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Genetic resources, justice, and reconciliation : Canada and global access and benefit sharing
\"When the oral history of a medicinal plant as a genetic resource is used to develop a blockbuster drug, how is the contribution of indigenous peoples recognized in research and commercialization? What other ethical, legal, and policy issues come into play? Is it accurate for countries to self-identify as users or providers of genetic resources? This edited collection, which focuses on Canada, is the result of research conducted in partnership with indigenous peoples in that country, where melting permafrost and new sea lanes have opened the region's biodiversity, underscoring Canada's status as a user and provider of genetic resources and associated indigenous knowledge\"-- Provided by publisher.
Book
Barriers and facilitators in the integration of oral health into primary care: a scoping review
ObjectiveThis scoping study has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care.MethodsGrounded in the Rainbow conceptual model and using the Levac et al six-stage framework, we performed a systematic search of electronic databases, organisational websites and grey literature from 1978 to April 2016. All publications with a focus on the integration of oral health into primary care were included except commentaries and editorials. Thematic analyses were performed to synthesise the results.ResultsFrom a total of 1619 citations, 58 publications were included in the review. Barrier-related themes included: lack of political leadership and healthcare policies; implementation challenges; discipline-oriented education; lack of continuity of care and services and patients’ oral healthcare needs. The facilitators of integration were supportive policies and resources allocation, interdisciplinary education, collaborative practices between dental and other healthcare professionals, presence of local strategic leaders and geographical proximity.Discussion and public health implicationsThis work has advanced the knowledge on the barriers and facilitators at each integration domain and level, which may be helpful if the healthcare organisations decide to integrate oral health and dental services into primary care. The scoping review findings could be useful for both dental and medical workforce and allied primary healthcare providers. They could also guide the development of healthcare policies that support collaborative practices and patient-centred care in the field of primary care.
Journal Article
Effectiveness of case-based learning in Chinese dental education: a systematic review and meta-analysis
ObjectiveThe application of case-based learning (CBL) pedagogy has been emerging as an improved and more practical learning method across the Chinese dental education system. This article provides a critical overview of CBL pedagogy and further assesses the effectiveness of this teaching model in Chinese dental education.DesignA systematic review and meta-analysis.MethodsStudies published up to December 2019 were searched in the following electronic databases: China National Knowledge Infrastructure, China Science Periodical Database, Chinese Biomedical documental database, Wanfang data, PubMed, EMBASE and Cochrane Central Register of Control Trials. All randomised controlled trials (RCTs) that compared the effectiveness of the CBL teaching model and the traditional lecture-based learning (LBL) model in all dental disciplines were included. The assessment of methodological quality was based on the guidelines described in the Cochrane Handbook for Systematic Reviews, and the meta-analysis was performed using the software RevMan V.5.3ResultsA total of 30 RCTs were finally included, with a total sample size of 2356 dental students. The CBL pedagogy significantly increased knowledge scores (standardised mean difference (SMD)=1.58, 95% CI: 0.95 to 2.20, p<0.0001), skill scores (SMD=1.22, 95% CI: 0.34 to 2.11, p<0.0001), comprehensive ability scores (SMD=1.91, 95% CI: 1.74 to 4.07, p<0.0001) and teaching satisfaction (risk ratio=1.38; 95% CI: 1.15 to 1.65; p=0.01) compared with the LBL teaching model among the dental students. Additionally, a subgroup analysis showed significant differences in the effects of CBL on knowledge scores, skill scores and comprehensive ability scores when comparing theoretical and practical courses.ConclusionsThe meta-analysis and systematic review of the eligible literature showed that the CBL pedagogy in Chinese dental education is an effective way to increase knowledge scores, skill scores, comprehensive ability scores and teaching satisfaction. Successful adaptation of this teaching model could solve the scarcity of highly skilled and professional dentists in dental schools and hospitals across China.
Journal Article
Covid-19 Pandemic: What Changes for Dentists and Oral Medicine Experts? A Narrative Review and Novel Approaches to Infection Containment
The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (pre- vs post-COVID19) for the most common dental procedures. The outcome is forecast to help dentists to individuate for a given procedure the differences in terms of safety protocols to avoid infectious contagion (by SARS-CoV-2 and others dangerous agents). An investigation was performed on the online databases Pubmed and Scopus using a combination of free words and Medical Subject Headings (MESH) terms: “dentist” OR “oral health” AND “COVID-19” OR “SARS-CoV-2” OR “coronavirus-19”. After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The authors have highlighted the importance of knowing exactly the risk of infections in the dental practice, and to modulate correctly the use of PPE, in order to invest adequate financial resources and to avoid exposing both the dental team and patients to preventable risks.
