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Abstract: Dental anxiety often persists through lack of good communication skills. Dental health providers (DHP) can use the treatment alliance to prevent dental anxiety from developing. DHPs should assist dentally [...]

Objective: To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health-related quality of life (COHRQoL). Setting: Primary schools, high social deprivation, Ireland/Northern Ireland. Design: Cluster randomised controlled trial. Method: A total of 383, 7- to 8-year-old children were invited to participate and randomly allocated into intervention and control conditions. Baseline and 12-month follow-up assessments of COHRQoL, self-esteem, toothbrushing-fluoride toothpaste knowledge and unstimulated saliva samples were made. An 18-hour post-brushing, saliva fluoride concentration was used to assess toothbrushing with fluoride toothpaste (behaviour). The data were entered onto SPSSv22. Structural equation modelling was applied using AMOSv22 to test for the role of health-learning capacity (baseline self-esteem and COHRQoL) and simultaneous effects of Winning Smiles upon knowledge, behaviour and COHRQoL (at follow-up). Results: A total of 238 children participated at baseline and follow-up. A partial latent hybrid model fitted the data reasonably well (X[superscript 2] = 65.6, df = 50, p = 0.07) as shown in addition by a Comparative Fit Index of 0.97 and a Root Mean Square Error of Approximation (RMSEA) value of 0.042 (90% confidence interval [CI]: 0.00, 0.06). The intervention had a significant effect on toothbrushing-fluoride toothpaste knowledge (p < 0.03) and an effect on COHRQoL at the 6% level (p < 0.06). Knowledge was strongly associated with saliva fluoride concentration (p < 0.002). The model of health-learning capacity assisted in explaining the effect of a school-based intervention upon knowledge, toothbrushing behaviour and tentatively on COHRQoL.

PurposeVitamin E analogues are potent novel anticancer drugs. The purpose of this study was to elucidate the cellular target by which these agents, represented by alpha-tocopoheryl succinate (alpha-TOS), suppress tumors in vivo, with the focus on the mitochondrial complex II (CII).Experimental designChinese hamster lung fibroblasts with functional, dysfunctional, and reconstituted CII were transformed using H-Ras. The cells were then used to form xenografts in immunocompromized mice, and response of the cells and the tumors to alpha-TOS was studied.ResultsThe CII-functional and CII-reconstituted cells, unlike their CII-dysfunctional counterparts, responded to alpha-TOS by reactive oxygen species generation and apoptosis execution. Tumors derived from these cell lines reciprocated their responses to alpha-TOS. Thus, growth of CII-functional and CII-reconstituted tumors was strongly suppressed by the agent, and this was accompanied by high level of apoptosis induction in the tumor cells. On the other hand, alpha-TOS did not inhibit the CII-dysfunctional tumors.ConclusionsWe document in this report a novel paradigm, according to which the mitochondrial CII, which rarely mutates in human neoplasias, is a plausible target for anticancer drugs from the group of vitamin E analogues, providing support for their testing in clinical trials.

PurposeVitamin E analogues are potent novel anticancer drugs. The purpose of this study was to elucidate the cellular target by which these agents, represented by alpha-tocopoheryl succinate (alpha-TOS), suppress tumors in vivo, with the focus on the mitochondrial complex II (CII).Experimental designChinese hamster lung fibroblasts with functional, dysfunctional, and reconstituted CII were transformed using H-Ras. The cells were then used to form xenografts in immunocompromized mice, and response of the cells and the tumors to alpha-TOS was studied.ResultsThe CII-functional and CII-reconstituted cells, unlike their CII-dysfunctional counterparts, responded to alpha-TOS by reactive oxygen species generation and apoptosis execution. Tumors derived from these cell lines reciprocated their responses to alpha-TOS. Thus, growth of CII-functional and CII-reconstituted tumors was strongly suppressed by the agent, and this was accompanied by high level of apoptosis induction in the tumor cells. On the other hand, alpha-TOS did not inhibit the CII-dysfunctional tumors.ConclusionsWe document in this report a novel paradigm, according to which the mitochondrial CII, which rarely mutates in human neoplasias, is a plausible target for anticancer drugs from the group of vitamin E analogues, providing support for their testing in clinical trials.

