Trial Protocol: Randomised controlled trial of the effects of very low calorie diet, modest dietary restriction, and sequential behavioural programme on hunger, urges to smoke, abstinence and weight gain in overweight smokers stopping smoking

Background\ud Weight gain accompanies smoking cessation, but dieting during quitting is controversial as hunger may increase urges to smoke. This is a feasibility trial for the investigation of a very low calorie diet (VLCD), individual modest energy restriction, and usual advice on hunger, ketosis, urges to smoke, abstinence and weight gain in overweight smokers trying to quit. \ud \ud Methods\ud This is a 3 armed, unblinded, randomized controlled trial in overweight (BMI > 25 kg/$m^2$), daily smokers (CO > 10 ppm); with at least 30 participants in each group. Each group receives identical behavioural support and NRT patches (25 mg(8 weeks),15 mg(2 weeks),10 mg(2 weeks)). The VLCD group receive a 429-559 kcal/day liquid formula beginning 1 week before quitting and continuing for 4 weeks afterwards. The modest energy restricted group (termed individual dietary and activity planning(IDAP)) engage in goal-setting and receive an energy prescription based on individual basal metabolic rate(BMR) aiming for daily reduction of 600 kcal. The control group receive usual dietary advice that accompanies smoking cessation i.e. avoiding feeling hungry but eating healthy snacks. After this, the VLCD participants receive IDAP to provide support for changing eating habits in the longer term; the IDAP group continues receiving this support. The control group receive IDAP 8 weeks after quitting. This allows us to compare IDAP following a successful quit attempt with dieting concurrently during quitting. It also aims to prevent attrition in the unblinded, control group by meeting their need for weight management. Follow-up occurs at 6 and 12 months. \ud \ud Outcome measures include participant acceptability, measured qualitatively by semi-structured interviewing and quantitatively by recruitment and attrition rates. Feasibility of running the trial within primary care is measured by interview and questionnaire of the treatment providers. Adherence to the VLCD is verified by the presence of urinary ketones measured weekly. Daily urges to smoke, hunger and withdrawal are measured using the Mood and Physical Symptoms Scale-Combined (MPSS-C) and a Hunger Craving Score (HCS). 24 hour, 7 day point prevalence and 4-week prolonged abstinence (Russell Standard) is confirmed by CO < 10 ppm. Weight, waist and hip circumference and percentage body fat are measured at each visit. \ud \ud Trial Registration\ud Current controlled trials ISRCTN83865809\ud \u

Children’s HEalthy Weight guideline Implementation in the dental setting : a multi-phase sequential mixed methods project : the CHEWI project

There has been an increasing prevalence of childhood overweight and obesity worldwide and locally, with a quarter of Australian children now considered overweight or obese. This is of concern as obesity in childhood is associated with obesity in adulthood and increased risk of chronic diseases. In response to this, in 2015 the New South Wales (NSW) government released a Premier’s Priority titled “Tackling Childhood Obesity”, which called for all public health services to identify children above a healthy weight and refer them to appropriate services. This priority encompassed public dental services, due to the shared risk factors between childhood obesity and oral health including consumption of sugar-sweetened beverages, and the opportunities they have to recall and monitor child patients at regular intervals. In light of this, in 2018 the NSW Ministry of Health released guidelines titled ‘Growth Assessment and Dietary Advice in Public Oral Health Services’ for dental staff (DS) such as dental and/or oral health therapists and dental assistants across the state. However, to ensure these guidelines are incorporated into practice, it is anticipated that implementation strategies will be required to support dental practitioners. This study aimed to develop and pilot implementation strategies to facilitate the translation of the ‘Growth Assessment and Dietary Advice in Public Oral Health Services’ guidelines into dental staff’s practice. Specific objectives included: 1. Summarise the existing evidence on the most effective guideline implementation strategies for the dental setting. 2. Codesign implementation strategies with dental staff and parents to facilitate implementation of children’s healthy weight guidelines into the dental setting. 3. Design and psychometrically evaluate an instrument that measures dental staff behavioural intention. 4. Refine and pilot test the implementation strategies using the developed instrument and service data. This project has provided valuable insight into the systematic development of implementation strategies for the dental setting by drawing upon the principles of codesign as well as involving a range of stakeholders. It was clear that dental staff can play a key role in addressing overweight and obesity in childhood, although this can be a challenging role expansion. A systematic approach where dental staff and parents could codesign their own strategies, and in ensuring involvement of other stakeholders in the refinement of these strategies produced strategies that were acceptable, feasible, and sustainable for all involved parties. Initial findings from this project showed promising improvements to behavioural determinants and self-reported behaviours following the introduction of the strategies for one district

Dental Education

The dental curriculum is like a living organism—it has developed through time, manifesting regional, cultural, and scientific heritage, and reflecting modern trends. The undergraduate dental curriculum is periodically rebuilt to ensure the harmonization of higher education systems between countries, especially in Europe. Structure, content, learning, and assessment in undergraduate and postgraduate dental education and auxiliary dental personnel training are shaped based on professional consensus. Constant updates on recent technological innovations and evidence-based best practice are necessary.In modern times, ethical issues are raised more than ever. Can we teach our students how to be dedicated health professionals and manage a successful practice at the same time? Does the commercialization of our profession also affect the dental curriculum today?The COVID-19 pandemic has imposed new challenges, moving us from lecture rooms and clinics to an online environment.This Special Issue is dedicated to developing the understanding of dental education