Segmentation of Mexican-Heritage Immigrants: Acculturation Typology and Language Preference in Health Information Seeking

With the fast growing number of Mexican immigrants in the United States, more attention is needed to understand the relationship between acculturation and language preference in health information seeking. Latent class analysis provides one useful approach to understanding the diversity in sample of Mexican immigrants (N = 238). Based on 13 linguistic, psychological and behavioral indicators for acculturation, four discrete subgroups were characterized: (1) Less acculturated, (2) Moderately acculturated, (3) Highly acculturated, (4) Selectively bicultural. A Chi-square test revealed that three sub-groups were significantly different in language preference when seeking health information. Less acculturated and moderately acculturated groups sought health information in Spanish, whereas the highly acculturated group preferred English for health information. Selectively bicultural group preferred bilingual health information. Implications for health campaign strategies using audience segmentation are discussed

Network science and oral health research

The present overview of research methods describes a scientific enquiry paradigm that is well established in other disciplines, including health research, but that is fairly new to oral health research. Social networks analysis (SNA) or network science research is a set of relational methods purporting to identify and characterize the connections between members of a system or network, as well as the structure of the network. Persons and communities making up the members of networks have commonly been the focus of SNA studies but corporations or living organisms might just as well be organized in networks. SNA is grounded in both graphic imagery and computational models. SNA is based on the assumptions that features and structure of networks are amenable to characterization, that such information sheds light on the ways members of the network relate to each other (sharing information, diseases, norms, and so on), and that through these connections between members the overall network structure and characteristics are shaped. The overview resorts to examples specific to oral health themes and proposes a few general avenues for population-based research

Clinician-Patient Small Talk: Comparing Fourth-Year Dental Students and Practicing Dentists in a Standardized Patient Encounter

The aim of this study was to establish whether frequency of non-diagnostic, non-management exchanges between clinicians and patient (called “socioemotional communication,” SC) during a consultation differed between fourth-year dental students and dentists, controlling for clinically driven exchanges of information. Fifteen dentists and 17 fourth-year dental students were recorded in 2006 while undergoing a consultation with a live standardized patient and were subsequently interviewed by investigators in a separate room with the recording present for analysis. Their shared interpretations of cognitive strategies were recorded and compared for differences in the presence of SC. The results showed that most of the students and dentists engaged in SC throughout the consultation with a few exceptions. There were no significant differences between student and dentist cohorts for overall SC presence (p=0.62), time to first instance of SC from overall start of the consultation (p=0.73), and time to first instance of SC after first intraoral examination had taken place (p=0.76). Nonsignificant differences were also recorded for overall frequency at which SC occurred from overall start of the consultation (p=0.89) and after the first intraoral examination had taken place (p=0.12). The patterns showed SC interaction occurring throughout the consultation, not concentrated at the beginning or end. SC did not appear to differ between practitioners and students in terms of prevalence, frequency, or timing. Future research should examine the detailed association between SC and diagnostic thinking processes to further delineate the relationship and characterize possible pedagogical applications

Clinician-Patient Small Talk: Comparing Competent Students and Expert Dentists in a Standardized Patient Encounter

poster abstractObjectives: To establish whether the frequency of non-diagnostic, non-management exchanges between clinicians and patient (socioemotional communication, SC) during the consultation differed between senior dental students and dentists, controlling for clinically driven exchanges of information. Methods: Dentists and students were recorded while undergoing a consultation with a live standardized patient, and subsequently interviewed by investigators; their shared interpretation of cognitive strategies were recorded and compared for differences in the presence of SC using a χ2 test; first consultation occurrence of SC using log-rank tests; and number of times that SC occurred using mixed-model ANOVA. Results: Most clinicians engaged in SC throughout the consultation with a few exceptions. Statistical analyses produced non-significant differences for overall SC presence (p=0.62), time to first instance of SC from overall start of the consultation (p=0.73), and time after first intraoral examination had taken place (p=0.76). Non-significant differences were also recorded for the summary of time intervals when SC occurred at time from overall start of the consultation (p=0.89), and time after first intra-oral examination had taken place (p=0.12). Conclusions: SC occurred in most clinicians. Patterns depicted this interaction occurring throughout the consultation, not concentrated at the beginning or end. SC did not appear to differ between experts and students in terms of prevalence, frequency, or timing. Future research should examine the detailed association between SC and diagnostic thinking processes, to further delineate their relationship and characterize possible pedagogical applications

"Does this Look Infected to You?" Social Network Predictors of Dental Help-Seeking Among Mexican Immigrants

Compared to U.S. born Latinos, Mexican immigrants (MAs) have diminished health care access and face substantial barriers to accessing needed dental health services. However, little research has examined how MAs social networks shape their use of dental health services. Using data from 332 Mexican immigrants to the Midwest, this research examines the significance of individual and egocentric network characteristics on two measures of dental health service utilization. Findings reveal that network size, network dental service utilization, and the frequency with which MAs discuss acute problems with network ties, positively correspond to use of oral health services. Conversely, embeddedness in networks where ties hassle egos about dental issues and have low levels of dental health knowledge correspond to lower odds of using these services. This research is among the first to use ego network data and methods to examine the ways network characteristics shape oral health behaviors among this underserved population

Assessment of the Calibration of Periodontal Diagnosis and Treatment Planning Among Dental Students at Three Dental Schools

Calibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning

Dental problems and Familismo: social network discussion of oral health issues among adults of Mexican origin living in the Midwest United States

