Dental hygienists' use of motivational interviewing and perceptions of effectiveness in changing patient behaviors.

BACKGROUND: The University of Minnesota (UMN) Dental Hygiene (DH) program devotes considerable time developing students' competency using motivational interviewing (MI). However, the extent to which graduates use MI in clinical practice and their perceptions of MI effectiveness in changing behavior is unknown. METHODS: A cross-section of UMN dental hygiene classes from 2010-2019 were emailed an electronic survey using Qualtricsxm software (n = 208). The survey instrument collected demographic information and queried respondents' current MI use and perceptions of its effectiveness in changing patients' behavior. Survey questions were aligned with the constructs of the Theory of Planned Behavior (TPB): attitudes, subjective norms, and perceived behavioral control. Data analyses included descriptive statistics, cross-tabulations, and one-way ANOVA tests. RESULTS: There were 73 responses for a 35% response rate and 58 surveys (28%) included in data analysis. Respondents (95%) used MI, held positive attitudes toward MI and perceived MI to be an effective behavior counseling method (98%). However, respondents expressed concerns about patients' abilities to change behaviors. The three TPB constructs were found to be predictors of MI use in the clinical environment. A significant association was found between age and the TPB construct: behavioral control (p = 0.02). CONCLUSION: The majority of respondents reported using MI in clinical practice. According to the TPB, respondents exhibited strong behavioral intentions to use MI. Respondents held favorable attitudes toward MI and believed it to be effective in motivating positive behavior change. Respondents were confident in their MI skills and felt supported to use MI in their work environments.

Effectiveness of brief motivational interviewing on perceived importance, interest and self-efficacy of oral health behaviors: A randomized clinical trial.

Objective: To investigate periodontal patients' perceived importance, interest and self-efficacy of oral hygiene (OH) behaviors. Methods: Secondary outcomes from a randomized single-site examiner-blinded clinical trial investigated the control group (traditional oral hygiene instructions) and the test group (brief motivational interviewing) over four time points. Analyses were performed using R version 4.1.1. Results: Sixty participants were eligible, and 58 completed the pre and post questionnaires for a 97% response rate. Importance was higher in the test group for good oral health and daily oral self-care (4.86 vs. 4.80). Interest in taking care of teeth and gums and changing a homecare routine was higher in the test group (4.89). Self-efficacy was higher in the test group for taking care of teeth and gums (4.18 vs. 4.07), making a change to improve oral health (4.29 vs. 4.27), and maintaining a change long-term (4.32 vs. 4.17). Statistical significance for self-efficacy was achieved for maintaining an OH behavior long-term. Conclusion: A brief motivational interviewing intervention was superior to enhance perceived importance, interest and self-efficacy of oral hygiene behaviors. Innovation: Contrary to previous motivational interviewing research, this study used a novel approach to evaluate MI-fidelity to determine the most effective MI strategies to support self-efficacy.

Gender Disparity between Donor Sites of the Trochlea Used for Autologous Osteoarticular Transfer: An MRI Analysis.

The purpose of this study was to assess potential gender differences in size of the lateral and medial trochlea of the male and female knee as well as the variation within gender of potential osteochondral autograft transfer (OAT) donor site area. Two hundred and twelve skeletally mature patients, 106 males and 106 females, who underwent a 3T magnetic resonance imaging of the knee for a variety of indications were utilized for analysis. Exclusion criteria included degenerative arthritis, trochlear dysplasia, and poor image quality. Medial and lateral femoral trochlear cartilage width was obtained using a linear radiologic measurement tool. Widths were measured from a reproducible anatomic location representing the maximal trochlear dimension in a region where donor plugs are commonly harvested. Trochlear width was also plotted as a function of patient height. Statistical analysis was performed using a two-sample t-test. The mean and standard deviation of the lateral trochlear cartilage width (mm) for males and females were 23.38 +/- 2.14 and 20.44 +/- 2.16, respectively (p < 0.00001). The mean and standard deviation of the medial trochlear cartilage width (mm) for males and females were 14.16 +/- 2.17 and 11.78 +/- 2.03, respectively (p < 0.00001). The overall range in trochlear width for both the lateral and medial sides was 22.22 and 19.73 mm for males and females, respectively. A graft measuring 10 mm could represent as little as 34% of the lateral trochlea in males versus as much as 65% in females. Our results indicate that donor OAT plug diameter relative to available trochlear cartilage width will vary significantly both between genders and individual patients. Trochlear width variability and its potential implications on donor site morbidity may be an important consideration when contemplating osteochondral plug harvest for OAT or other indications. The level of evidence is IV.

Educational Case: Pediatric Osteosarcoma.

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.

Arthroscopic Resection of Symptomatic Bennett Lesions.

Bennett lesions, also known as "thrower's exostosis" of the shoulder, involve ossification of the posteroinferior glenoid and are not uncommon in overhead throwing athletes. The literature surrounding the optimal operative management of the symptomatic Bennett lesion is limited. The purpose of this article is to describe the arthroscopic surgical technique for the visualization and excision of the symptomatic extra-articular pathologic ossification involving the posteroinferior glenoid. Because many surgeons may not be familiar with this problem or procedure, we present a straightforward method that allows for identification and excision of the exostosis through an arthroscopic posterior arthrotomy.