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ObjectiveTo compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit.DesignPremature infants (birth weight ≤1250 g) fed an exclusive HM-based diet were examined at 12–15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18–22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry.ResultsOf 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25±1.10 vs −0.21±0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0±3.7 vs 17.3±15.1 µU/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1±0.9 vs 4.3±4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity.ConclusionsSGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with ≤1250 g birth weight, specifically SGA.

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Uncivil behavior by a faculty member or student can threaten a classroom environment and make it less conducive to learning. The aim of this study was to explore faculty behaviors that dental faculty and students perceive to be uncivil when exhibited in the classroom and clinic. In 2015, all faculty, administrators, and students at a single academic dental institution were invited to participate in an electronic survey that used a five‐point Likert scale for respondents to indicate their agreement that 33 faculty behaviors were uncivil. Response rates were 49% for faculty and 59% for students. Significant differences were found between student and faculty responses on 22 of the 33 behavioral items. None of the three category composite scores differed significantly for students compared to faculty respondents. The category composite scores were not significantly associated with gender, ethnicity, or age for faculty or students. Overall, this study found significant differences between students and faculty about perceived uncivil faculty behaviors, though not for categories of behaviors.

Perinatal hypoxic ischemic encephalopathy (HIE) can lead to severe neurodevelopmental outcome and death. Therapeutic hypothermia is neuroprotective for infants with moderate-to-severe HIE. However, therapeutic hypothermia is only offered at high-level regional neonatal intensive care units (NICUs), necessitating the need to transport sick infants to referral centers. The goal of this study was to evaluate whether active cooling on transport is more effective than passive cooling in achieving temperatures in the treatment target range (33°C–34°C) on arrival to the Texas Children's Hospital (TCH) NICU. This was a retrospective quasi-experimental study of 42 infants who were transported to TCH for treatment of perinatal HIE between August 2012 and April 2016. Active cooling using a continuous core temperature servo-controlled cooling device (CritiCool) began in January 2014; before that, passive cooling on transport was used. Passive cooling was initiated by turning off external heating devices. Fourteen infants received active cooling, and 28 were passively cooled. Demographic data, gestational age at birth, birth weight, and Sarnat stage were not different between groups. Although TCH arrival temperatures were not different between the groups (p= 0.841), there was greater variability of temperatures in the passively cooled group (p= 0.001). More actively versus passively cooled patients arrived at the cooling center within the goal temperature range (79% vs. 25%, p= 0.003). After controlling for multiple variables, active cooling was a significant independent predictor for arriving at the cooling center within the goal temperature range. Active cooling during transport of infants with moderate-to-severe HIE was more effective than passive cooling in achieving the target goal temperature range on arrival at the cooling center. If cooling is being considered during transport, we suggest that active servo-controlled therapeutic hypothermia be used.

Anemia is common among adult heart failure patients and is associated with adverse outcomes, but data are lacking in children with heart failure. The purpose of this study was to determine the prevalence of anemia in children hospitalized with acute heart failure and to evaluate the association between anemia and adverse outcomes. Review of the medical records of 172 hospitalizations for acute heart failure. Single, tertiary children's hospital. All acute heart failure admissions to our institution from 2007 to 2012. None. Composite endpoint of death, mechanical circulatory support deployment, or cardiac transplantation. Patients ages ranged in age from 4 months to 23 years, with a median of 7.5 years, IQR 1.2, 15.9. Etiologies of heart failure included: dilated cardiomyopathy (n= 125), restrictive cardiomyopathy (n= 16), transplant coronary artery disease (n = 18), ischemic cardiomyopathy (n= 7), and heart failure after history of congenital heart disease (n = 6). Mean hemoglobin concentration at admission was 11.8 g/dL (±2.0 mg/dL). Mean lowest hemoglobin prior to outcome was 10.8 g/dL (±2.2 g/dL). Anemia (hemoglobin <10 g/dL) was present in 18% of hospitalizations at admission and in 38% before outcome. Anemia was associated with increased risk of death, transplant, or mechanical circulatory support deployment (adjusted odds ratio 1.79, 95% confidence interval = 1.12–2.88, P= .011). For every 1 g/dL increase in the patients' lowest hemoglobin during admission, the odds of death, transplant, or mechanical circulatory support deployment decreased by 18% (adjusted odds ratio = 0.82, 95% confidence interval = 0.74–0.93, P = 0.002). Anemia occurs commonly in children hospitalized for acute heart failure and is associated with increased risk of transplant, mechanical circulatory support, and inhospital mortality.

The aim of this study was to investigate the existence of correlations between dental admissions criteria, including a chalk carving exercise, and students’ subsequent academic performance. The retrospective cohort study examined the records of dental students at Louisiana State University Health Science Center School of Dentistry for the years 1998 to 2008. Only those students who could be categorized into the following four groups were included: 1) those who graduated in the top 10% of their class, 2) those who graduated in the bottom 10% of their class, 3) those who repeated a year of dental school, and 4) those who were dismissed or resigned. The study sample consisted of 176 students: 62 in the first group, 62 in the second group, 25 in the third group, and 27 in the fourth group. Data collected were each student's undergraduate grade point average (GPA); chalk carving score; undergraduate biology, chemistry, physics (BCP) GPA; Dental Admission Test (DAT) Academic Average; Perceptual Ability Test (PAT) score of the DAT; total DAT score; grade in preclinical operative dentistry class; grade in morphology and occlusion class; and dental school GPA at graduation. The results showed that only the undergraduate GPA and BCP GPA were significantly higher for students in the top 10% of their class than for other groups. The only positive correlation involving the chalk carving scores was with the preclinical operative dentistry course grade. This study thus found limited correlations between this institution's admissions criteria and its students’ success in dental school.

