Aspects of water sorption in filled resin restorative materials

Abstract no. 826published_or_final_versio

Effectiveness of a mindfulness and acceptance-based intervention for improving the mental health of adolescents with HIV in Uganda: An open-label trial

Adolescents with HIV (AWH) face the double burden of dealing with challenges presented by their developmental phase while coping with stigma related to HIV, affecting their mental health. Poor mental health complicates adherence to daily treatment regimens, requiring innovative psychosocial support strategies for use with adolescents. We assessed the effectiveness of a mindfulness and acceptance-based intervention on the mental health of AWH in Uganda. One hundred and twenty-two AWH, mean age 17 ±1.59 (range 15 to 19 years), 57% female, receiving care at a public health facility in Kampala were enrolled in an open-label randomized trial (ClinicalTrials.gov: NCT05010317) with assessments at pre-and post-intervention. The mindfulness and acceptance-based intervention involved weekly 90-minute group sessions for four consecutive weeks facilitated by two experienced trainers. Sessions involved clarifying values, skillfully relating to thoughts, allowing and becoming aware of experiences non-judgmentally, and exploring life through trial and error. The control group received the current standard of care. Three mental health domains (depression, anxiety, and internalized stigma) were compared between the intervention and control groups. A linear mixed effects regression was used to analyze the effect of the intervention across the two time points. Results showed that the intervention was associated with a statistically significant reduction in symptoms of depression (β = -10.72, 95%CI: 6.25, -15.20; p < .0001), anxiety (β = -7.55, 95%CI: 2.66, -12.43; p = .0003) and stigma (β = -1.40, 95%CI: 0.66 to -2.15; p = .0004) over time. Results suggest that mindfulness and acceptance-based interventions have the potential to improve the mental health of AWH

Acceptability of an adapted mindfulness and acceptance-based intervention to support adolescents with HIV: A qualitative study with Ugandan health care providers

While the adaptation of evidence-based psychosocial support tailors the intervention components to the targeted context, minimizing the associated costs of developing new interventions for low-income contexts, the acceptability of such adapted interventions is important for augmenting successful implementation and sustainability. Given that psychosocial support to persons living with HIV is mostly rendered by healthcare providers, their acceptance of adapted interventions before implementation is crucial. This study explored healthcare providers' acceptance of an adapted mindfulness and acceptance-based intervention supporting adolescents with HIV. Ten healthcare providers at two urban clinics in Kampala, Uganda attended a three-day training on using the adapted intervention and gave feedback on its appropriateness during in-depth interviews conducted thereafter. Semi-structured interviews were based on the Theoretical Framework of Acceptability and findings were analyzed abductively within the seven components of the framework. Overall, the adapted intervention was perceived to be acceptable and appropriate for use with adolescents. Benefits included the intervention offering support beyond a focus on adherence to drugs, refocusing adolescents on aspects in their lives that matter most, and being easy to integrate into providers’ work processes. Providers however expressed concern about the time the intervention requires and the possibility of increasing their workload. These findings will support further adaptation and implementation

Aspects of water sorption from the air, water and artifical saliva in resin composite restorative materials