Objective: To use the Theory of Diffusion of Innovations as a framework to explore the qualitative data gleaned from a process evaluation of the Smile4life intervention across Scottish National Health Service (NHS) Boards and to inform future oral health promotion and homelessness. Design: A qualitative exploration. Setting: In 2012, the Smile4life programme to promote the oral health of homeless people was launched in Scotland. Practitioners received training to ensure its successful implementation and adoption. A process evaluation began in February 2013. Method: A total of 20 oral health officers from the 11 participating NHS Boards took part in the process evaluation. They were interviewed each month for a 17-month period. Boards were placed into adoption categories based on the time taken to adoption. The data were analysed using a framework approach. Results: The Theory of Diffusion of Innovations was used to define "time to adoption" and to classify participating NHS Boards' adoption categories. It was also used to identify diffusion variables that underpinned Smile4life adoption. For Boards that more readily adopted Smile4life, the diffusion variables of familiarity and good social exchanges appeared to promote implementation. Numerous conflicts emerged, however, in late adoption Boards. These included a lack of resources and practitioner ambivalence, which slowed up implementation. Conclusion: The Theory of Diffusion of Innovations provided a useful theoretical framework for understanding the processes in the implementation and adoption of the Smile4life programme. It allowed specific training requirements for the practitioners to emerge to facilitate diffusion of the programme in their Boards.

La gamma delle iniziative introdotta dal governo scozzese e dalle agenzie partner, nazionali e locali, ha lo scopo di ridurre il ricorso alla detenzione di breve durata, di promuovere una risposta più efficace nei confronti delle cause del crimine e di ridurre la recidiva. Queste iniziative indicano che il governo ed i suoi partner riconoscono che, anche se di cruciale importanza, le misure in comunità da sole saranno inefficaci. Sono state previste anche altre risposte che focalizzano chiaramente l’attenzione sulla prevenzione, sulla riduzione delle disuguaglianze e sulle problematiche connesse all'infanzia e associate alla recidiva in età adulta. Viene prestata particolare attenzione all'importanza della tipologie di condanne disponibili e alle agenzie che lavorano in modo collaborativo e responsabile nella comunità, al fine di concentrarsi su obiettivi condivisi. Resta da verificare se, dopo anni di continuo aumento della popolazione carceraria, queste diverse misure possono dimostrare di avere un impatto sia sul ricorso alla custodia in carcere sia sui tassi di recidiva. Tuttavia, in conformità con la ricerca, in merito a ciò che funziona per ridurre il crimine e a quello che potrebbe ridurre il ricorso alla carcerazione, sembra che l'approccio si mostri complessivamente promettente. Les différentes initiatives mises en ɶuvre par le gouvernement écossais et par les agences partenaires nationales et locales ont pour but de réduire le recours à l'emprisonnement de courte durée, de promouvoir une réponse plus efficace aux causes de la criminalité et de réduire la récidive. Elles indiquent que le gouvernement et les partenaires reconnaissent que, bien qu’elles soient extrêmement importantes, les solutions communautaires alternatives à l’incarcération seules s’avéreront inefficaces. D’autres réponses, clairement axées sur la prévention, sur la réduction des inégalités et sur des questions liées à l’enfance et associées à la récidive à l’âge adulte, sont mises en place. Il reste à voir si, après des années d’augmentation constante de la population carcérale, ces différentes mesures pourront produire un effet clairement positif aussi bien sur la mise en détention que sur les taux de récidive. Toutefois, conformément à la recherche sur les moyens efficaces de prévenir le crime et sur les mesures pour réduire le recours à la prison, il semblerait que cette approche s’annonce généralement prometteuse. The range of initiatives being introduced by the Scottish Government and national and local partner agencies are intended to reduce the use of short-term imprisonment, promote a more effective response to the causes of crime and reduce re-offending. They indicate that the Government and partners recognize that, although crucially important, alternative community based options alone will be ineffective. Other responses, involving a clear focus on prevention and reducing the inequalities and related issues in childhood associated with re-offending into adulthood, are also being introduced. There is a clear emphasis on the importance of available sentencing powers and of agencies working collaboratively and accountably in the community to focus on shared aims. Whether, after years of steadily increasing prison populations, these various measures can demonstrably impact on both the use of custody and re-offending rates remains to be seen. However, in accordance with the research on what works to reduce crime and what might reduce the use of custody, it would appear that the approach collectively shows promise.