Students and faculty members in the health professions classroom are expected to exhibit professional behaviors that are conducive to maintaining a positive learning environment, but there is little published research concerning incivility in the area of dental education. The aim of this study was to evaluate differences in perceptions of incivility between dental faculty and students, between students in different courses of study, and between students in different years of dental study. The study utilized an anonymous electronic survey of all dental faculty and administrators and all dental, dental hygiene, and dental laboratory technology students at a single institution. The survey instrument contained questions concerning perceived uncivil behavior in the classroom and clinical settings. Response rates were 54% for faculty and administrators and ranged from 60% to 97% for students in various years and programs. The results were analyzed based on gender, course of study, year of study, and ethnicity. Significant differences were found regarding perceptions of civil behaviour between faculty and students, male and female students, the year of study, and the course of study. These differences point to the need for further research as well as administrative leadership and faculty development to define guidelines in this area in order to ensure a positive learning environment.

With the support for curriculum change expressed by the American Dental Education Association's Commission on Change and Innovation in Dental Education (ADEA CCI), the Louisiana State University Health Sciences Center School of Dentistry (LSUSD) initiated a course that vertically integrates the basic sciences and clinical sciences and promotes critical thinking. The resulting Dental Rounds course includes presentations by D3 and D4 students on interesting clinical cases, which the entire student body is required to attend. Following the third year of the program, a formal evaluation was conducted, in which surveys were disseminated to students, recent graduates, and faculty members to collect feedback on the efficacy of the course, its perceived value, and its success as an educational tool. Of the 242 students and graduates who were sent surveys, 181 responded, a 74 percent response rate. Of the eighty full‐time faculty members, sixty‐one responded, a 76 percent response rate. Most respondents reported that the objectives of the course were being achieved, but they identified case‐related discussion as an area for strengthening critical thinking skills. As a result, modifications were planned to include formal participation of D1 and D2 students in the presentations, less frequent sessions to accommodate more complete cases, more emphasis on basic science, more structured mentoring, and a modified question format. Dental Rounds was a necessary integration step in dental education for LSUSD, and it is anticipated that the planned modifications will lead to strengthening of critical thinking skills in both students and faculty.

The professional dental literature is lacking in information concerning the use of technology in evaluation procedures utilized in postgraduate dental education. The purpose of this study was to identify the methods of evaluation of U.S. postgraduate specialty residents currently in place. The study also sought to determine if there were any patterns among programs more likely to utilize electronic submission in the evaluation process. An electronic survey consisting of eighteen questions was sent to the program directors of all accredited U.S. dental specialty programs (n=416). The survey yielded 150 responses, for a 36 percent response rate. The results showed that the majority of responding program directors (68 percent) evaluate their residents using a hardcopy evaluation instrument, while a minority of directors (32 percent) reported using an electronic evaluation instrument. The majority of respondents (58 percent) said they require faculty members to formally evaluate residents semiannually. Fifty percent of responding program directors reported a need for improvement in their current evaluation system. Those reporting a need for improvement were less likely to be using an electronic format. There was no statistical significance between faculty responsiveness and the mode of evaluation used. With many program directors reporting room for improvement in their current evaluation system, innovation in the evaluation systems of postgraduate dental education is needed.

Devastated by the aftermath of Hurricane Katrina in August 2005, the New Orleans campus of the Louisiana State University School of Dentistry was closed for two years. With help from the university's Systems Office, the school created a temporary campus in Baton Rouge, seventy‐five miles from the New Orleans campus. The eight postdoctoral education programs, however, were forced to find clinic and seminar space in other facilities and cities. Of the seventy‐nine students in these programs, only sixteen did not continue after the storm. This article describes how each program maintained its curriculum while the main campus was closed. By comparing numbers of student applications to these programs in each year since Hurricane Katrina with the average baseline for each in the ten years preceding the storm, this article illustrates the current viability of these residency programs. Total applications in 2005–07 were significantly lower than baseline measures, but applications in 2008 and 2009 have returned to pre‐storm levels. A comparison of these application numbers with national trends also demonstrates that these programs have rebounded from the effects of Hurricane Katrina.

The various reasons for the current and projected shortages of dental faculty members in the United States have received much attention. Dental school deans have reported that the top three factors impacting their ability to fill faculty positions are meeting the requirements of the position, lack of response to position announcement, and salary/budget limitations. An electronic survey sent to program directors of specialty programs at all accredited U.S. dental schools inquired about the number of vacant positions, advertised vacant positions, reasons for not advertising, selection of advertising medium, results of advertising, and assistance from professional dental organizations. A total of seventy‐three permanently funded full‐time faculty positions were reported vacant, with 89.0 percent of these positions having been advertised in nationally recognized professional journals and newsletters. Networking or word‐of‐mouth was reported as the most successful method for advertising. The majority of those responding reported that professional dental organizations did not help with filling vacant faculty positions, but that they would utilize the American Dental Association's website or their specialty organization's website to post faculty positions if they were easy to use and update.