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Perceptions of Dental Schools from Within and Outside the University

Dr. Dederich is Head, Department of Periodontics, LSU School of Dentistry; Dr. Lloyd is Dean, University of Minnesota School of Dentistry; Dr. Dixon-Farmer is Associate Dean for Student Affairs, Meharry School of Dentistry; Dr. Geurink is Associate Professor/Clinical, Department of Dental Hygiene, School of Allied Health Sciences, University of Texas Health Science Center; Dr. Nadershahi is Chairman, Dental Faculty Council, University of the Pacific School of Dentistry; Dr. Robinson is Division Chief of Prosthodontics, University of Kentucky, College of Dentistry; and Dr. Scannapieco is Professor and Associate Chair of Oral Biology, School of Dental Medicine, State University of New York at Buffalo. Direct correspondence and requests for reprints to Dr. Douglas N. Dederich, Department of Periodontics, LSU School of Dentistry, 1100 Florida Avenue, Box 138, New Orleans, LA 70119-2799; 504-619-8610 phone; 504-670-2709 fax; ddeder{at}lsuhsc.edu.

Key words: dental education, oral health, dental care, dental health education, dental schools

Submitted for publication 05/18/04; accepted 09/03/04

	Abstract

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
Perceptions of dental schools held by high-level administrators of their parent institutions and officials in the local community have great potential to influence the future of dental education. The intent of this investigation was to gain a preliminary knowledge of such perceptions at seven institutions in the United States and to use this information to formulate hypotheses that can provide the basis for further targeted investigations that provide evidence useful in decision making and planning processes within dental schools. Interviews with university administrators, executive directors of state dental associations, and state government officials in seven areas of the United States were conducted. The hypotheses drawn from these interviews are: 1) dental schools are generally too insular and need to interact more with their parent institutions and external community; 2) dental schools need to systematically and continually get the message of the value of their services out to the public and political constituencies; and 3) multidisciplinarity and integration with other units are important to university administrators but largely outside the concerns of those external to the university. We suggest that these hypotheses form the basis of subsequent, more targeted, follow-up investigations with the intent of formulating specific recommendations for action.

Perhaps the real truth lies somewhere in between. Presumably, all these positions would maintain that dental schools, while having an admirable history of service and innovation, have nevertheless arrived at a moment in their history where it is necessary to reassess themselves from both internal and external perspectives with the goal of making the changes that will lead to excellence in dental education, dental research, and community service in the twenty-first century.^2,15–17 It is interesting to note, however, that some analysts have argued that the schools that were closed during the last twenty years were performing relatively well in these three areas. It has been suggested that the internal and external perceptions of these schools by strategically important leaders, and not the actual performance of the school, played the most important role in their closings.⁴ If true, this underscores the importance of gaining a better understanding of how the dental school is perceived both from within and external to its own parent organization.

The goal of this study was to develop insight into the perspectives that strategically important leaders both within and outside the university have with regard to the role of the dental school in the larger community and how it is fulfilling that role. We anticipate that this knowledge will allow the identification of specific hypotheses that can form the basis of subsequent targeted investigations whose results can be useful in decision making and strategic planning efforts by individual dental schools.

	Methods

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
A list of important leaders internal and external to the dental school at each of the authors’ institutions was created by the authors. Information on these institutions is shown in Table 1. While the titles of these individuals varied between institutions, the determining characteristic of whether a leader was included in the list was whether they had a relationship of significant influence to the dental school and the performance of its mission. Questions were then developed regarding the perceptions of these leaders of the dental school and how it is fulfilling its mission (Table 2). This list of leaders included the presidents, chancellors and/or provosts, vice presidents, vice chancellors, state commissioners of higher education, and campus directors for external relations (hereafter referred to as High Level Administrators);ADA trustees and officers of the state dental associations (hereafter referred to as Officers of the Local and State Dental Associations); and local state senators, representatives, and institutional government liaisons (hereafter referred to as State Government Officials). The questions were posed during interviews in seven different dental school parent institutions and their external communities.

	Results

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
The predominant responses of the interviewees for each of the questions listed in Table 2 are summarized in this section.