OBJECTIVE: Primarily to establish whether artificial saliva (AS) at 37 degrees C is essential as a clinically relevant environment for testing filled, resin composite restorative materials. The effect of other storage conditions was also investigated for comparison and controls: desiccation, exposure to the laboratory atmosphere, high humidity cabinet, saturated water vapor, and deionized water. METHODS: Two visible light-cured products were used: Heliomolar Radiopaque (HR) and Tetric Ceram (TC) (Ivoclar, Schaan, Liechtenstein). Bar specimens (26 x 1.5 x 1.0 mm(3)) were cured at five overlapping spots for 60s per spot and randomly distributed into groups of six. Trial 1: one group of each material was exposed first to atmospheric air at 24 degrees C, approximately 50% RH (24WV(50)), then to water vapor at 37 degrees C, approximately 97% RH (37WV(97)), and then immersed in deionized water at 37 degrees C (37DW). Trial 2 used three groups of each material, one first exposed to 37WV(97) followed by 37DW, the other two were immediately immersed in 37DW or artificial saliva (37AS). Trial 3: two groups of each material were vacuum desiccated at 37 degrees C, then exposed to 37 degrees C, approximately 100% RH (37WV(100)), then immersed in 37DW or 37AS. Trial 4: four groups of HR were treated similarly to Trial 3; one was left under desiccation, and another in 37WV(100) for the remaining period. Three-point bend tests for flexural strength (F), flexural modulus (E), and total energy to failure (W) were performed at the end of Trials 2-4. RESULTS: Environmental moisture absorption was substantial at 24WV(50)(c. 0.2%), at least 40% of that in 37DW (HR: c. 0.7%, TC: c. 0.5%). Saturation was achievable in 37WV(100). Mass loss on desiccation (HR: c. 0.4-0.5%, TC: c. 0.25%) was reversible in 37WV(100). There were some significant effects of exposure conditions on mechanical properties (e.g. F for HR: after desiccation, 85.7+/-1.4MPa; after 37WV(100), 73.2+/-3.6MPa; difference: p<0.0002), but overall the results were unclear. After a rapid gain in mass, there was a gradual loss in both 37DW and 37AS for both materials, slightly more in 37AS than 37DW. SIGNIFICANCE: Water vapor absorption is substantial, hence attention must be paid to the laboratory working environment and conditions of storage and testing, i.e. temperature and RH must be stated to assist interpretation of data and comparisons between studies. Test conditions need to be standardized and with reference to normal oral conditions, immediate immersion in artificial saliva at 37 degrees C is the preferred treatment for these materials, whatever time of testing is chosen

The effect of a group-based mindfulness and acceptance training on psychological flexibility and adherence to antiretroviral therapy among adolescents in Uganda: an open-label randomized trial

Adherence to antiretroviral therapy (ART) is lower in adolescents with HIV (AWH) than in any other age group, partly due to self-regulatory challenges during development. Mindfulness and acceptance training have been shown to support psychological flexibility, a self-regulatory skill that potentially improves adolescent adherence to medication. We assessed the effect of weekly group-based mindfulness and acceptance training sessions on ART adherence among older adolescents (15-19 years) in Kampala, Uganda. One hundred and twenty-two AWH (median age 17, range 15-19 years, 57% female) receiving care at a public health facility in Kampala were randomized 1:1 to receive 4 weekly 90-min group sessions facilitated by experienced trainers or standard-of-care ART services. The training involved (Session 1) clarifying values, (Session 2) skillfully relating to thoughts, (Session 3) allowing and becoming aware of experiences non-judgmentally, and (Session 4) exploring life through trial and error. At baseline, postintervention, and 3-month follow-up, psychological flexibility was measured using the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8), and self-reported ART adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8). At baseline, the intervention and standard-of-care arms had similar psychological flexibility (AFQ-Y8 score:15.45 ± 0.82; 15.74 ± 0.84) and ART adherence (MMAS-8 score: 5.32 ± 0.24; 5.13 ± 0.23). Retention through the study was moderate (71%). Completion of mindfulness and acceptance training was associated with a significant reduction in psychological inflexibility at the 3-month follow-up (AFQ-Y8 score: 12.63 ± 1.06; 14.05 ± 1.07, P = .006). However, no significant differences were observed in self-reported adherence to ART at the 3-month follow-up (MMAS-8 score: 5.43 ± 0.23; 4.90 ± 0.33, P = .522). Group-based mindfulness and acceptance training improved psychological flexibility in this population of adolescents on ART in Uganda but did not significantly improve ART adherence. Future research should explore integrated approaches that combine behavioral management training with other empowerment aspects to improve ART adherence among AWH.</p