In North America, all dental schools have adopted some form of community-based dental education (CBDE) or service-learning, but little is known about the areas being researched and reported in published studies. The aim of this study was to conduct a scoping review to determine what areas of research had been conducted to determine the effects of CBDE on dental students' readiness to treat populations that are underserved. A systematic search of articles published in English or French since 2000 was performed on July 29, 2015, and combined quantitative and qualitative synthesis of data was conducted. Of the 32 studies evaluated, 23 (72%) were quantitative, seven (22%) were qualitative, and two were multi-method. The majority (66%) used self-report methods, most frequently surveys. Participants in 50% of the studies were fourth-year dental students; the others assessed third- and fourth-year (13%), first- and second-year (6%), and first-year (13%) students. Dentists were the participants in three studies (9%), with dentists and students in one study (3%). Either the types of populations receiving care were unspecified or four or more groups were pooled together in 25 studies (78%), while two focused on children, one on rural populations, one on elderly populations, two on persons with special health care needs, and one on low-income populations. The study areas were wide-ranging, but generally fell into three categories: student performance (37.5%), teaching approaches and evaluation methods (37.5%), and perceptions of CBDE (25%). This review identified many research gaps for determining whether students are prepared to treat populations that are underserved. The disparate nature of CBDE research demonstrates a compelling argument for determining elements that define student readiness to care for patients who are underserved and for research that includes the voices of patients, curriculum development, and more comprehensive and rigorous evaluation methodologies.
Psychosocial death is a significant dimension of the Dementia of the Alzheimer's Type disease process but poorly studied. This article explores three phases of psychosocial death that emerged from in-depth interviews with three daughters caring for a parent with this chronic illness. The phases discussed include: (1) daughters creating a new relationship with their parent; (2) daughters grieving chronically throughout the illness; (3) daughters negotiating coherence between the parent that once was and the parent that exists now. Daughters' narratives reveal that witnessing the deterioration of a mind was a burdensome grave learning process that encompassed many losses. These daughters lacked appropriate education and support. Future research in this area is required to develop strategies for informal caregivers that respond to this disease process.
Successful recruitment and retention for population-based longitudinal studies requires understanding facilitators and barriers to participation. This study explored Canadians' views regarding one such study, the proposed Canadian Longitudinal Study on Aging (CLSA). Focus groups of participants > or =40 years of age were held in six proposed CLSA data collection sites (Halifax, Montreal, Hamilton, Winnipeg, Calgary, and Vancouver) to discuss participating in a long-term study of healthy aging. There was fundamental support for longitudinal research on health and aging. Altruism was a key motivation to participation, and universities were viewed as credible parties to conduct such studies. Participants had few worries about providing biological samples but expressed concern about potential misuse of genetic materials, commercialization of participant data, and privacy issues. These findings have already informed current, and will inform future, work on the CLSA, and will also provide useful information to researchers who undertake other population-based longitudinal studies.
The goal of the Canadian Longitudinal Study on Aging (CLSA) is to recruit 50,000 participants aged 45 to 85 years of age and follow them for at least 20 years. The sampling and recruitment processes for a study of this scope and magnitude present important challenges. Statistics Canada was approached to collaborate with the CLSA with the goal of determining whether the Canadian Community Health Survey (CCHS) could be used as a recruitment vehicle for the CLSA. In this pilot study conducted in 2004, it was determined that 63.8 per cent and 75.8 per cent of the respondents agreed to share their contact information and their survey responses with the CLSA, respectively. The most commonly reported concerns were confidentiality/privacy issues, lack of interest, and commitment issues. This pilot study identified some challenges to the use of the CCHS as a recruitment vehicle for the CLSA.
As part of its recruitment process, the Canadian Longitudinal Study on Aging (CLSA) will face the challenge of screening out individuals who are sufficiently impaired in their ability to provide informed consent. In the process of developing the design of the CLSA, a review of the literature was performed with the goal of identifying currently existing telephone cognitive screening tools that can be used to identify eligible study participants for population-based research on aging. We identified 12 telephone screening tools, four of which were based on the Mini-Mental State Exam (MMSE) and eight that were based on other face-to-face screening tools. Characteristics - including the constructs measured, the length of time for administration, the scoring/classification scheme, and any information regarding the validation of each tool - were extracted and summarized.
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