Can motivational interviewing for dental settings be taught online? Results of an uncontrolled interventional trial.

BACKGROUND: Motivational interviewing (MI) is an evidence-based method of promoting oral healthcare behaviour. Conventional training of MI is a time-consuming and costly aspect in the dental curriculum. Therefore, the aim of this study was to evaluate the effectiveness and acceptance of a MI-blended learning programme for dental students. MATERIALS AND METHODS: Dental students had to perform an interdisciplinary created "ecourse Motivational Interviewing in medical settings" (eMI-med). After completion, patient-student interviews were recorded and evaluated using the Motivational Interviewing Treatment Integrity Code (MITI-d). Furthermore, the students' self-efficacy regarding smoking cessation and oral hygiene motivation was examined and the acceptance of the tool was enquired. RESULTS: Forty interviews with 25 different students were analysed with the MITI-d. Students showed high levels of MI-adherent behaviour (15.45 ± 6.98), open-ended questions (9.95 ± 6.90) and reflections (10.43 ± 8.85), which were comparable to previous classroom trainings. In addition, 90% of the students preferred e-learning over classroom teaching. Furthermore, the students' therapeutical self-efficacies were significantly increased by the programme. CONCLUSION: Within the limitations of this study, the created e-learning programme was able to equip dental students with basic knowledge and MI skills. Furthermore, learning MI through e-learning may heighten the self-efficacy of dental students regarding smoking cessation and oral hygiene promotion. Students showed a high acceptance of e-learning, preferring it over traditional learning.

Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review.

AIM: The aim of this systematic review was to identify the most recent widely accepted guidelines for risk factor control interventions and to assess their impact in patients with periodontitis. MATERIALS AND METHODS: The electronic search strategy included a first systematic search to identify guidelines for interventions for smoking cessation, diabetes control, physical exercise (activity), change of diet, carbohydrate (dietary sugar) reduction and weight loss in the general population and a second systematic search to identify the studies evaluating these interventions in periodontitis patients. RESULTS: A total of 13 guidelines and 25 studies were selected. Most guidelines included recommendations for all healthcare providers to provide interventions and follow-up counselling with the risk factors considered in the present review. In patients with periodontitis, interventions for smoking cessation and diabetes control were shown to improve periodontal health while the impact of dietary interventions and the promotion of other healthy lifestyles were moderate or limited. CONCLUSIONS: While aiming to improve treatment outcomes and the maintenance of periodontal health, current evidence suggests that interventions for smoking cessation and diabetes control are effective, thus emphasizing the need of behavioural support in periodontal care.

Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: A systematic review.

AIM: This systematic review investigates the impact of specific interventions aiming at promoting behavioural changes to improve oral hygiene (OH) in patients with periodontal diseases. METHODS: A literature search was performed on different databases up to March 2019. Randomized and non-randomized controlled trials evaluating the effects of behavioural interventions on plaque and bleeding scores in patients with gingivitis or periodontitis were considered. Pooled data analysis was conducted by estimating standardized mean difference between groups. RESULTS: Of 288 articles screened, 14 were included as follows: 4 studies evaluated the effect of motivational interviewing (MI) associated with OH instructions, 7 the impact of oral health educational programmes based on cognitive behavioural therapies, and 3 the use of self-inspections/videotapes. Studies were heterogeneous and reported contrasting results. Meta-analyses for psychological interventions showed no significant group difference for both plaque and bleeding scores. No effect was observed in studies applying self-inspection/videotapes. CONCLUSIONS: Within the limitations of the current evidence, OH may be reinforced in patients with periodontal diseases by psychological interventions based on cognitive constructs and MI principles provided by oral health professionals. However, no conclusion can be drawn on their specific clinical efficacy as measured by reduction of plaque and bleeding scores over time.

The impact of motivational interviewing on communication of patients undergoing periodontal therapy.

