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Item Interdisciplinary treatment for a compensated Class II partially edentulous malocclusion: Orthodontic creation of a posterior implant site(Elsevier, 2018) Chiu, Grace; Chang, Chris; Roberts, W. Eugene; Orthodontics and Oral Facial Genetics, School of DentistryA 36-year-old woman with good periodontal health sought treatment for a compensated Class II partially edentulous malocclusion associated with a steep mandibular plane (SN-MP, 45°), 9 missing teeth, a 3-mm midline discrepancy, and compromised posterior occlusal function. She had multiple carious lesions, a failing fixed prostheses in the mandibular right quadrant replacing the right first molar, and a severely atrophic edentulous ridge in the area around the mandibular left first and second molars. After restoration of the caries, the mandibular left third molar served as anchorage to correct the mandibular arch crowding. The mandibular left second premolar was retracted with a light force of 2 oz (about 28.3 cN) on the buccal and lingual surfaces to create an implant site between the premolars. Modest lateral root resorption was noted on the distal surface of the mandibular left second premolar after about 7 mm of distal translation in 7 months. Six months later, implants were placed in the mandibular left and right quadrants; the spaces were retained with the fixed appliance for 5 months and a removable retainer for 1 month. Poor cooperation resulted in relapse of the mandibular left second premolar back into the implant site, and it was necessary to reopen the space. When the mandibular left fixture was uncovered, a 3-mm deep osseous defect on the distobuccal surface was found; it was an area of relatively immature bundle bone, because the distal aspect of the space was reopened after the relapse. Subsequent bone grafting resulted in good osseous support of the implant-supported prosthesis. The relatively thin band of attached gingiva on the implant at the mandibular right first molar healed with a recessed contour that was susceptible to food impaction. A free gingival graft restored soft tissue form and function. This severe malocclusion with a discrepancy index value of 28 was treated to an excellent outcome in 38 months of interdisciplinary treatment. The Cast-Radiograph Evaluation score was 13. However, the treatment was complicated by routine relapse and implant osseous support problems. Retreatment of space opening and 2 additional surgeries were required to correct an osseous defect and an inadequate soft tissue contour. Orthodontic treatment is a viable option for creating implant sites, but fixed retention is required until the prosthesis is delivered. Bone augmentation is indicated at the time of implant placement to offset expected bone loss. Complex restorative treatment may result in routine complications that are effectively managed with interdisciplinary care.Item Preliminary investigation of interdisciplinary trainee’s improvement in knowledge about autism spectrum disorder(Emerald, 2022-01) Ryan, Tybytha D.; Brunson McClain, Maryellen; Merrill, Anna; Dahir, Naima; Harris, Bryn; Irby, Sarah M.; Pediatrics, School of MedicinePurpose Individuals with autism spectrum disorder (ASD) often receive services from a variety of professionals. However, not all providers receive adequate training in ASD. The Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program includes a core competency of increasing knowledge about neurodevelopmental and related disabilities. This study attempted to assess trainees’ ASD knowledge and self-reported confidence in working with individuals with ASD and sought to understand if training through the LEND program increases these competencies. Additionally, the purpose of this study is to determine factors that predict ASD knowledge and self-reported confidence in providing services to this population, specifically in an interdisciplinary trainee sample. Design/methodology/approach Participants were 170 interdisciplinary LEND trainees during the 2017–2018 academic year. Participants across the USA completed online pre- and posttraining surveys. The survey included demographics, ASD knowledge, questions assessing training experiences, perceived ASD knowledge and self-reported confidence. Findings A one-way analysis of variance determined that there was a statistically significant difference in measured ASD knowledge across disciplines F(7, 148) = 5.151, p < .001. Clinical trainees (e.g. psychology, pediatrics and speech) exhibited more measured ASD knowledge than nonclinical trainees (e.g. neuroscience, legal). Additionally, training experiences, self-reported confidence and perceived ASD knowledge were predictors of measured ASD knowledge. Moreover, trainees increased their measured ASD knowledge, self-reported confidence and had more experiences with individuals who have ASD at the end of the training year. Originality/value These findings suggest that the LEND program may assist in the preparation of professionals to work with individuals with ASD. Training opportunities, including educational and practical experience, to train interdisciplinary providers who will work with individuals with ASD are advised.Item Structure and Functions of Pediatric Aerodigestive Programs: A Consensus Statement(AAP, 2018-03) Boesch, R. Paul; Balakrishnan, Karthik; Acra, Sari; Benscoter, Dan T.; Cofer, Shelagh A.; Collaco, Joseph M.; Dahl, John P.; Daines, Cori L.; DeAlarcon, Alessandro; DeBoer, Emily M.; Deterding, Robin R.; Friedlander, Joel A.; Gold, Benjamin D.; Grothe, Rayna M.; Hart, Catherine K.; Kazachkov, Mikhail; Lefton-Greif, Maureen A.; Miller, Claire Kane; Moore, Paul E.; Pentiuk, Scott; Peterson-Carmichael, Stacey; Piccione, Joseph; Prager, Jeremy D.; Putnam, Philip E.; Rosen, Rachel; Rutter, Michael J.; Ryan, Matthew J.; Skinner, Margaret L.; Torres-Silva, Cherie; Wootten, Christopher T.; Zur, Karen B.; Cotton, Robin T.; Wood, Robert E.; Pediatrics, School of MedicineAerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions. After 3 iterations of survey, consensus was obtained by either a supermajority of 75% or stability in median ranking on 33 of 36 items. This included a standard definition of an aerodigestive patient, level of participation of specific pediatric disciplines in a program, essential components of the care cycle and functions of the program, feeding and swallowing assessment and therapy, procedural scope and volume, research priorities and outcome measures, certification, coding, and funding. We propose the first consensus definition of the aerodigestive care model with specific recommendations regarding associated personnel, infrastructure, research, and outcome measures. We hope that this may provide an initial framework to further standardize care, develop clinical guidelines, and improve outcomes for aerodigestive patients.