Practicum Experiences: Effects on Clinical Self-Confidence of Senior Dental Hygiene Students.

PURPOSE: The purpose of this study was to determine the effects of a 3-week practicum experience on the clinical self-confidence of University of North Carolina (UNC) senior dental hygiene students. METHODS: A mixed methods approach was utilized. Before and after a 3-week practicum experience, UNC senior dental hygiene students (n=32) were asked to complete a 20-statement clinical self-confidence survey based on the dental hygiene process of care. Statements were Likert-scaled, ranging from "not at all confident" to "totally confident." The stratified Mantel Haenszel row mean score test with the subject as strata as a repeated approach was used to assess whether on average across subjects, the pre- and post-surveys had the same mean score. Students were also asked to submit reflective journal entries discussing critical incidents during their practicum experience. Representative comments from students' journal entries were selected as qualitative data to support survey results. RESULTS: Pre- and post-practicum surveys (31 and 32, respectively) were completed, and all 32 students submitted journal entries. The differences in the row mean scores from pre- to post-practicum survey were statistically significant (p<0.05), indicating an overall positive gain in clinical self-confidence from the practicum experience. Students' journal entries provided comments that supported the quantitative results. CONCLUSION: The results suggest that a 3-week practicum experience in dental hygiene students' final semester increased UNC dental hygiene students' clinical self-confidence in the dental hygiene process of care. Dental hygiene administrators may want to consider the benefits of requiring students to participate in a practicum experience if they do not already do so.

Treatment of clozapine-associated weight gain: a systematic review.

PURPOSE: Clozapine is an antipsychotic drug with superior efficacy in treatment-resistant schizophrenia. Clozapine is associated with a low likelihood of extrapyramidal symptoms and other neurological side-effects but a high propensity to induce weight gain and general metabolic dysregulation. Various pharmacological and behavioral treatment approaches for reducing clozapine-associated weight gain exist in the literature; however, there are currently no clear clinical guidelines as to which method is preferred. The aim of the current review is to systematically summarize studies that have studied both pharmacological and non-pharmacological interventions to attenuate or reverse clozapine-associated weight gain. METHODS: A systematic review of EMBASE and MEDLINE databases of all articles published prior to January 2014 was conducted. Seventeen studies were identified as meeting inclusion criteria and included in the review. RESULTS: Aripiprazole, fluvoxamine, metformin, and topiramate appear to be beneficial; however, available data are limited to between one and three randomized controlled trials per intervention. Orlistat shows beneficial effects, but in males only. Behavioral and nutritional interventions also show modest effects on decreasing clozapine-associated weight gain, although only a small number of such studies exist. CONCLUSIONS: While a number of pharmacological interventions can produce modest weight loss, each may be associated with negative side effects, which should be considered before beginning treatment. Given the pressing need to improve cardiometabolic health in most clozapine-treated patients, substantially more research is needed to develop sound clinical practice guidelines for the treatment of clozapine-associated weight gain.

Association of drug abuse with inhibition of HIV-1 immune responses: studies with long-term of HIV-1 non-progressors.

Recreational drug use has been proposed to affect the course of human immunodeficiency virus (HIV) infections. To investigate the effects of substance abuse on HIV infections, we compared virus-specific cytotoxic T lymphocyte (CTL) responses and the expression of IL-16, TGF-beta1, and CXCR4 in three different cohorts of HIV-infected patients: (1) long-term nonprogressors (LT-NPs) of HIV infection who do not use recreational drugs; (2) nondrugs using normal progressors (NPs), and (3) drugs using NPs. Our results show that LT-NPs manifest increased CTL activity and IL-16 expression and decreased expression of TGF-beta1 and CXCR4 compared to NPs, regardless of recreational drug usage. Furthermore, drugs using NPs showed significantly lower levels of CTL and IL-16 expression and increased TGF-beta1 and CXCR4 expression compared to nondrugs using NPs. Our results suggest that recreational drug use may reduce CTL and IL-16 expression and increase the expression of TGF-beta1 and CXCR4, all of which may facilitate progression of HIV infections.