFIs; however, 53 of 69 program directors agreed or strongly agreed that the role of dental hygienists in MFIs should be covered in dental hygiene curricula. The top three barriers to incorporating such training reported by respondents were time requirements, lack of faculty expertise, and lack of equipment. Future research is needed to establish standardized competencies for mass fatality preparedness and response in dental hygiene education

Performance of Dental Hygiene Students in Mass Fatality Training and Radiographic Imaging of Dental Remains

Purpose: Mass fatality incidents can overwhelm local, state and national resources quickly. Dental hygienists are widely distributed and have the potential to increase response teams\u27 capacity. However, appropriate training is required. The literature is void of addressing this type of training for dental hygienists and scant in dentistry. Hence, the purpose of this study was to assess one facet of such training: Whether the use of multimedia is likely to enhance educational outcomes related to mass fatality training. Methods: A randomized, double-blind, pre- and post-test design was used to evaluate the effectiveness of comparable educational modules for 2 groups: a control group (n=19) that received low media training and a treatment group (n=20) that received multimedia training. Participants were second-year, baccalaureate dental hygiene students. Study instruments included a multiple-choice examination, a clinical competency-based radiology lab scored via a standardized rubric, and an assessment of interest in mass fatality education as a specialty. ANOVA was used to analyze results. Results: Participants\u27 pre- and post-test scores and clinical competency-based radiology lab scores increased following both educational approaches. Interest in mass fatality training also increased significantly for all participants (p=0.45). There was no significant difference in pre- and post-test multiple choice scores (p=0.6455), interest (p=0.9133) or overall competency-based radiology lab scores (p=0.997) between groups. Conclusion: Various educational technique may be effective for mass fatality training. However, mass fatality training that incorporates multimedia is an appropriate avenue for training instruction. Continued research about multimedia\u27s role in this specialty area is encouraged

Postmortem Dental Records Identification by Dental Hygiene Students: A Pilot Study

Purpose: Dental hygienists have the potential for filling critical roles in multidisciplinary victim identification teams. The purpose of this pilot study was to evaluate the accuracy of dental hygiene students utilizing dental charting, bitewings, and skull dentitions for the purpose of making identification matches. Methods: Thirty senior dental hygiene students (n=30) independently viewed an asynchronous online multimedia-based presentation on the procedures used for collecting and recording forensic dental evidence. Following the presentation participants attempted to chart and match three bitewing radiograph sets to three human skull dentitions by correlating matches/exclusions. Immediately following the activity, each student completed a questionnaire rating the difficulty of the exercise, as well as their confidence, and willingness to volunteer as a forensics team member. Descriptive statistics were used to analyze the data. Results: Of the total sample 36.7% (n=11) reported having prior experiences with dental radiography; while the majority (63.33%, n=19) reported no prior experience. Participants\u27 accuracy scores for dental charting ranged from 91.23% (SD=9.42) to 99.06% (SD=3.60), with no statistically significant difference based on prior experience (p\u3e0.05). The average interrater reliability was 86% (p\u3c0.0001), indicating a high level of agreement with charting skulls and radiographs. No statistically significant differences were found for charting time, perceived difficulty, or level of confidence when comparing experience among the participants (p\u3e0.05). Conclusions: Regardless of previous experience, dental hygiene students were able to match postmortem dentitions and radiographs with good interrater reliability and did not differ statistically for charting time, perceived difficulty, or confidence. Results suggest dental hygienists can work as effective victim identification team members when educational programs are implemented

The impact of reduction of doublet well spacing on the Net Present Value and the life time of fluvial Hot Sedimentary Aquifer doublets

This paper evaluates the impact of reduction of doublet well spacing, below the current West Netherlands Basin standard of 1000 to 1500 m, on the Net Present Value (NPV) and the life time of fluvial Hot Sedimentary Aquifer (HSA) doublets. First, a sensitivity analysis is used to show the possible advantage of such reduction on the NPV. The parameter value ranges are derived from West Netherlands Basin HSA doublet examples. The results indicate that a reduction of well spacing from 1400 to 1000 m could already influence NPV by up to 15%. This effect would be larger in more marginally economic HSA doublets compared to the West Netherlands Basin base case scenario. The possibility to reduce well spacing is supported by finite element production simulations, utilizing detailed facies architecture models. Furthermore, our results underline the necessity of detailed facies architecture models to assess the potential and risks of HSA doublets. This factor significantly affects doublet life time and net energy production of the doublet

Protocol for the United Kingdom Rotator Cuff Study (UKUFF) : a randomised controlled trial of open and arthroscopic rotator cuff repair

This project was funded by the NIHR Health Technology Assessment programme (project number 05/47/02). J. L. Rees has received a grant from Oxford University which is related to this paper. J. Dawson reports that Oxford University has received a grant from HTA which is related to this paper, as well as a study grant.Peer reviewedPublisher PD