The effectiveness of computer based interactive oral health education

The Western Isles of Scotland have historically high levels of dental disease in the five year old age group amongst the worst in the UK. The “Action Plan for Scotland” has implemented a multidisciplinary approach to deal with this problem. This includes a major role for schools in supporting and improving oral health, by reducing the availability of cariogenic produce in schools and actively promoting healthier diets. In light of this the researcher created an interactive computer programme, designed to educate children about healthy eating and improve their ability to identify cariogenic foods. The interactive computer programme was designed to integrate into the school curriculum providing a combined teaching tool and learning resource; for elements of both the health curriculum and IT attainment targets. To assess the efficacy of the interactive computer programme a blind randomised controlled trial was designed to measure: • Its ability to teach children the difference between healthy and unhealthy food. • If it could positively influence the children’s selection of playtime snack. The computer programme was initially assessed by a peer group consisting of Primary School Teachers, Dental staff (Glasgow University Dental School) and Dieticians (Western Isles Health Board). This was to ensure the content contained the correct nutritional and oral health message and that the interactive computer programme was educationally appropriate, for the age group within the study. The computer programme was then assessed by a user group, consisting of pupils from Sandwick Hill Primary School, aged from four and a half to seven. Changes were then made in relation to the format and content of the programme to improve and refine it. An initial pilot study was undertaken within Sandwick Hill Primary School to assess the methodology of the controlled trial and the randomisation and blinding of the participants. This also allowed refinement of the assessment tool to be used within the study. The assessment tool was designed to determine the children’s ability to identify healthy and unhealthy foods and to record their playtime snack. Two schools were involved in the controlled trial, Stornoway Primary School and Laxdale Primary School. Positive consent was received for Eighty-six pupils in total. There were forty five boys (52.3%) and forty one girls (47.7%). The mean age was 5.7, (range 4 to 7 years). The teaching staff involved within the study were given a tutorial to explain the use of the programme and the protocols relating to randomisation and blinding. The participants were then randomly allocated to one of two groups, the intervention or control group. Both groups were then assessed to provide a comparative baseline. The intervention group were provided with the interactive computer programme. They were to use the programme for fifteen minutes a time over three weeks. The teachers were encouraged to allow the children to access the programme at least five to six times during this period. The control group were provided with traditional paper based educational material which was completed during class time. After three weeks the children were reassessed and the educational materials removed. The children were then assessed again after three months to assess longevity and retention of the acquired knowledge. The researcher remained blind to group allocation until the key was broken after analysis of the results. Regarding identification of healthy food, regression analysis showed significant improvement in both groups, but t-tests revealed no significant difference between them. The groups matched well at baseline [Two- Sample T-test for means, p=0.979 95% CI -4.88, 4.76]; the intervention group showed greater improvement at 3 weeks but this was not significant [Two- Sample T-test for means, p= 0.135 95% CI -7.56, 1.04]. There was no difference seen at 3 months [Two- Sample T-test for means. P= 0.547, 95% CI -5.12, 2.74]. There was neither an improvement nor a difference between the two groups in snack selection. This study provides evidence as to the effectiveness of interactive technology in relation to oral health education. It shows that interactive computer technology can provide an alternative to paper based educational materials. This study does not however show it to be significantly more effective. The study also shows that the use of the interactive computer programme was ineffective in modifying behaviour, in relation to diet, in this age group

Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies

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

Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

Abstract: Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies

Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

Abstract: Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies

Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes

publisher: Elsevier articletitle: Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes journaltitle: Cell articlelink: https://doi.org/10.1016/j.cell.2018.05.046 content_type: article copyright: © 2018 Elsevier Inc

An oral health education video game for high caries risk children:Study protocol for a randomized controlled trial

BACKGROUND: Tooth decay is the most common chronic disease of childhood in the world. Many children develop caries early in their lives, and go on to develop further caries and sepsis as they grow up, indicating failure in prevention. As a result, many end up requiring general anaesthesia to undergo treatment for a disease that is completely preventable. Previous studies have suggested that the families of these children need better oral health education as well as better support in implementing healthy practices at home, as they feel impeded by broader life challenges. Parents of these children have suggested utilizing modern technologies, such as the internet, DVDs and video games as methods of delivery of education that might fit in with their busy lifestyles. The aim of this investigation is to assess the acceptability and efficiency of an oral health education video game directed at these children and their families. METHODS/DESIGN: A two-armed phase-II randomized controlled trial will assess a children’s oral health education video game in comparison with verbal oral health education in terms of: family satisfaction, effect on oral health knowledge, and effect on dietary and oral hygiene habits. Up to 110 four- to ten-year-old children, referred for tooth extraction under general anaesthesia due to caries, will be recruited. A sample of 45 participants in each group will be needed to provide 80 % statistical power. The primary outcome measures for this study are: (1) parent and child satisfaction with the intervention, as indicated using a visual analogue scale; (2) improvement in the child’s dietary knowledge measured by a pictorial dietary quiz; and (3) changes in the child’s diet and oral hygiene habits, measured using a children’s dietary questionnaire completed by the parent, and snacking and toothbrushing diaries completed by the child. Measures will be taken at baseline, directly after the intervention, and three months later. DISCUSSION: This study is a phase-II randomized controlled trial of an oral health education video game for high caries risk children and their families. Few protocols such as this are available in this much-needed research area. TRIAL REGISTRATION: ISRCTN94617251

Temperature dependence of a1 and b2 type modes in the surface enhanced Raman from 4-Aminobenzenethiol

We study here the effect of temperature upon the continuum emission and Stokes Raman peak ratios from a monolayer of 4-Aminobenzenethiol molecules prepared on a plamon active nanocavity array from an active spherical cap architecture nanomaterial substrate. Our results show that there is partial recover of SERS spectral profile following heating. Our results show that chemical enhanced b2-type modes are affected differently relative to electromagnetic enhanced a1-type modes and to the continuum emission background.Author has checked copyrightAMS. No Keywords