Post‐Affirmative Action Supreme Court Decision: New Challenges for Academic Institutions

This article describes several aspects of the University of Michigan Supreme Court cases regarding diversity in higher education. It provides a number of resources that are useful in shaping the rationale and institutional practices and policies for admissions and the recruitment and retention of diverse classes of students for the health professions.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153759/1/jddj0022033720056911tb04020x.pd

Eating Disorders in the Oral Health Curriculum

Due to the oral/systemic nature of eating disorders, this serious health issue requires comprehensive patient assessment and coordinated health treatment. The purpose of this study was to assess the breadth and depth of eating disorder and comprehensive care within the dental and dental hygiene curriculum. Survey data were collected from deans of U.S. dental programs (n=24) and dental hygiene program directors (n=94). Statistically significant differences were observed between dental programs (DP) and dental hygiene programs (DHP) as more DHP reported including anorexia nervosa (p\u3c.001), bulimia nervosa (p\u3c.001), and oral manifestations of eating disorders (p=.003) within their curricula. Clock hours dedicated to these topics ranged from seventeen to thirty-five minutes, with no statistically significant differences observed between DP and DHP. Only 58 percent of DP and 56 percent of DHP included patient communication skills specific to eating disorders. Moreover, DHP were observed dedicating more instruction time for this skill (p=.011). As greater emphasis is placed on oral/systemic health and the provision of comprehensive care, many oral health professionals may not be adequately trained to identify, provide education, and communicate with patients regarding the oral/systemic nature of eating disorders. The findings from this study indicate that there is a need for appropriate training to better prepare oral health professionals for comprehensive patient care

Knowledge of Oral and Physical Manifestations of Anorexia and Bulimia Nervosa Among Dentists and Dental Hygienists

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153559/1/jddj002203372005693tb03921x.pd

Dental Education and Changing Oral Health Care Needs: Disparities and Demands

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153776/1/jddj002203372012761tb05236x.pd

Efficacy and Dose of Rehabilitation Approaches for Severe Upper Limb Impairments and Disability during Early Acute and Subacute Stroke: A Systematic Review

Objective. The purpose of this study was to examine the evidence regarding the efficacy of rehabilitation approaches for improving severe upper limb impairments and activity during acute and early subacute stroke, taking into consideration the dosage of therapy. Methods. Randomized controlled trials from PubMed, Web of Science, and Scopus databases were searched by 2 independent researchers. Studies were selected if they involved active rehabilitation interventions that were conducted in the acute stage (<7 days after stroke) or the early subacute stage (>7 days–3 months after stroke), with the aim of improving severe upper limb motor impairments and disability. Data were extracted on the basis of the type and effect of rehabilitation interventions, and on the dosage (duration, frequency, session length, episode difficulty, and intensity). Study quality was assessed using the Physiotherapy Evidence Database Scale. Results. Twenty-three studies (1271 participants) with fair to good methodological quality were included. Only 3 studies were performed in the acute stage. Regardless of the type of intervention, upper limb rehabilitation was found to be beneficial for severe upper limb impairments and disability. Robotic therapy and functional electrical stimulation were identified as the most popular upper limb interventions; however, only a limited number of studies showed their superiority over a dose-matched control intervention for severe upper limb impairments in the subacute stage. A longer rehabilitation session length (<60 minutes) did not seem to have a larger impact on the magnitude of improved upper limb impairments. Conclusion. Different rehabilitation approaches seem to improve severe upper limb impairments and disability in the subacute stage after stroke; however, they are not distinctly superior to standard care or other interventions provided at the same dosage. Impact. Robotic therapy and functional electrical stimulation add variety to rehabilitation programs, but their benefit has not been shown to exceed that of standard care. Further research is necessary to identify the impact of dose (eg, intensity) on upper limb motor impairments and function, especially in the acute stage

The Macy Study: A Framework for Consensus

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153738/1/jddj0022033720056911tb04018x.pd

The Macy Study: A Framework for Consensus

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153659/1/jddj002203372008722suppltb04486x.pd

Physical Activity Level, Barriers, and Facilitators for Exercise Engagement for Chronic Community-Dwelling Stroke Survivors in Low-Income Settings: A Cross-Sectional Study in Benin

After a stroke incident, physical inactivity is common. People with stroke may perceive several barriers to performing physical activity (PA). This study aimed to document the PA level and understand the barriers and facilitators to engaging in PA for community-dwelling stroke survivors in Benin, a lower middle-income country. A cross-sectional study was conducted in three hospitals in Benin. Levels of PA were recorded by means of the Benin version of the International Physical Activity Questionnaire long form (IPAQ-LF-Benin), which is validated for stroke survivors in Benin. The perceived exercise facilitators and barriers were assessed by the Stroke Exercise Preference Inventory-13 (SEPI-13). A descriptive analysis and associations were performed with a Confidence Interval of 95% and <0.05 level of significance. A total of 87 participants (52 men, mean age of 53 ± 10 years, mean time after a stroke of 11 (IQR: 15) months and an average of 264.5 ± 178.9 m as distance on the 6 min walking test (6MWT) were included. Overall, stroke survivors in Benin reached a total PA of 985.5 (IQR: 2520) metabolic equivalent (METs)-minutes per week and were least active at work, domestic, and leisure domains with 0 MET-minutes per week. The overview of PA level showed that 52.9% of participants performed low PA intensity. However, 41.4% performed moderate PA or walking per day for at least five days per week. Important perceived barriers were lack of information (45.3%), hard-to-start exercise (39.5%), and travelling to places to exercise (29.9%). The preference for exercise was with family or friends, outdoors, for relaxation or enjoyment (90.2%), and receiving feedback (78.3%). Several socio-demographic, clinical, and community factors were significantly associated with moderate or intense PA (p < 0.05) in stroke survivors in this study. Our findings show that the PA level among chronic stroke survivors in Benin is overall too low relative to their walking capacity. Cultural factors in terms of the overprotection of the patients by their entourage and/or the low health literacy of populations to understand the effect of PA on their health may play a role. There is a need for new approaches that consider the individual barriers and facilitators to exercise

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke

Background: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting. Objective: Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors. Methods: PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs). Results: Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings. Conclusions: Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL. Clinical implications: A high dosage of aerobic exercise, duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve is beneficial for improving walking capacity

Religion between State and Society

In contrast to mainstream historiography, secularisation was not a distinct process in nineteenth-century Europe, since the century was a period of religious revival. In the late nineteenth century, in spite of weakening church attendance and rising agnosticism brought on by urbanisation and migration, religion remained attractive for the middle class and social movements related to church membership emerged in politics. In this chapter the diversity of religion in Europe is treated. The author distinguishes between hierarchical and nonhierarchical types of Christian churches, and between four religious regions in Europe. This situation had effects on the relationship between state and religion