Oral health literacy in adult dental patients - A clinical study

Paper II: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl, J.: “The association between oral health literacy and alexithymia: Implications for patient-clinician communication”. (Manuscript). Published version with title “Exploring the association between oral health literacy and alexithymia” available in Community Dental Health 2015, 32(3):143 - 147. Paper III: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl, J.: Effects of communication sensitive to oral health literacy: A randomized controlled trial of adult patients. (Manuscript). Final version available in Munin at https://hdl.handle.net/10037/13475. Oral health literacy encompasses individuals’ capacity to obtain, process, and understand basic oral health information and services needed to make appropriate health decisions. Evidence suggests that limited oral health literacy inhibit patients from getting necessary oral health information, and that communication with dental professionals may be problematic. Various personality traits are also regarded as challenges to successful communication, and are together with oral health literacy considered as risk factors for poorer oral health outcomes. Health literacy models have proposed that knowing the health literacy level of the patients makes it possible to tailor communication, which in turn might lead to better comprehension and enhanced health outcomes. The aim of the thesis was to develop and validate the Adult Health Literacy Instrument for Dentistry (AHLID), an instrument to assess oral health literacy in Norwegian adult dental patients. Further, the aim was to investigate if oral health literacy was associated with the personality trait alexithymia, and test the effect of communication at the dental clinic sensitive to patients’ oral health literacy. The AHLID was found to be a reliable tool for measuring oral health literacy, and we discovered that limited oral health literacy was associated with Lactobacillus count in saliva and reduced knowledge of risk factors for oral health diseases. One out of three participants scored on an oral health literacy level considered less than minimum for understanding important oral health information. An association between oral health literacy and alexithymia was revealed, indicating that alexithymia may be an important factor for limited oral health literacy. The combination of limited oral health literacy and alexithymia may lead to communication challenges for dental professionals when providing information to patients and teaching them skills for self-management of oral diseases. In a RCT, the effect of communication sensitive to patients’ oral health literacy was tested. The result indicated that providing information regarding patients’ oral health using oral health literacy sensitive communication techniques may enhance patients’ oral hygiene and gingival status compared to a control group. When communicating with patients regarding their oral health, dental professionals need to take oral health literacy into account to reduce the barriers of limited oral health literacy and enhance patients’ ability to process and understand oral health information. Knowledge regarding oral health literacy and psychological factors is essential for dental professionals, and communication skills are also needed to treat different patients properly

Evaluering av implementeringen av RETHOS for studieprogrammene i tannpleie

Sammendrag De nye nasjonale retningslinjene for helse- og sosialfagutdanningene (RETHOS) er en del av et nytt styringssystem. Intensjonen er at de nye retningslinjene skal bidra til at nyutdannede kandidater har en likeverdig sluttkompetanse som imøtekommer tjenestenes kompetansebehov. Implementeringen av retningslinjene er inndelt i tre faser, der den første fasen begynte høsten 2020. Kunnskapsdepartementet har gitt NOKUT i oppdrag å evaluere implementeringen av retningslinjene. Formålet er å framskaffe informasjon som er nyttig for videreutviklingen av RETHOS som styringssystem og institusjonenes studieplanarbeid. Evalueringen omfatter åtte fagområder, og i denne rapporten presenteres funnene fra tannpleierutdanningene. Evalueringen tar for seg tre områder: Vurdering av etterlevelse mellom studieplaner og de nye retningslinjene, institusjonenes erfaringer med implementeringen og tjenestenes erfaring med implementeringen. Vurderinger av etterlevelse utført av en sakkyndig komite Den sakkyndige komiteen har tillit til at studentene ved alle institusjoner vil kunne oppnå det intenderte læringsutbyttet i de nye retningslinjene. Samtidig viser komiteen til en rekke punkter institusjonen bør se nærmere på, blant annet spesifikke læringsutbytter, bruk av Nasjonalt kvalifikasjonsrammeverk og praksis. Institusjonenes erfaring med implementeringen Institusjonene har ulike erfaringer knyttet til retningslinjene anvendelighet. Retningslinjene bidrar imidlertid til å harmonisere utdanningene på tvers av institusjoner. Det at retningslinjenes er generelle kan gjøre de vanskelige å tolke, men dette bidrar også til lokalt handlingsrom. Det lokale handlingsrommet kan imidlertid begrenses av lokale føringer. De fleste institusjonene opplever at tjenestene har fått økt innflytelse på studieplanen, men at koronapandemien har vanskeliggjort samarbeidet. Tjenesterepresentantenes erfaring med implementeringen på tvers av fagområdene Tjenesterepresentantene har ulike erfaringer med implementeringen, men de har klare meninger om hva som skal til for å sikre et godt samarbeid. De ønsker å bli involvert tidlig i prosessen, slik at de kan være med og påvirke den overordnede tematikken i studieplanarbeidet. Videre bør det være en bredde i utvalget av tjeneste- og studentrepresentanter. Det kommer også fram at det er viktig at institusjonene følger opp tjenesterepresentantene godt både før, underveis og etter innspillsprosesser, slik at de er godt informert om forventninger til arbeidet, kan forankre innspill i egen virksomhet og se resultater av samarbeidet.publishedVersio

