Providing Oral Health Education to Underserved Children and Families within an Interdisciplinary Team

This paper outlines the background literature, needs assessment process, and project activities of a master’s project focused on oral health outcomes through use of an interprofessional team. The project activities were based on recommendations from current literatures, including interprofessional education and teaming, as well as family-centered education to promote positive oral health outcomes for young children and their families. Recommendations for future collaborations and the occupational therapy role within interprofessional oral health care teams are shared

DNA methylation in newborns conceived by assisted reproductive technology

Assisted reproductive technology (ART) may affect fetal development through epigenetic mechanisms as the timing of ART procedures coincides with the extensive epigenetic remodeling occurring between fertilization and embryo implantation. However, it is unknown to what extent ART procedures alter the fetal epigenome. Underlying parental characteristics and subfertility may also play a role. Here we identify differences in cord blood DNA methylation, measured using the Illumina EPIC platform, between 962 ART conceived and 983 naturally conceived singleton newborns. We show that ART conceived newborns display widespread differences in DNA methylation, and overall less methylation across the genome. There were 607 genome-wide differentially methylated CpGs. We find differences in 176 known genes, including genes related to growth, neurodevelopment, and other health outcomes that have been associated with ART. Both fresh and frozen embryo transfer show DNA methylation differences. Associations persist after controlling for parents’ DNA methylation, and are not explained by parental subfertility.publishedVersio

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Murillo,

"The principal works of Murillo": p. [65]-86.Mode of access: Internet

An approach to developing oral health knowledge for allied health students

Background: Oral health competency-based education approaches have been proposed as a mechanism to address oral health outcomes and equity issues. Recommendations for oral health education for allied health professional students include practices to increase team members\u27 knowledge and skills in the integration of oral health and primary care practice (IOHPCP) initiative\u27s oral health clinical competencies for primary care providers.Aims: This study aimed to examine changes in self-reported knowledge of occupational therapy students in the topics of oral health, the dental profession, and the dental healthcare systems following participation in a series of webinars and a community-engaged learning project.Materials and Methods: This study utilized an oral health education program through webinars and a community-engaged learning project for occupational therapy students. Program evaluation measures were utilized to assess the oral health education activities through self-reported knowledge in oral health topics aligned with IOHPCP domains along with topics identified by the community partner organization.Results: Findings demonstrate that asynchronous webinars can increase self-reported knowledge in occupational therapy students.Discussion: Recommendations for inclusion of oral health education for allied health students related to knowledge of oral health, the dental profession, and dental healthcare systems are shared.Conclusions: Asynchronous webinars have the potential to increase self-reported oral health knowledge for allied health professionals

A test-retest analysis of the Vanderbilt Assessment for Leadership in Education in the USA

The Vanderbilt Assessment for Leadership in Education (VAL-ED) is a 360-degree learning-centered behaviors principal evaluation tool that includes ratings from the principal, supervisors, and teachers. The current study assesses the test-retest reliability of the VAL-ED for a sample of seven school districts as part of multiple validity and reliability assessments based on various samples of real users of the VAL-ED. We administered the VAL-ED twice and examined the correlations and mean differences between time 1 and time 2. We find that the principal and teacher ratings from time 1 and time 2 have large, positive, and significant correlations. Additionally, for both time points, principals are rated as being at least satisfactorily effective. Principals rate themselves slightly higher at time 2, while teachers rate principals slightly higher at time 1

An Analysis of Microlitter and Microplastics from Lake Superior Beach Sand and Surface-Water

An Analysis of Microlitter and Microplastics from Lake Superior Beach Sand and Surface-Water. This report describes work done in 2018 to evaluate the presence/absence of microplastics within and near the Apostle Islands National Lakeshore. We wish to archive the information for preservation and availability for other interested parties.This project was funded by a cooperative agreement between the National Park Service and the University of Minnesota with support from the Great Lakes Restoration Initiative and the National Park Service Water Resources Division

A known group analysis validity study of the Vanderbilt Assessment of Leadership in Education in US elementary and secondary schools

The Vanderbilt Assessment of Leadership in Education (VAL-ED) provides educators with a tool for principal evaluation based on principal, teacher, and supervisor reports of principals’ learning-centered leadership. In this study, we conduct a known group analysis as part of a larger argument for the validity of the VAL-ED in US elementary and secondary schools. We asked superintendents to select the principals in their district who they believe in performance of their duties are in the top 20 % and the bottom 20 %. We ask how accurately VAL-ED scores can identify membership of the two known groups. Using a discriminant analysis, the VAL-ED places principals in the superintendent groups, on average, 70 % of the time for both elementary and secondary schools. Placement accuracy is greater for the top group than the bottom group