	High-Level Administrators Internal to the Dental School’s Parent Institution

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
What would you most like the public to know about the university system?

A common theme voiced by most of the high-level university administrators was that the public does not comprehend the complexity and depth of activities of their institutions; this was especially true of research-intensive institutions. Accordingly, most of the responses indicated a need to better educate the public with regard to what the dental school and its parent institution do and the value of that work to society. Interviewees acknowledged that public knowledge and support were necessary for the institution to be successful in obtaining the funds necessary to continue its work. It was also considered important that the public appreciate the specific ways in which it benefits from the services of those the institution trains. Further, interviewees indicated that better public appreciation was necessary of how innovations arising from the institution’s research improve individual and public quality of life. Similarly, high-level administrators reported that the public’s understanding of the important role that the university has in the economic health of the community is woefully inadequate, both with respect to its direct economic contributions and from fostering economic growth through invention and entrepreneurial activities.

While expressing pride in the performance of their institutions and dental schools, the administrators sometimes expressed frustration with regard to their efforts to effectively communicate that pride in academic programs to important constituencies. Perhaps this was best expressed by one president who said he wanted the public to realize that the institution was more than "just the football team." The high profile of the "mass entertainment"¹⁸ activities of educational institutions appeared to be, ironically, in competition with the dental school and its parent institution in the battle for the ear of the public. The administrators feared that other interests in the media drowned out their serious message relating to the mission and excellent performance of the institution and its critical need for funding. Further, the tradition for the public to demand more and more while giving less and less financial support appeared to be strong and continued to present significant challenges for their institutions.

In your view, what is the role of the dental school in meeting the mission of the university? What factors, both positive and negative, may impact on the school’s ability to fulfill this role?

Interviewees expressed the belief that professional schools, such as the dental school, contribute immensely to the mission of the institution through teaching, research, community service, and patient care. They observed that direct patient care is a particular advantage of the dental school and that this helps to put a public face on the institution, although perhaps not to the extent of the athletics program. Some interviewees noted that dental schools have also educated many dental hygienists who serve the public in a high-demand area.

Several factors that may impact on a school’s ability to fulfill its research mission were identified, including difficulty in recruitment and retention of competitive faculty, procurement of funding, and the relatively small size of most dental schools. In small schools, faculty often have restricted time for research because of a faculty-intensive teaching curriculum. Such schools may have neither the infrastructure nor the personnel resources to mount a competitive research effort.

Some administrators believed that the primary role of the dental school was to educate general dentists, with research and community outreach being important but secondary priorities. Most felt that more interaction needed to occur between the dental school and other units of the institution if the dental school is to grow and change in response to the changing environment. A common concern also voiced was that the dental school often tended to be too insular; the resultant lack of cross-fertilization fostered attitudes of autonomy that are not conducive to achieving collaboration with other health professional schools.

Administrators expressed three predominant concerns in regard to the ability of the dental school to fulfill its mission of teaching, research, community service, and patient care:

1. There is a great need for more public awareness of the mission and accomplishments of the dental school. The public’s support is vital to accomplish the mission of the university and the dental school.
   
2. State appropriations have been consistently decreasing, with several private schools receiving no such funding. Enhanced societal value for oral health care might, in time, result in more support from the state.
   
3. Dental schools need to become more integrated into the university system in regard to their overall vision and teaching and research activities.
   

Is an evaluation of the school’s effectiveness and contribution to the university’s mission a contributing factor in decisions of resource allocation from the university?

There were diverse responses on this topic from the interviewees. In some institutions, formal assessment of the effectiveness of component schools was performed with future investment dependent on positive performance. In others, allocations were formula-based. Future growth was said to depend on entrepreneurial strategies in some of the university environments.

What would you like to see the dental school do differently or in addition to what it does now? In your view, how should it accomplish this?

In general, all of the interviewed administrators expressed satisfaction regarding the contributions of the dental school to the university mission. Again, some commented that dental schools need to be proactive to educate the public regarding their activities in teaching, research, and service to the community. Some suggested that their dental school should engage in strategic planning more in harmony with the strategic plans of the parent universities. Many expressed the need for the dental school to collaborate more with other schools and that they should be better integrated with other units to improve the operations of their institution and the dental school.