Objective: To use a qualitative exploration to evaluate whether "Something to Smile About" (STSA), an oral health intervention, had increased the oral health capacity of staff working with homeless people. Setting: A National Health Service board area in Scotland. Method: A purposive sample of 14 staff members from STSA-participating organizations took part in the evaluation. Three focus groups were held and the participants were encouraged to speak freely about their views on the intervention. The qualitative data was analyzed using content analysis. Results: The majority of participants stated they were able to use their newly-acquired oral health knowledge and pass it to their homeless clients. STSA appeared to be less successful with regard to assisting clients to change their oral health behaviours. Staff felt that oral health considerations were a low priority compared to the need for shelter, food, clothing and money. In addition, they stated that the level of success with clients was influenced by the homeless person’s specific and complex needs. Conclusion: STSA was successful in building staff oral health capacity; however, for STSA to be successful with clients, and for clients to achieve adherence with oral health messages, the complex needs and current life circumstances of homeless client groups must be incorporated into STSA. (Contains 1 table and 1 figure.)

Objective: To examine if social support in the guise of a culturally sensitive, community-based oral health intervention could promote mother-infant bonding in socially-isolated immigrant mothers. Design: A quasi-experimental design. Participants: A convenience sample of 36 Chinese immigrant mothers with 8-week-old infants was divided into intervention and control groups. Intervention: The ChIME (Chinese Immigrant Mothers oral health Education) programme, a culturally-sensitive oral health education intervention included social support elements. Intervention mothers had five home-visits augmented by telephone calls and open access to the first author (SY). All mothers completed the Postpartum Bonding Questionnaire (PBQ) at baseline, when the infant was aged six months and 12 months. The PBQ screened for impaired mother-infant bonding. Results: At baseline, the Chinese mothers had significantly greater mean scores for bonding disorder; rejection and pathological anger and for incipient abuse compared with normative values but equivalent mean scores when compared with normative values for depressed mothers. At 12-month follow-up the intervention compared with control group mothers had significantly greater decreases in mean scores for bonding disorder, rejection and pathological anger and infant-centred anxiety. Conclusion: Social support provided within the guise of a culturally-sensitive oral health education programme assisted socially-isolated immigrant mothers to improve the quality of their relationship with their infants. (Contains 3 tables and 2 figures.)

Objective: To investigate the views and experiences of parents whose children have rampant tooth decay. Methods: In-depth, semi-structured interviews were carried out with 19 parents of varied age and social background whose children had been referred to Dundee Dental Hospital for assessment for dental extractions. Participants were encouraged to discuss their own and their child's dental experiences and their views on how the child developed rampant caries. The interview data was systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. Results: The parents found it difficult to avoid sweets and giving their children sweet treats. They had limited knowledge of oral health maintenance which was poorly applied. These factors, combined with the difficulties of family life--in particular illness and life events--created circumstances in which their children experienced tooth decay. Conclusions: Parents find it difficult to restrict their children's sugar intake in an environment where sugary snacks are so readily available. More societal support in restricting children's sugar intake is of central importance. Parents would benefit from more sympathetic and explicit diet and toothbrushing messages tailored to their individual circumstances from those involved in the care of children's oral health. (Contains 1 table.)