Journal Article
Therapy outcome measures in temporomandibular disorder: a scoping review
ObjectivesTherapy outcome measures (TOMs) in temporomandibular disorders (TMDs) have not been systematically evaluated. We systematically explored the main TOM assessment methods for TMD TOMs used in previous studies.DesignScoping review.Data sourcesAccording to Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Review reporting guidelines, we systematically searched five key databases (MEDLINE/PubMed, Web of Science, Embase, Epistemonikos and ClinicalTrials) and thoroughly scanned relevant grey literature using Medical Subject Headings, Emtree and index terms.Eligibility criteriaWe considered primary research papers published from January 2010 to December 2020 that included patients with TMD aged ≥18 years, diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders.Data extraction and synthesisFour reviewers extracted general information and information on study design and setting, target, interventions, and outcome type.ResultsOne hundred and seventy-two of the 3726 screened articles (3704 by search engines and 22 manually) were included. The TOMs analysed included pain (n=161 articles), maximal mouth opening (MMO) (91), jaw function (32), jaw movement (26), joint sound (16), quality of life (QOL) (15), depression/anxiety (14), oral QOL (10) or others (30). Evaluation periods were <4 weeks (111), <8 weeks (62), <12 weeks (59), >12 weeks (75) or ‘not mentioned’ (12). Pain outcomes (229) included general pain (115), tenderness (45), pain during functioning (44), resting pain (16) and others (8). Pain outcome evaluation methods included Visual Analogue Scale (VAS; 121), Numerical Rating Scale (21) and other methods (21). Pain outcome indicators were binary (10) or continuous (158); only five studies reported the least significant difference in treatment efficacy. MMO evaluation using painless methods (19) and jaw function evaluation using methods assessing mandibular movement range (23) were the most frequent.ConclusionsTMD TOMs are diverse; the major outcomes were pain, MMO, jaw function and jaw movement. Most pain outcomes are evaluated by VAS Score changes.
Journal Article
Association of oral health knowledge, self-efficacy and behaviours with oral health-related quality of life in Chinese primary school children: a cross-sectional study
ObjectiveAchieving good oral health-related quality of life (OHRQOL) is of particular concern in children. The inter-relations among oral health knowledge, self-efficacy, behaviours and OHRQOL in children groups remain unclear. This study aimed to explore the inter-relations between these oral health behaviour-related factors and OHRQOL in primary school children.MethodsIn this cross-sectional study, 651 children in grades 2 and 3 were recruited in October 2020 from two primary schools in Minhang District, Shanghai, China. Data were collected through self-reported questionnaires, consisting of demographic characteristics, oral health knowledge, self-efficacy, oral health behaviours and OHRQOL. Pearson’s correlation analyses were used to analyse the relationship between study variables. Structural equation models were used to test the inter-relations between OHRQOL and oral health behaviour-related factors.ResultsFour hypothetical structural equation models were tested and one of them was selected as the most appropriate model, which explained 15.0% of the variance in OHRQOL. This selected model showed that oral health behaviours were directly related to OHRQOL. Oral health knowledge was indirectly associated with OHRQOL through both self-efficacy and oral health behaviours. Self-efficacy was directly associated with OHRQOL or was indirectly associated with OHRQOL through oral health behaviours.ConclusionThis study revealed a pathway of association between children’s oral health knowledge and their OHRQOL, in which children’s oral health self-efficacy and behaviours had indirect effects. This provides a basis for understanding the mechanism of oral health promotion interventions to improve children’s OHRQOL and helps to identify direct or indirect intervention targets.
Journal Article
Theory-derived intervention to improve oral health of older adults: study protocol for a randomised controlled trial
IntroductionChanging health behaviours is an important and difficult task. Despite growing interest in behavioural theories and models, there is a paucity of research examining their validity in explaining oral health behaviours, and there is a need for interventional studies to assess their effectiveness in improving oral health. This study aims to test the explanatory power of the dominant psychological theories, develop theory-derived intervention and evaluate its effectiveness in improving oral health of older adults.Methods and analysis440 community dwelling older adults will be recruited. To be eligible for this trial, one needs to be 55–79 years old, having at least 8 natural teeth, and with no life-threatening disease, impaired cognitive function, or radiotherapy in the head and neck region. At the initial visit, each participant will be required to complete a detailed questionnaire which collects information on sociodemographic background, oral health behaviours and domains of three psychological theories and models: (1) health belief model, (2) theory of planned behaviour and (3) social cognitive theory. The theory or model that best explains the health behaviours will be selected for designing the oral health intervention. The effectiveness of the theory-derived intervention will be evaluated in a randomised controlled trial. Participants will be randomly assigned to two groups, receiving theory-derived intervention and conventional health education, respectively. At baseline and at 12 and 24 months post intervention, each participant will complete a short questionnaire and undergo an oral examination (dental check-up). The effectiveness of the interventions will be evaluated using behavioural outcomes (diet, toothbrushing, interdental cleaning) and clinical outcomes (oral hygiene, dental caries and periodontal conditions).Ethics and disseminationThis study has been approved by the Institutional Review Board of National University of Singapore (Ref: NUS-IRB-2020-417). Findings will be presented in international conferences and peer-reviewed journals.Trial registration numberNCT04946292.