	Officers of the Local and State Dental Associations

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
In your view, what is the role of the dental school in meeting the needs of your membership and the profession at large?

All executive directors (EDs) agreed that the primary role of the dental school was to provide for the education of new dentists, be a resource for scientific information and continuing education, and serve as a source of associates to buy their practices. One ED recognized the symbolic value of the dental school to both the practicing profession and the larger community. It was acknowledged that previous downturns in practitioners’ patient population and thus income had created negative feelings of competition between association members and the dental school, but that the current good economic times have resolved this problem. Some interviewees also emphasized that the education of dental hygienists was very important. Another ED mentioned the need for a strong partnership between the state dental society and the dental school to work on overlapping roles of the two organizations. Those included advocacy, education, service, and research. That ED stated that research support was a growing interest of the state dental association.

What would you like to see the dental school do differently or in addition to what it does now? Are you prepared to help make these changes with political, moral, and financial support?

Two EDs reported being very satisfied with their relationship with and the performance of their dental schools. Several noted that membership and participation in the state dental association by faculty could be better and that obtaining that support was vital to enhancing their ability to work effectively on projects of mutual interest. They noted that this would facilitate cooperation and result in progress on many other important dental issues and projects. Another ED related his perception that the relationship of the state dental society was excellent at the administrative level of the dental school, but weak at the faculty level. He told of situations where the mutual support and cooperation between the state dental associations (SDA) and dental school were outstanding, but that the faculty appeared to have very little idea of what was going on within their SDA. This ED indicated general satisfaction with how the dental school was performing its mission, but also said that the dental school was missing opportunities to promote itself and communicate with the membership and the public. One example that this particular ED provided was that very few articles were being submitted to the SDA journal. Another ED indicated that the SDA membership perceived that today’s dental graduates are not as thoroughly or technically trained as the graduates of ten or twenty years ago and do not receive as much clinical experience as needed to succeed in private practice. This ED also reported perceiving that some members believed dental students needed to learn more about public health programs and be encouraged to participate in them. In the opinion of one ED and his SDA membership, new graduates also needed more knowledge of the business aspect of private practice. EDs also admonished dental schools to provide a better foundation in the development of professionalism, including the importance of participation in organized dentistry, stating that this effort must start with faculty involvement in these issues, especially professionalism and ethics. EDs further stated that these core values should be presented to dental students on an ongoing basis throughout their predoctoral years.

What is your perception of the quality of education that occurs at the dental school and whom should we be educating?

The majority of the SDA directors perceived the quality of dental education to be excellent. One indicated that concerns about quality did arise periodically, but that the SDA was unlikely to know about problems in this area unless the dean brought them to the SDA. There were diverse responses about whom the dental school should be educating. One director found this a difficult question to answer, but stated that it was a priority to educate those who would serve in chronically underserved areas. This acknowledgment of the need to have dentists practice in underserved areas was common to the majority of directors. One felt that while the demographics of his school’s students was representative of the community, diversity was nevertheless a nationwide concern. Directors also perceived that dental schools need to continue to participate in community outreach service programs and to look for additional ways to address the access to care issue. A need for stronger collaboration between the dental school and dental hygiene programs in facing these challenges was noted.

What is your perception of the value of the research that occurs at the dental school?

Responses to this question were more limited than responses about the quality of education. Several SDA directors acknowledged the importance of research, while one admitted possessing only a very limited knowledge of this issue. He did express an interest in being updated by the dental school, however. One ED expressed strong support for the research mission of the dental school, discussed the need to find ways to fund it, and spoke of the need for collaboration with other dental schools and medical centers as well as other state research programs.

How could the relationship between the state dental society and the dental school be made more mutually supportive? In your view, how can the communication between the dental school and organized dentistry be improved?