Evaluering av implementeringen av RETHOS for studieprogrammene i tannpleie

Source at https://www.nokut.no/.Denne rapporten omhandler implementeringen av retningslinjene for helse- og sosialfagutdanningene, RETHOS. NOKUT har på oppdrag fra Kunnskapsdepartementet evaluert implementeringen av RETHOS gjennom tre ulike deler: Kartlegging av etterlevelse av de nasjonale retningslinjene. Her presenteres det vurderinger fra sakkyndige om studieplanene ved institusjonene er i tråd med de nasjonale retningslinjene. Kartlegging av institusjonenes erfaringer. Her presenteres en oppsummering av institusjonenes erfaring med studieplanarbeidet. Kartlegging av tjenestenes erfaringer. Her presenteres tjenestenes erfaringer med samarbeidet om utviklingen av nye studieplaner. Gjennom denne tilnærmingen ønsker vi å frembringe kunnskap om hvordan prosessen rundt selve implementeringen av retningslinjene har vært, både for institusjonene og for tjenestene. De viktigste bidragene til evalueringens datagrunnlag er de sakkyndige komiteenes vurderinger, institusjonenes selvevalueringer og intervjuer med representanter fra tjenestene som har vært involvert i samarbeidet om utviklingen av studieplaner. Vi håper rapporten gir et nyttig bidrag til videreutviklingen av RETHOS som styringssystem og til institusjonenes arbeid med å videreutvikle studieplanene sine

Restorative treatment decisions for carious lesions: Do Russian dentists and dental students apply minimal intervention dentistry?

Background - The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions. Methods - We included 171 general dental practitioners and dental therapists (collectively referred to here as “dentists”) from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis. Results - For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13–15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33–6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite. Conclusions - The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results

Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration)

Both young and advanced maternal age is associated with adverse birth and child outcomes. Few studies have examined these associations in low-income and middle-income countries (LMICs) and none have studied adult outcomes in the offspring. We aimed to examine both child and adult outcomes in five LMICs

Genome-wide association study of generalized anxiety symptoms in the Hispanic Community Health Study/Study of Latinos

Although generalized anxiety disorder (GAD) is heritable and aggregates in families, no genomic loci associated with GAD have been reported. We aimed to discover potential loci by conducting a genome-wide analysis of GAD symptoms in a large, population-based sample of Hispanic/Latino adults. Data came from 12,282 participants (aged 18–74) in the Hispanic Community Health Study/Study of Latinos. Using a shorted Spielberger Trait Anxiety measure, we analyzed: (1) a total trait anxiety score based on summing responses to all ten items; and (2) a GAD symptoms score restricted to the three items tapping diagnostic features of GAD as defined by DSM-V. We first calculated the heritability due to common variants (h2SNP) and then conducted a genome-wide association study (GWAS) of GAD symptoms. Replication was attempted in three independent Hispanic cohorts (Multi-Ethnic Study of Atherosclerosis, Women’s Health Initiative, Army STARRS). The GAD symptoms score showed evidence of modest heritability (7.2%; p=0.03), while the total trait anxiety score did not (4.97%; p=0.20). One genotyped SNP (rs78602344) intronic to Thrombospondin 2 (THBS2) was nominally associated (p=4.18×10−8) in the primary analysis adjusting for psychiatric medication use and significantly associated with the GAD symptoms score in the analysis excluding medication users (p=4.18×10−8). However, meta-analysis of the replication samples did not support this association. Although GWAS revealed a genome-wide significant locus in this sample, we were unable to replicate this finding. Evidence for heritability was also only detected for GAD symptoms, and not the trait anxiety measure, suggesting differential genetic influences within the domain of trait anxiety

The transcriptional landscape of Shh medulloblastoma

© The Author(s) 2021. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Sonic hedgehog medulloblastoma encompasses a clinically and molecularly diverse group of cancers of the developing central nervous system. Here, we use unbiased sequencing of the transcriptome across a large cohort of 250 tumors to reveal differences among molecular subtypes of the disease, and demonstrate the previously unappreciated importance of non-coding RNA transcripts. We identify alterations within the cAMP dependent pathway (GNAS, PRKAR1A) which converge on GLI2 activity and show that 18% of tumors have a genetic event that directly targets the abundance and/or stability of MYCN. Furthermore, we discover an extensive network of fusions in focally amplified regions encompassing GLI2, and several loss-of-function fusions in tumor suppressor genes PTCH1, SUFU and NCOR1. Molecular convergence on a subset of genes by nucleotide variants, copy number aberrations, and gene fusions highlight the key roles of specific pathways in the pathogenesis of Sonic hedgehog medulloblastoma and open up opportunities for therapeutic intervention.info:eu-repo/semantics/publishedVersio

ARTEFACTS: How do we want to deal with the future of our one and only planet?

The European Commission’s Science and Knowledge Service, the Joint Research Centre (JRC), decided to try working hand-in-hand with leading European science centres and museums. Behind this decision was the idea that the JRC could better support EU Institutions in engaging with the European public. The fact that European Union policies are firmly based on scientific evidence is a strong message which the JRC is uniquely able to illustrate. Such a collaboration would not only provide a platform to explain the benefits of EU policies to our daily lives but also provide an opportunity for European citizens to engage by taking a more active part in the EU policy making process for the future. A PILOT PROGRAMME To test the idea, the JRC launched an experimental programme to work with science museums: a perfect partner for three compelling reasons. Firstly, they attract a large and growing number of visitors. Leading science museums in Europe have typically 500 000 visitors per year. Furthermore, they are based in large European cities and attract local visitors as well as tourists from across Europe and beyond. The second reason for working with museums is that they have mastered the art of how to communicate key elements of sophisticated arguments across to the public and making complex topics of public interest readily accessible. That is a high-value added skill and a crucial part of the valorisation of public-funded research, never to be underestimated. Finally museums are, at present, undergoing something of a renaissance. Museums today are vibrant environments offering new techniques and technologies to both inform and entertain, and attract visitors of all demographics.JRC.H.2-Knowledge Management Methodologies, Communities and Disseminatio

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors

Analysis of shared heritability in common disorders of the brain

ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders