Randomised clinical trial of a motivational interviewing intervention to improve oral health education amongst older adults in Philadelphia: 12-month evaluation of non-clinical outcomes.

OBJECTIVES: We conducted a trial to assess the treatment fidelity of an individual-based oral health education intervention utilising motivational interviewing (MI) techniques and its efficacy when compared to a group-based traditional oral health education intervention (TOHE) and a standard of care group (SC) in a sample from Philadelphia during a 12-month follow-up. BACKGROUND: There is lack of information on how different types of oral health educational interventions affect older adults on non-clinical outcomes including changes in oral health-related quality of life (OHRQoL), oral health self-efficacy (SE) and oral health knowledge (OHK). MATERIALS AND METHODS: One hundred and eighty patients were randomly allocated to TOHE, MI and SC groups. Treatment fidelity was measured in 16 non-study patients. The MI intervention was administered by a public health dental hygienist (PHDH). All interviews were audio-recorded and coded by an expert using the Motivational Interviewing Treatment Integrity (MITI) Code. Multivariable longitudinal regression analyses accounting for baseline demographics and correlated errors due to repeated measures via generalised estimating equation were conducted following an intention to treat approach. RESULTS: Over the 1-year follow-up, SE and OHRQoL scores significantly improved amongst the MI group whereas both outcomes worsened amongst the SC group. During the same period, SE and OHRQoL did not change in the TOHE group. CONCLUSION: Findings from the study support the fidelity of this intervention and the improvement of all non-clinical outcomes after 12 months amongst the MI group.

A Pilot Study Exploring Caregivers' Experiences Related to the Use of a Smart Toothbrush by Children with Autism Spectrum Disorder.

BACKGROUND: Research on caregivers for children with intellectual disabilities, particularly those with autism spectrum disorder (ASD), has highlighted several obstacles to achieving better oral health. These include challenges with tolerating oral care, sensory processing differences, uncooperative behaviors, and communication impairments. There is limited understanding of what caregivers would consider "successful assistance" in improving oral health for these children. OBJECTIVES: This pilot study aimed to examine caregivers' and user's experiences with a Kids Smart Electric Toothbrush used by children with ASD. METHODS: It involved open-ended interviews and questionnaires with caregivers prior to utilization of the toothbrush and after 4 weeks of product use by the child. RESULTS: Seventeen children with ASD, aged 5-12, participated. A total of 58.8% of caregivers said their child brushed more often, and all reported brushing at least twice a day by week 4. Caregivers reported that children became more independent while brushing their teeth and achieved better quality brushing. Caregivers' frustration with the brushing process, satisfaction with the device, and need to assist the child with brushing were improved. Caregivers did encounter some technical difficulties with the app. CONCLUSION: This study will assist in exploring "smart" toothbrush technologies for oral hygiene in children with ASD.

Motivational interviewing and oral health education: Experiences from a sample of elderly individuals in North and Northeast Philadelphia.

BACKGROUND: Health education has a focus on knowledge dissemination and advice giving, which seldom translates into behavioral changes. Motivational interviewing (MI) has potential for helping elderly patients. However, most oral health studies conducted to date have excluded older individuals, and the outcomes examined have been exclusively clinical. This study examines the treatment fidelity of an individual-based MI intervention and assesses baseline characteristics related to older adults' self-efficacy (SE), oral-health-related quality of life (OHRQoL), oral health knowledge, and facilitators, barriers, and confidence on achieving MI goals. METHODS: A convenience sample of 60 seniors was recruited. Participants were obtained through the flow of patients at dental clinics, and received a 45-min individual-based MI education session during a scheduled dental appointment. RESULTS: Regarding MI treatment fidelity, basic proficiency or higher was achieved in all global areas. Significant correlations were found between SE and OHRQoL scores and rating elements of the MI intervention (P = 0.0001). Lack of knowledge related to connections between poly pharmacy and caries risk, and the importance of use of fluorides were evident. CONCLUSION: Findings from the study support the reliability of this new MI intervention. Dental professionals are encouraged to adopt the spirit of MI in their one-on-one patient counseling.