All of the EDs were very positive about their existing relationships with their local dental schools, and some of them listed successful examples of how they were interacting. Several specific suggestions were made, however, regarding how their relationships may be made even better. One ED encouraged better exchange of information between the state dental society and the faculty. He saw a need to find more opportunities to interact directly and indicated that this should be a mutual effort of the society and the school. Another ED indicated that improvement of relations should be an explicit objective and that progress towards this objective should be monitored. This interviewee felt that doing anything less would result in the relations between the society and school getting less attention than is necessary. A third ED encouraged involving more dental faculty in the state dental association and providing more positive information to students about their association.

What is your perception of the community service activities, such as patient care, distance learning, and outreach programs, that occur in and are facilitated by the dental school? How can the dental school better meet the needs of the community?

A majority of the EDs thought the dental school was fulfilling its community service mission quite well. However, suggestions were made with regard to how the dental school might further improve in this area. The majority of EDs suggested that the school increase support for allied health programs such as distance learning for dental hygiene students. One ED emphasized the need for the school to engage in public health services and in the formation of public health policy. This ED felt that oral health must be publicly advanced as a primary, not secondary, concern and the dental school should be involved in this effort. Another ED admitted knowing very little about the outreach activities of their dental school, and yet another reported that members had complained that school clinics have competed with local dentists for patients with dental insurance and patients who can afford private dental fees.

The majority of the ADA trustees felt that progress is needed in meeting the needs of the underserved and recommended this be done through distance learning and community-based education. One trustee went on to suggest that distance learning be given by only the best faculty and that the facilities for distance learning must be good. He felt that we should do our best to avoid a two-tiered learning system. Another trustee admonished our profession to be open-minded towards the future and to think in innovative and creative ways.

	State Government Officials

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
In your view, how and how well does the dental school serve your constituents and society in general?

All of the state officials were very pleased with the services being offered by the dental school to the larger community. They were aware of the dental schools’ various outreach programs and professed commitment to maintaining these programs and even expanding them. Programs mentioned included mobile dental clinics, continuing dental educational programs, student clinics, and services provided for patients with special needs. However, one interviewee expressed concern that it was too difficult to get an appointment in the dental school clinic, that the clinic was too isolated and impossible for constituents to walk to, and that there were no bus routes that provided access to the dental school.

What types of information about the dental school would you like to have in more detail or greater frequency?

The majority of the state officials wanted to know more about the dental school and its activities. Only one indicated that the newsletter they received from the dental school was sufficient, but acknowledged that more information could be requested if needed. One public official stated that only a few colleagues had any compelling interest in oral health. Most were largely ignorant of oral health issues and the effect on their constituents’ quality of life. One legislator actually was indignant when informed about the link between periodontal disease and systemic disease and demanded to know why this information had not previously been made available to his office.

During the interviews, several state officials requested other information about four issues:

1. What is the actual capacity of the student clinic to treat patients? The official who raised this question stated that knowledge of the school’s treatment capacity would allow systematic referral processes to be considered, perhaps including bussing for those not able to drive themselves to the dental school. Such processes had not been considered to date because of the prevalent perception that being accepted by the dental school as a patient was very difficult and the waiting list was very long.
   
2. How many patients are treated by the dental clinics and what are the demographics of this patient population?
   
3. How many minority students are recruited and graduate from the dental school, and do they choose to practice in underserved areas?
   
4. What services does the dental school provide to the community? Several state government officials took the position that they knew when they needed more information and it was preferable for the dental school to wait until they asked for more information. The majority indicated that they were dependent upon the dental school to determine what information they needed and when they should receive it.
   

How much do you know about our school, and how much do you think your colleagues know about our programs?

In response to this question, the majority of those interviewed indicated that neither they nor their colleagues knew as much about the dental school as they should. One said there was good communication with the dean, with the result that they were well informed. One public official stressed that the dental school needs to communicate better with state officials if they want better funding, because the dental school is not on the radar screen of either the legislators or the community without prompting.

Would you be willing to help acquire funding for expansion to cover areas you believe need to be enhanced?

All of the legislators expressed a willingness to work to find funding for dental school programs that serve the needs of the community. One said this assistance would by necessity have to be based on knowing more about the dental school, its programs, and its capabilities to serve community needs. Another official also explained that the legislature’s distribution of resources was influenced by what it heard from the president of the parent institution as well as lobbyists.

Do you know how the dental school is supported? What are your thoughts on this? For example, do you think that the cost of dental education should be entirely borne by the individual and his or her family, especially in view of the shortage of dentists?

None of the officials was aware of how the dental school was supported. They all also agreed that the students should not be expected to bear the complete cost of their education. Several interviewees expressed the opinion that graduates remain in the state to service the community that subsidized their education.

	Discussion

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
Interviewees internal to the dental school’s parent institution appeared to be more consistent with each other than with those external to the institution. However, there were numerous areas of concern and expressed willingness from both groups to work together with the school to better serve the public. Increasing financial stress on academic institutions increases the burden on professional schools to demonstrate their value to their parent institution.³ This is especially relevant since senior university officials agree that financing is their most immediate concern for dental schools.³ This perception was reinforced by the responses obtained in the interviews. Perhaps the most consistently reported need was for the parent institution and dental school to do a better job of informing external constituents of the value of what the dental school is doing for the parent institution and the community at large. Likewise, it was felt that the parent institution also needed to be more successful in promoting its core values and an understanding of the need for its services to the public.

There is growing concern among those interviewed that business as usual is no longer sufficient. Producing dentists, doing research, and performing community service at existing levels need to be augmented with a systematic process of routinely promoting the value of the work of the dental school to both the parent institution and the larger community. At a time when our profession is promoting the notion that "the mouth is connected to the rest of the body," it appears consistent and potentially beneficial for the dental schools to ask themselves how they might better communicate the importance of overall oral health and how improving oral health can positively influence the quality of life of the larger community.

The following suggestions are based on our assessment of the interviews and are offered for consideration by dental schools to improve communication internally and externally:

1. Establish a systematic process of periodic updates issued by the dental school, complete with "talking points," that can be used by leaders in other areas not only to inform them but also to aid them in passing this information forward in public, academic, and legislative arenas.
   
2. Appoint a clinical science faculty liaison to the external relations committee to keep the committee informed of new scientific knowledge that directly affects public health such as the link between periodontal disease and systemic diseases.
   
3. Establish a speakers’ bureau that would disseminate information within the community about the school and its activities either through community service talks or included within continuing education seminars.
   

The concern that the dental school had become too insular was commonly expressed by the interviewees within the parent institution. This may be a significant concern in view of the perception among high-level administrators that lack of integration of the dental school and its faculty with the overall academic community of the parent institution may have contributed significantly to the closing of several dental schools.⁴ One might speculate that the increasingly multidisciplinary nature of twenty-first century research and education partly explains why parent institution administrators would find deficiency with the characteristic isolation of dental schools. On the other hand, those closer to the world of full-time clinical practice appeared to have more of an interest in serving the present needs and traditions of the profession as they conceived it and did not voice any concern about the need for integrating the dental school into the university environment.

The following suggestions are offered for consideration by dental schools to increase integration with their parent institution:

1. Dental schools and parent institutions should both encourage and reward interdisciplinary research between other institutional units and the dental school.
   
2. Deans should appoint to administrative positions within the dental school and to university committees strong faculty members who are of high character and who are committed to moving the dental school towards excellence.¹
   
3. Dental school deans themselves need to become more prominent within the university in ways that are beneficial to both the dental school and the university.¹ For example, deans should look for opportunities to interact administratively with the medical school and also to become members of the higher-level governance structure of the university.
   
4. The dental school should promote its important function as the "front porch" of the university that invites the public in and builds a positive relationship with them.³
   
5. Faculty-initiated efforts to integrate the activities of the dental school with those of the parent institution should be encouraged because faculty support will be the greatest factor leading toward success in the long term.¹
   
6. The dental school should develop a shared vision that integrates well with the mission, goals, and priorities of the parent university.³
   
7. The dental school should foster leadership development experiences for their best young faculty to help them develop the broad viewpoint they will need as they move up in leadership positions.¹
   

While some acknowledgment of the importance of research was made by interviewees external to the parent institution, it is relevant to note that the new dental schools appearing on the scene in the last several years are focusing primarily on producing general dentists, with little emphasis on research programs. This de-emphasis of the research mission is striking and may become a focus of debate and discussion as it relates to the future of our profession.