Objective: To examine the influence of collectivist orientation (often called familismo when applied to the Latino sub-group in the United States) in oral health discussion networks. Basic Research Design: Through respondent-driven sampling and face-to-face interviews, we identified respondents' (egos) personal social network members (alters). Egos stated whom they talked with about oral health, and how often they discussed dental problems in the preceding 12 months. Participants: An urban community of adult Mexican-American immigrants in the Midwest United States. We interviewed 332 egos (90% born in Mexico); egos named an average of 3.9 alters in their networks, 1,299 in total. Method: We applied egocentric network methods to examine the ego, alter, and network variables that characterize health discussion networks. Results: Kin were most often leveraged when dental problems arose; egos relied on individuals whom they perceive to have better knowledge about dental matters. However, reliance on knowledgeable alters decreased among egos with greater behavioral acculturation. Conclusions: This paper developed a network-based conceptualization of familismo. We describe the structure of oral health networks, including kin, fictive kin, peers, and health professionals, and examine how networks and acculturation help shape oral health among these Mexican-Americans

Assessing the Medical Emergency Preparedness of Dental Faculty, Residents, and Practicing Periodontists: An Exploratory Study

With the increased number of elderly and medically compromised individuals receiving dental care and the presence of systemic comorbidities and associated treatment modalities in this patient population, it is imperative that dentists be prepared to manage a variety of medical emergencies. The aim of this study was to assess the knowledge of and preparedness to manage common medical emergencies of cohorts of practicing periodontists, specialty residents, and faculty members, both for comparative purposes and as an aid to refining a dental school’s standardized case scenarios. The study, conducted in 2017, was designed for four groups of randomly selected participants with at least 20 in each group; the actual number of voluntary participants was 28 private practice periodontists, 22 residents in specialty programs, 21 specialist faculty members, and 24 general practice faculty members. Participants were asked to evaluate ten clinical emergency cases and identify the diagnosis and indicated intervention for each. Groups were also evaluated for differences among correct responses for each case. Overall, there were no statistically significant differences for number of correct diagnoses or interventions among the four groups. However, several cases had varying degrees of incorrect diagnoses and management across all groups. Participants who had recently graduated or were still in school were able to treat cases appropriately more often than the other participants. Further refinement of cases to assess provider preparedness to correctly diagnose and manage medical emergencies is needed, specifically establishing case-specific features and addressing areas of potential confusion before the cases are used for educational purposes

Résugence de la fièvre aphteuse en Europe en 2001

La fièvre aphteuse est une maladie virale, très contagieuse, qui touche tous les artiodactyles : bovins, ovins, porcins, caprins, et autres biongulés sauvages. Elles entraîne rarement la mort des animaux adultes, mais elle est responsable de graves pertes économiques (amaigrissement, chute de la production laitière, avortements...). L'Union européenne ne vaccinait plus contre cette maladie depuis 1991, ce qui lui avait permis de conquérir de nombreux marchés d'exportation, puisque dès lors , elle obtenait son statut de pays indemne de fièvre aphteuse. Mais au mois de février 2001, l'Angleterre vit apparaître des foyers de fièvre aphteuse, qui se transformèrent rapidement en une grave épizootie touchant l'ensemble du pays. Ensuite la maladie s'est étendue sur le continent, en touchant la France et les Pays-Bas. Cependant, grâce à une prophylaxie sanitaire très efficace, ces pays ont réussi à enrayer l'épizootie sévissant sur leurs territoires, et les autres états membres de l'union ont pu protéger leurs frontière. En outre, même si c'est la Grande Bretagne qui a le plus souffert économiquement de cette crise, l'ensemble de l'Union européenne a été touchée, en se voyant fermer les frontières de beaucoup de pays importateurs. Toutefois, l'Europe n'a pas souhaité reprendre la vaccination des animaux d'espèces sensibles, exceptés dans quelques cas exceptionnels. En effet, non seulement elle nous ferait perdre le statut de pays indemnes de fièvre aphteuse, ce qui n'arrangerait rien pour les exportations, mais en plus, au dire des spécialistes, elle n'aurait pas permis une efficacité plus grande dans la lutte contre cette épizootie. Notons que des progrès certains sont réalisés en matière de vaccination anti-fièvre aphteuse, et que l'on peut envisager dans l'avenir, une reconsidération de la politique vaccinale

Identification of barriers and beliefs influencing engagement by adult and teen Mexican-Americans in oral health behaviors

OBJECTIVE: To identify barriers and beliefs influencing oral health and dental care-seeking among Mexican-Americans. RESEARCH DESIGN: Interviews and Likert-scale survey questions were utilized to explore urgent and preventive dental care-seeking, oral hygiene habits and lifestyle practices. Thirty-three interviews were conducted with 16 adults (ages 33-52), and 17 adolescents (ages 14-19). RESULTS: Teens identified the same main barriers to accessing dental care as adults: high cost, financial limitations and lack of insurance. Most Mexican-Americans agreed with the belief that everyone will need urgent dental treatment and the majority believed that going to a dentist in private practice instead of the Emergency Room was important. Although adults recognized the importance of preventive dental care, half reported being unlikely to seek such care while half of teens reported that they were likely to do so. Adults reported relying equally on themselves and on peers to make dental care decisions, while teens mostly depended on others to make decisions about urgent and preventive care. Virtually all respondents believed regular brushing to be important and many flossing too. A major barrier to flossing was being unsure of the proper technique. Another barrier to better oral health was not having seen messages encouraging changes in lifestyle. CONCLUSIONS: This study found that Mexican-American teens and adults may experience oral health similarly. Teens do not have more positive oral health beliefs and encounter mostly the same barriers to care as adults