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Biomedical subjects

D W Chambers

Publications and source records attributed to D W Chambers.

At least 19 recordsLinked to original sources
PubMed2004

Association amongst factors thought to be important by instructors in dental education and perceived effectiveness of these instructors by students.

It is hypothesised that dental educators have perceptions of their roles as effective teachers. It is expected that subject matter expertise would be amongst the components of such personal philosophies of education, but it is unclear whether faculty member self-perceptions carry over into student ratings of instructors' effectiveness. A 20-item survey of 'Teaching Characteristics' was completed by 86% of full-time and 64% of the part-time faculty members at the University of the Pacific. Respondents distributed 100 points amongst the descriptions of what makes an effective instructor. The responses were factor-analysed, resulting in four general faculty 'types' that explained about 50% of the variance in ratings: expert, enthusiast, judicial and good soldier. Student ratings for the 2 years running up to the date of the survey administration were used to gauge student perceptions of instructor effectiveness. Faculty members who placed emphasis on expertise as key to being a good instructor received significantly lower ratings for teacher effectiveness from students than did other faculty members. Faculty members who conceived their roles as motivating students, explaining difficult concepts, displaying interest in the subject, showing compassion and caring, and being proactive tended to receive high ratings for teaching effectiveness from students.

Education, Dental↗
PubMed2001

Longitudinal evaluation of GCF MMP-3 and TIMP-1 levels as prognostic factors for progression of periodontitis.

BACKGROUND: To determine whether matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in gingival crevicular fluid (GCF) could serve as prognostic factors for the progression of periodontitis, we monitored GCF MMP-3 and TIMP-1 and periodontal status of selected sites in 40 medically healthy subjects over a 6-month period. METHOD: Clinical measurements including gingival index (GI), plaque index, bleeding on probing, suppuration, probing depth (PD), attachment loss (AL), and GCF samples were taken from 2 healthy sites (including sites with gingival recession, GI=0 PD < or =3 mm; AL < or =2 mm) and 2 periodontitis sites (GI > or =1; PD > or =5 mm; AL > or =3 mm) of each patient at baseline, 3-month and 6-month visits by means of sterile paper strips. GCF levels of MMP-3 and TIMP-1 were determined by sandwich ELISA assays. RESULTS: The mean amounts of MMP-3 and TIMP-1 in diseased sites were significantly higher than in healthy sites (p<0.0001). Significantly higher GCF levels of MMP-3 and TIMP-1 were found at progressing sites than in nonprogressing periodontitis sites (0.001 or =2 mm loss of attachment during 6- month study period. GCF levels of MMP-3 were highly correlated with clinical measurements taken at baseline, 3-month and 6-month visits (p<0.001). TIMP-1 levels were only moderately correlated with probing depth and attachment level (p<0.01). Step-wise multiple regression analysis was performed to construct models for the prediction of probing depth and attachment loss increases. The most parsimonious regression models which had the best R2 values included the following variables and accounted for the indicated % of variability. The regression model for the prediction of probing depth increase included MMP-3, smoking pack-years, TIMP-1 and accounted for 53% of the variability. The best model for the prediction of attachment loss increase included MMP-3, smoking pack-years, age, TIMP-1 and explained 59% of the variability. CONCLUSION: These data indicate that sites with high GCF levels of MMP-3 and TIMP-1 are at significantly greater risk for progression of periodontitis.

Adult↗
PubMed2001

Crevicular fluid elastase levels in relation to periodontitis and metabolic control of diabetes.

The purpose of this study was to investigate the associations between gingival crevicular fluid (GCF) elastase levels, clinical measures of periodontal status, and metabolic control of diabetes in insulin dependent (type 1) diabetes (IDDM) and non-insulin dependent (type 2) diabetes (NIDDM) patients. Sixty patients were recruited from the Diabetes Center at the University of California in San Francisco. Thirty subjects were type 1 diabetics and 30 subjects were type 2 diabetics. Metabolic control was evaluated by glycosylatted hemoglobin (HbA1c) levels. Demographic information was obtained using a structured interview with the subjects. Clinical measurements and GCF samples were taken from the mesio-buccal surfaces of 2 premolars and 2 molars from the most diseased sextant. GCF elastase was determined by measurement of p-Nitroanalide resulting from hydrolysis of elastase specific peptide. Crevicular fluid elastase levels were significantly correlated with gingival index, bleeding index, probing depth and attachment level in both type 1 and type 2 diabetes groups (0.01 <p < 0.001). HbA1c levels were not correlated with clinical measurements and GCF elastase. The results suggest that GCF elastase. age and smoking are risk indicators for periodontitis in patients with diabetes mellitus, and periodontal status is not associated with the duration and metabolic control of diabetes.

Adult↗
PubMed2001

Benchmarking.

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Benchmarking↗
PubMed2001

Technology innovation.

Technology is the way dentistry is practiced--the materials and methods, characteristics of the dentist and staff, and nature and values of patients. Innovation is a conscious process of improving that technology. Dentists, not researchers or manufacturers, are the source of most innovation in dentistry. Characteristics such a innate curiosity, sophistication, discretionary income, and practice isolation contribute to innovativeness. Innovation diffusion has a characteristic S-shape, with few early and late adopters and a rapid spread in the middle phase. Much is known regarding the personality and behavior of early and late adopters and those types of innovations that are likely to diffusion rapidly.