	Conclusions

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 
Based on initial interviews with university administrators, executive directors of state dental associations, and state government officials in seven areas of the United States, we offer the following hypotheses:

• Dental schools are generally perceived to be too insular and need to interact more with their parent institutions and external communities.
  
• Dental schools need to systematically and continually communicate the value of their services to the public and political constituencies.
  
• Multidisciplinarity and integration with other units is important to university administrators, but does not appear to be a major concern of state dental association directors and government officials external to the university.
  

More targeted research is required to examine these hypotheses in greater detail and to provide evidence that can be used in decision making and planning processes within dental schools.

	REFERENCES

Top Abstract Methods Results High-level administrators... Officers of the local... State government officials Discussion Conclusions References

 

1. Iacopino AM, Lynch DP, Taft T. Preserving the pipeline: a model dental curriculum for research non-intensive institutions. J Dent Educ 2004;68(1):44–9.[Abstract]
2. Ranney RR. Future priorities for a successful dental school. Eur J Dent Educ 1999;3(Suppl 1):104–10.
3. Oliver R, Paganelli C, Cerny D, Gravert C, Klinge B, Kordass B, et al. Towards a global superstore of quality-assured modularized learning programmes. Eur J Dent Educ 2002;6(Suppl 3):147–51.
4. Nattestad A, Attstrom R, Mattheos N, Ramseier C, Canegallo L, Eaton K, et al. Web-based interactive learning programmes. Eur J Dent Educ 2002;6(Suppl 3): 127–37.
5. Clark GT. Education problems and web-based teaching: how it impacts dental educators? J Am Coll Dent 2001;68(3):25–34.
6. Susarla SM, Medina-Martinez N, Howell TH, Karimbux NY. Problem-based learning: effects on standard outcomes. J Dent Educ 2003;67(9):1003–10.[Abstract]
7. Pau AK, Croucher R. The use of PBL to facilitate the development of professional attributes in second year dental students. Eur J Dent Educ 2003;7(3):123–9.[Medline]
8. Gerzina TM, Worthington R, Byrne S, McMahon C. Student use and perceptions of different learning aids in a problem-based learning (PBL) dentistry course. J Dent Educ 2003;67(6):641–53.[Abstract]
9. Use of problem-based learning in Canadian and U.S. dental schools: results of a survey. J Can Dent Assoc 2002; 68(1):26.
10. Hoad-Reddick G, Theaker E. Providing support for problem-based learning in dentistry: the Manchester experience. Eur J Dent Educ 2003;7(1):3–12.[Medline]
11. Bailitt H, Weaver R, Haden K, Kotowicz W, Hovland E. Dental education summits: the challenges ahead. J Am Dent Assoc 2003;134(8):1109–13.[Abstract/Free Full Text]
12. Weaver RG, Haden NK, Valachovic RW. Survey of dental student financial assistance, 2001–02. J Dent Educ 2004;68(1):89–102.[Abstract]
13. Noonan AS, Evans CA. The need for diversity in the health professions. J Dent Educ 2003;67(9):1030–3.[Abstract]
14. Altieri JP, Bruce SM, Crall JJ, Eklund SA, Parrish JL, Schneider DA, et al. Future of dentistry: access to care. Today’s vision: tomorrow’s reality. J Am Dent Assoc 2002;133(10):1408–24.[Free Full Text]
15. Haden NK, Morr KE, Valachovic RW. Trends in allied dental education: an analysis of the past and a look to the future. J Dent Educ 2001;65(5):480–95.[Abstract]
16. Kennedy JE. Building on our accomplishments. J Am Dent Assoc 1999;130(12):1729–35.[Abstract/Free Full Text]
17. Chang JW. Clinical education in dentistry: in light of form & content issues. N Y State Dent J 2002;68(8):24–33.
18. Duderstadt JJ. A university for the 21st century. Ann Arbor: University of Michigan Press, 2000:358.

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Dederich, D. N. Articles by Scannapieco, F. A. Search for Related Content PubMed PubMed Citation Articles by Dederich, D. N. Articles by Scannapieco, F. A.