Journal Article
Health policy analysis on barriers and facilitators for better oral health in German care homes: a qualitative study
ObjectivesTo assess possible health policy interventions derived from the theoretical domains framework (TDF) by studying barriers and facilitators on the delivery of oral healthcare and oral hygiene in German care homes using a behavioural change framework.DesignQualitative correlational study to evaluate a national intervention programme.SettingPrimary healthcare in two care homes in rural Germany.ParticipantsEleven stakeholders participating in the delivery of oral healthcare (hygiene, treatment) to older people, including two care home managers, four section managers, two nurses/carers and three dentists.InterventionsSemistructured interviews conducted in person in the care homes or by phone. A questionnaire developed along the domains of the TDF and the Capabilities, Opportunities and Motivations influencing Behaviours model was used to guide the interviews. Interviews were transcribed and systematised using Mayring’s content analysis along the TDF.Results860 statements were collected. We identified 19 barriers, facilitators and conflicting themes related to capabilities, 34 to opportunities and 24 to motivation. The lack of access to professional dental care was confirmed by all stakeholders as a major limitation hampering better oral health.Primary outcomeA range of interventions can be discussed with the methodology we utilised. In our interviews, lack of dentists willing to treat patients at these facilities was the most discussed barrier for improving oral health of nursing home residents.Secondary outcomesDentists highlighted the need for better incentives and facilities to deliver oral healthcare in these institutions. Differences with urban settings regarding access to healthcare were frequently discussed by our study participants.ConclusionsWithin our sample, greater capacitation of care home staff, better financial incentives for dentists and increased cooperation between the two stakeholders should be considered when designing interventions to tackle oral health of care home residents in Germany.
Journal Article
Knowledge, attitude and practice towards oral health in parents and teachers of kindergarten students: a cross-sectional survey
ObjectivesThis study aimed to explore the relationship between oral health and the knowledge, attitudes and practices (KAP) of parents and teachers of kindergarten students towards oral health.DesignThis web-based cross-sectional survey was conducted in Ningbo City from February 2023 to March 2023.SettingThe study targets parents and teachers of kindergarten students in Ningbo City (five kindergartens selected using convenience sampling). The research aimed to explore the relationships between oral health practices, knowledge and attitudes among parents and teachers.ParticipantsA total of 540 valid questionnaires were collected from parents and teachers. Clear definitions of selection, entry and exclusion criteria were followed to ensure comprehensive data collection.Outcome measuresAssessment of oral health KAP among parents and teachers and correlation between KAP levels and students’ oral hygiene habits.ResultsKey findings include comparatively high levels of oral health knowledge among parents (7.29±1.74), positive attitudes towards oral health (23.69±2.97), and commendable practices (51.92±4.76). The structural equation model suggested a direct positive influence of attitude (β=0.27, p<0.001) and knowledge (β=0.51, p<0.001) on practice. Daily habits were also influenced indirectly by both attitude (β=0.10, p<0.001) and knowledge (β=0.20, p<0.001).ConclusionsThe study underscores the significant effect of parents’ and teachers’ KAP on kindergarten students’ oral health. The unknown representativeness of the sample necessitates caution in generalisation; nonetheless, the findings highlight the importance of enhancing oral health education and implementing targeted interventions to improve hygiene practices, with the potential to decrease dental caries prevalence among children. Collaborative efforts are essential in promoting effective oral health practices among young populations.
Journal Article
Performance evaluation and clinical application exploration of a ViT-CNN ensemble model for multiclass oral mucosal disease classification: a pilot retrospective analysis based on public datasets
ObjectiveTo assess the performance of a Vision Transformer (ViT)-based deep learning model in classifying oral mucosal diseases (OMD) and to explore the value of the integrated model for clinical support.DesignA pilot study that combines publicly available datasets with integrated modelling.MethodsDeveloped an EfficientNet-B0 convolutional neural network and a ViT-B16 model, and tested three integration strategies: average method, weighted method and geometric average method. Evaluation metrics included accuracy, F1 score and inference speed. Diagnostic subject performance was compared between general dentists and oral specialists to validate model efficacy.ResultsThe integrated model outperformed individual models, with the geometric average integration method achieving an accuracy of 94.32%. When used by general dentists, the diagnostic time was reduced from 241 s to 112.4 s, with an accuracy rate of 93%.ConclusionsThe ViT-enhanced integrated system can improve the classification efficiency of OMD and provide support for non-specialist doctors. However, validation with larger datasets is needed in future research.
Journal Article