Dentists↗
PubMed2001

Preliminary evidence for a general competency hypothesis.

Although predoctoral dental education is generally taught and evaluated by disciplines, there is no evidence bearing on whether the competencies necessary to begin independent practice are learned and practiced as a general set of skills, understanding, and values or as groups of discipline-specific skills, understanding, and values, which together constitute graduation competency. There is some support in the literature for each view In this preliminary investigation, 64,000 faculty ratings of student clinical competency were analyzed in a Year x Quarter x Discipline x Model design. The dependent variable was predictive validity of graduation quarter competency ratings using R-values from four prediction models. Results of a multiple repeated measures ANOVA show that models based on technical skills other than the one being predicted, clinical judgment and patient management, and the combination of these two models all predict graduation competency in each of four disciplines better than do ratings in the disciplines being predicted. As the time gap between predictive and predicted competence decreases, predictions become more accurate, but an asymptote is reached by the middle of the final clinical year. By using general models to evaluate students rather than discipline-specific ones, students needing intervention and remediation and those who could benefit from enrichment experiences can be identified as accurately at the beginning of their clinical careers as they can near the graduation deadline. This study provides preliminary support for a general competency hypothesis and suggests that research is necessary to better understand how students and dentists learn and practice rather than how they are taught.

Analysis of Variance↗
PubMed2001

The role of dentists in dentistry.

The extent to which dentists influence the outcomes of dental care, compared to the effects of dental technology or patient variation, has not been well studied. A review of the literature on the personality and value structures of dentists and dental students reveals general trends involving preferences of concrete, utilitarian, unambiguous, and conventional situations that are classified and judged in terms of their potential for dentists' power and control and for relationships of helping others but avoiding mutual dependency. These findings are summarized in a hypothesis that dentists seek situations where they can exercise control and establish paternalistic relationships with others. The evidence about career satisfaction of dentists is difficult to interpret. Between 20 percent and 50 percent of dentists report that they would not choose to enter the profession again if given a chance. Yet the number leaving the profession voluntarily is less than the number of career changers in the general population by a factor of about 1 to 15. Career satisfaction of practitioners can be partially predicted from an understanding of dentists' personality and values. Factors such as uncooperative patients, incompetent staff, and government and insurance intrusions are major dissatisfiers; they threaten dentists' core need for control. Factors such as quality of work, which is under the control of dentists, are major satisfiers. The personalities and values of dentists and the expression of these in professional norms may function to limit our understanding of dentistry. Based on this analysis, eight predictions are offered about the profession.

Attitude of Health Personnel↗
PubMed2001

A brief history of conflicting ideals in health care.

Three medical traditions were in conflict in fifth century B.C. Greece. The Aesculapian view was grounded in illness as a mystery and remedies based on authority. The Cnidian School emphasized early views of disease and science. The School of Cos, commonly associated with the name Hippocrates, was patient and practice based. The history of medicine is a complex intertwining of these traditions. Each developed its own epistemology--theory of how we come to know things and what basis is used to ground truth. These three traditions can be found in dentistry today. Even taken together, however, they fail to account for modern dental practice.

History, 16th Century↗
PubMed2001

Peer review.

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Humans↗
PubMed2001

Red beads and funnels.

Dentists, like most managers, believe that unanticipated team results are evidence of poor performance on the part of employees. While this can be the case, it is much more likely that most variation is inherent in the system and is probably not under the control of staff. The dentist, as the manager, has full control and full responsibility for guaranteeing that the office runs effectively and for improving its operation.

Dental Auxiliaries↗
PubMed2000

Emerging trends in professional development.

The shape of professional development in dentistry can better be guessed from imagining the emerging needs of practitioners than from the technology of education. Four predictions are offered: professional development is likely to involve a greater blend of learning and doing, customized to individual dentists, emphasizing value added rather than evaluation of dentists, and to be distributed in the sense that dentists will take their learning in smaller doses and at their own convenience.

Dentistry↗
PubMed2000

Having your say.

Effectiveness in speaking at meetings is more a matter of fit with the emerging image the group has of itself than the persuasiveness of the speaker. In addition to rhetorical messages, people speak at meetings to confirm their right to membership, obtain or exercise status, achieve social goals, and provide or reinforce the structural and procedural needs of the group. Persuasive speeches should fit the flow of the meeting, state the desired result of the speech, and give a reason. Style points are also mentioned.

Humans↗
PubMed1999

Faculty ratings as part of a competency-based evaluation clinic grading system.

The traditional system for determining grades in dental school clinic courses has been counts of productivity and daily marks for degree of technical excellence. One dental school with a competency-based educational model has redesigned its evaluation system to include assessment of understanding as well as performance of procedures, diagnosis and judgment, and patient management. Competency tests were instituted in all disciplines to replace the required volume of work. A quarterly rating system was developed to replace daily grading. Results from one of the first administrations of the ratings are presented. They show excellent face validity and rater consistency in some cases. Gradients of generalizability are reported, demonstrating that the ratings satisfy the school's standard for grade defensibility.

Bias↗