A randomised controlled feasibility trial for an educational school-based mental health intervention: study protocol

Background: With the burden of mental illness estimated to be costing the English economy alone around £22.5 billion a year [1], coupled with growing evidence that many mental disorders have their origins in adolescence, there is increasing pressure for schools to address the emotional well-being of their students, alongside the stigma and discrimination of mental illness. A number of prior educational interventions have been developed and evaluated for this purpose, but inconsistency of findings, reporting standards, and methodologies have led the majority of reviewers to conclude that the evidence for the efficacy of these programmes remains inconclusive. Methods/Design: A cluster randomised controlled trial design has been employed to enable a feasibility study of 'SchoolSpace', an intervention in 7 UK secondary schools addressing stigma of mental illness, mental health literacy, and promotion of mental health. A central aspect of the intervention involves students in the experimental condition interacting with a young person with lived experience of mental illness, a stigma reducing technique designed to facilitate students' engagement in the project. The primary outcome is the level of stigma related to mental illness. Secondary outcomes include mental health literacy, resilience to mental illness, and emotional well-being. Outcomes will be measured pre and post intervention, as well as at 6 month follow-up. Discussion: The proposed intervention presents the potential for increased engagement due to its combination of education and contact with a young person with lived experience of mental illness. Contact as a technique to reduce discrimination has been evaluated previously in research with adults, but has been employed in only a minority of research trials investigating the impact on youth. Prior to this study, the effect of contact on mental health literacy, resilience, and emotional well-being has not been evaluated to the authors' knowledge. If efficacious the intervention could provide a reliable and cost-effective method to reduce stigma in young people, whilst increasing mental health literacy, and emotional well-being. Trial registration: ISRCTN: ISRCTN0740602

Reinforcement effect of polyethylene fibre in root-filled teeth: comparison of two restoration techniques

Erdemir, Ali/0000-0002-6489-9620; yildirim, cihan/0000-0001-7218-9832; Erdemir, Ali/0000-0003-1140-3887WOS: 000235099100007PubMed: 16454794To compare in vitro two different fibre placement techniques on reinforcement of root-filled molar teeth with mesio-occluso-distal (MOD) cavities. Fifty sound extracted human mandibular molars were used (n = 10). Group 1 served as control. From group 2-5, endodontic access and standard MOD cavities were prepared. Following root canal treatment, group 2 was kept unrestored. In groups 3 and 4, the teeth were restored with composite resin (AP-X; Kuraray, Japan). A groove was prepared on occlusal surface of the finished restorations in group 4 from buccal to lingual direction. Polyethylene woven fibre (Ribbond; Seattle, WA, USA) was inserted in the groove in combination with flowable resin that was cured for 20 s and covered with composite resin. Cavity surfaces were covered with flowable resin in group 5, and polyethylene fibre was placed into the bed of resin in a buccal to lingual direction before the composite restoration was placed. All specimens were stored in 100% humidity at 37 degrees C for 24 h. Compressive loading of the teeth was performed by a universal testing machine at a crosshead speed of 0.5 mm min(-1) until failure. The data were recorded in Newton and submitted to ANOVA and Tukey post hoc test. The mean load necessary to fracture the samples in each group was: G1: 1671.57 +/- 131.54(a); G2: 375.21 +/- 34.30(b); G3: 749.47 +/- 124.54(c); G4: 1224.36 +/- 132.17(d); G5: 926.88 +/- 118.28(e). Different superscript letters demonstrate significant difference between groups. Polyethylene fibre use over or under MOD composite restorations significantly increased fracture strength. However, when the fibre was placed on the occlusal surface of the restoration in buccal to lingual direction, significantly higher fracture resistance was observed

The effect of fibre insertion on fracture resistance of root filled molar teeth with MOD preparations restored with composite

Erdemir, Ali/0000-0003-1140-3887WOS: 000226528900001PubMed: 15667628Aim To evaluate the effect of using flowable composite with or without leno woven ultra high modulus polyethylene fibre reinforcement on fracture resistance of root filled mandibular molars with mesio-occluso-distal (MOD) preparations. Methodology Sixty sound extracted human mandibular molars were randomly assigned to five groups (n = 12). Group 1 did not receive any preparation. From groups 2 to 5, the teeth were root filled and MOD preparations were created. Group 2 remained unrestored. Group 3 was restored with a dentine bonding system (DBS; SE Bond, Kuraray, Japan) and composite resin (CR) (AP-X; Kuraray). In group 4, flowable composite resin (Protect Liner F; Kuraray) was used before restoring teeth with CR. In group 5, leno woven ultra high modulus polyethylene ribbon fibre (Ribbond, Seattle, WA, USA) was inserted into the cavities in a buccal to lingual direction and the teeth were then restored with DBS and CR. After finishing and polishing, the specimens were stored in 100% humidity at 37 degreesC for 1 day. Compressive loading of the teeth was performed using a universal testing machine at a crosshead speed of 0.5 mm min(-1). The mean load necessary to fracture the samples were recorded in newtons (N) and were subjected to analysis of variance (anova) and Tukey post-hoc test. Results The mean load necessary to fracture the samples in each group were (in N): group 1: 1676.75 +/-154.63(a), group 2: 376.51 +/- 37.36(b), group 3: 733.23 +/- 133.33(c), group 4: 786.48 +/- 145.34(c), group 5: 943.63 +/- 121.15(d). There were statistically significant differences between the groups annotated with different letters. Conclusions (i) Use of flowable composite resin under composite restorations had no effect on fracture resistance of root filled molar teeth with MOD preparations, (ii) use of polyethylene ribbon fibre under composite restorations in root filled teeth with MOD preparations significantly increased fracture strength