Dental professionals’ views on motivational interviewing for the prevention of dental caries with adolescents in central Norway

Background Establishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients. Methods As part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level. Results A total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists. Conclusions A high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry

High-sensitivity cardiac troponin T levels are increased in stable COPD

Objective To assess the distribution of high-sensitivity cardiac troponin T (hs-cTnT) concentrations in stable chronic obstructive pulmonary disease (COPD), and whether hs-cTnT is associated with pulmonary function. Design Prospectively designed, cross-sectional study. Setting Outpatient clinic of Norwegian teaching hospital and community-based setting. Participants Sample of 101 stable COPD patients from the hospital's outpatient clinic and 120 individuals derived from a random general population sample. Main outcomes Ratio of hs-cTnT in stable COPD patients compared with references from the general population. Change in ratio of hs-cTnT per unit increase of relevant covariables. Results The crude geometric means of circulating hs-cTnT in the cases and the references were 7.75 and 3.01 ng/l, respectively (p <0.001); that is, a relative ratio of 2.57 (95% CI 2.05 to 3.23). After adjustment for relevant confounders, this ratio was moderately attenuated to 1.65 (1.31–2.08). In the total study cohort, as well as among stable COPD patients, we found a significant positive association between hs-cTnT and interleukin-6 concentrations (p <0.001) and the presence of pathologic Q waves (p=0.023). Among stable COPD patients, one quartile increase in forced expiratory volume 1 was associated with a 39% decrease in hs-cTnT and patient category (Global Initiative of Obstructive Lung Disease classification 2011) was positively associated with hs-cTnT (p trend <0.001) after multivariate adjustment. Conclusions Stable COPD is independently associated with higher hs-cTnT compared with randomly drawn subjects from the general population. In patients with stable COPD, higher hs-cTnT seems to be associated with immune activation and the severity of the disease

Investigating hope in oral health promotion for adolescents: an exploratory study based on observations at the dental clinic

Introduction: Maintaining well-being is crucial, especially in challenging conditions, considering the common public health issue of dental caries. Within the context of adolescent oral health, this research explores the techniques employed by dental professionals to potentially foster hope -a positive manner that promotes well-being- in adolescents during consultations, opening a window into the realm of patient engagement and well-being. Materials and methods: Data were collected through observations conducted at public dental clinics in Norway, with the participation of three dental professionals and four adolescents between the ages of 12 and 15 years. The data were analyzed using thematic analysis. Practices were observed from dental professionals in their interactions with adolescents, which align with features of hope. Result: Three core themes were identified: (1) bonding strategies; (2) verbal and non-verbal strategies for creating positive relationships; and (3) adolescents' empowerment in dental consultations. Conclusion: Although a new concept within oral health promotion, it seems that dental professionals in this study were observed to be facilitating hope in adolescents when they were providing their dental care. Consideration should be given to the potential for future approaches to be developed for use in dental consultations to facilitate hope strategically. While these approaches are likely to contribute to improving patient-centredness, consideration is needed of challenges and barriers to their implementation

Brukermedvirkning og brukerinvolvering. Evaluering av KS’ læringsnettverk for gode pasientforløp for personer med psykiske problemer og/eller rusproblemer

Kompetansesenter for brukererfaring og tjenesteutvikling i Midt-Norge (KBT-Midt-Norge) fikk sommeren 2015 i oppdrag å gjennomføre en brukerevaluering av KS’ prosjekt med å etablere læringsnettverk for gode pasientforløp for personer med psykiske problemer og/eller rusproblemer. Visjonen for prosjektet har vært å snu tjenestenes tenking fra «hva er i veien med deg?» til «hva er viktig for deg?», med vekt på det gode pasientforløp der samhandling mellom tjenestene fungerer optimalt. Satsningen har hatt et mål om aktiv deltakelse fra brukere og brukerorganisasjoner. Denne rapporten evaluerer satsningen

Brukermedvirkning og brukerinvolvering. Evaluering av KS’ læringsnettverk for gode pasientforløp for personer med psykiske problemer og/eller rusproblemer

Evaluering av KS' læringsnettverk for personer med psykiske problemer og/ eller rusproblemer.Kompetansesenter for brukererfaring og tjenesteutvikling i Midt-Norge (KBT-Midt-Norge) fikk sommeren 2015 i oppdrag å gjennomføre en brukerevaluering av KS’ prosjekt med å etablere læringsnettverk for gode pasientforløp for personer med psykiske problemer og/eller rusproblemer. Visjonen for prosjektet har vært å snu tjenestenes tenking fra «hva er i veien med deg?» til «hva er viktig for deg?», med vekt på det gode pasientforløp der samhandling mellom tjenestene fungerer optimalt. Satsningen har hatt et mål om aktiv deltakelse fra brukere og brukerorganisasjoner. Denne rapporten evaluerer satsningen