Valoración de buenas prácticas docentes a través de observación sistemática / Assessing of Good Teaching Practicesthrough Systematic Observation

Las buenas prácticas docentes requieren del diseño de distintas formas de medición al ser un tema de especial relevancia para determinar la calidad de la educación superior. Una gran parte de las buenas prácticas corresponden a comportamientos desarrollados por el profesor en el aula de clase, lo que se puede medir y analizar mediante metodología observacional. Se seleccionaron diez profesores de la Universidad de La Laguna (España) y siete de la Universidad de Guadalajara (México), codificando sus comportamientos mediante una escala de calificación y los patrones comportamentales de interacción con el alumnado mediante el Protocolo de Observación de Funciones Docentes (PROFUNDO_UNI). El análisis secuencial de retardos extrajo patrones significativos relacionados con la retroalimentación a las preguntas del alumnado, el refuerzo dado y el fomento a la participación de los estudiantes.

The best teaching practices, an issue of particular relevance in determining the quality of higher education, requires different forms of measuring design. A big part of good practice in teacher performance corresponds to behaviors developed by the teacher in the classroom, which can be measured and analyzed using observational methodology. The study evaluates ten teachers from the University of La Laguna (Spain) and seven from Guadalajara (Mexico). Their behavior was coded using a rating scale and the behavioral interaction patterns with students were coded using the Observational Protocol of Teaching Functions (Protocolo de Observación de Funciones Docentes, PROFUNDO_UNI). The lag sequential analysis extracted significant patterns related to the feedback given to questions from the students, the reinforcement and the encouragement given to the students for their participation.

Comportamiento del embarazo en mujeres mayores de 40 años / Behaviour of pregnancy in over 40 years-old females

OBJETIVO: evaluar el comportamiento de algunas variables biomédicas y sociodemográficas y las complicaciones más frecuentes en mujeres que parieron con 40 y más. MÉTODOS: se realizó estudio observacional analítico tipo caso control de algunos aspectos del embarazo en mujeres mayores de 40 años, se escogieron las 93 mujeres que parieron un nacido vivo en el período del 1ro. de enero al 31 de diciembre del año 2007, como caso control se tomó cada mujer que parió a continuación de cada una de ellas. Se revisaron las historias clínicas de todos los casos en estudio, y se tomaron datos según variables biomédicas y sociodemográficas. RESULTADOS: se encontró que la incidencia de partos en estas edades fue incrementándose en los últimos 5 años, representan en la actualidad el 3 por ciento, nulíparas el 19 por ciento, más del 60 por ciento tenían el antecedente de haber cambiado de pareja, predominaron las sobrepesos al inicio del embarazo, con un 43 por ciento, un 39,7 por ciento de los casos eran fumadoras y más de la mitad, el 59,1 por ciento tuvieron un parto distócico. La enfermedad hipertensiva representó el mayor porciento de las patologías asociadas. Hubo un 9,6 por ciento de complicaciones y la más frecuente fue la histerectomía obstétrica. CONCLUSIONES: Se encuentra una tendencia al incremento en el número de mujeres que paren con 40 años y más. Es de vital importancia el trabajo en las consultas de riesgo pre-concepcional. Se puede concluir que una mujer con buen estado y con una atención prenatal adecuada, tiene grandes probabilidades de tener un parto feliz.

OBJECTIVES: to evaluate the behaviour of some biomedical and sociodemographic variables and the most frequent complications in over 40 years-old females who gave birth. METHODS: an analytical observational case-control study of some aspects of over 40 years-old female pregnancies was conducted in 93 selected females who had livebirths from January 1st to December 31st, 2007. Every woman who had a baby after each of these over 40 years-old mothers were taken as control. Medical histories of all the cases under study were revised and data were taken according to biomedical and sociodemographic variables. RESULTS: it was found that incidence of childbirths in these age groups increased in the last five years, accounting for 3 percent at present and 19 percent of nulliparas; over 60 percent had a history of changing their couple; overweight was predominant in 43 percent at the onset of pregnancy; 39,7 percent were smokers and 59,1 percent had dystocic childbirth. Hypertension prevailed in associated pathologies. There was 9,6 percent complications, being obstetric hysterectomy the most common one. CONCLUSIONS: the increase in the number of women who give birth at age 40 and older was the observed tendency. The work of the pre-conception risk medical consultation service is of vital importance. It may be concluded that every woman in good health condition with adequate prenatal care can mostly succeed in having good childbirth.