AIM: There has been growing interest in motivational interviewing (MI) as a structured method for supporting health behaviour change in periodontal therapy. The aim of this study was to investigate the influence of communication techniques used in MI on statements of patients undergoing periodontal therapy. MATERIALS AND METHODS: Thirty audio-recorded sessions between dental MI providers and their patients undergoing periodontal therapy were coded using the German version of the Motivational Interviewing Sequential Code for Observing Process Exchanges (MISCOPE; D). Sequential analyses were performed to access transition probabilities among certain counsellor and patient statements. RESULTS: MI-consistent counsellor statements were statistically significantly positive correlated with patients' language in favour of change (change talk) (OR = 1.31; p = 0.027). MI-inconsistent statements were statistically significantly more likely to be followed by patients' language against change (sustain talk) (OR = 2.27, p = 0.002). An additional sequential analysis revealed significant correlations between certain evocative counsellor behaviours and the language of their patients. CONCLUSION: Specific verbal expressions described in the theory of MI significantly influence the subsequent statements of the patient in periodontal therapy. Accordingly, the periodontist can guide patient communication in a desired direction, evoke motivational statements and reduce expressions of resistance.

Current Modulation of a Heterojunction Structure by an Ultra-Thin Graphene Base Electrode.

Graphene has been proposed as the current controlling element of vertical transport in heterojunction transistors, as it could potentially achieve high operation frequencies due to its metallic character and 2D nature. Simulations of graphene acting as a thermionic barrier between the transport of two semiconductor layers have shown cut-off frequencies larger than 1 THz. Furthermore, the use of n-doped amorphous silicon, (n)-a-Si:H, as the semiconductor for this approach could enable flexible electronics with high cutoff frequencies. In this work, we fabricated a vertical structure on a rigid substrate where graphene is embedded between two differently doped (n)-a-Si:H layers deposited by very high frequency (140 MHz) plasma-enhanced chemical vapor deposition. The operation of this heterojunction structure is investigated by the two diode-like interfaces by means of temperature dependent current-voltage characterization, followed by the electrical characterization in a three-terminal configuration. We demonstrate that the vertical current between the (n)-a-Si:H layers is successfully controlled by the ultra-thin graphene base voltage. While current saturation is yet to be achieved, a transconductance of ~230 µ S was obtained, demonstrating a moderate modulation of the collector-emitter current by the ultra-thin graphene base voltage. These results show promising progress towards the application of graphene base heterojunction transistors.

Perfluorodecyltrichlorosilane-based seed-layer for improved chemical vapour deposition of ultrathin hafnium dioxide films on graphene.

We investigate the use of perfluorodecyltrichlorosilane-based self-assembled monolayer as seeding layer for chemical vapour deposition of HfO2 on large area CVD graphene. The deposition and evolution of the FDTS-based seed layer is investigated by X-ray photoelectron spectroscopy, Auger electron spectroscopy, and transmission electron microscopy. Crystalline quality of graphene transferred from Cu is monitored during formation of the seed layer as well as the HfO2 growth using Raman spectroscopy. We demonstrate that FDTS-based seed layer significantly improves nucleation of HfO2 layers so that graphene can be coated in a conformal way with HfO2 layers as thin as 10 nm. Proof-of-concept experiments on 200 mm wafers presented here validate applicability of the proposed approach to wafer scale graphene device fabrication.

Residual metallic contamination of transferred chemical vapor deposited graphene.

Integration of graphene with Si microelectronics is very appealing by offering a potentially broad range of new functionalities. New materials to be integrated with the Si platform must conform to stringent purity standards. Here, we investigate graphene layers grown on copper foils by chemical vapor deposition and transferred to silicon wafers by wet etching and electrochemical delamination methods with respect to residual submonolayer metallic contaminations. Regardless of the transfer method and associated cleaning scheme, time-of-flight secondary ion mass spectrometry and total reflection X-ray fluorescence measurements indicate that the graphene sheets are contaminated with residual metals (copper, iron) with a concentration exceeding 10(13) atoms/cm(2). These metal impurities appear to be partially mobile upon thermal treatment, as shown by depth profiling and reduction of the minority charge carrier diffusion length in the silicon substrate. As residual metallic impurities can significantly alter electronic and electrochemical properties of graphene and can severely impede the process of integration with silicon microelectronics, these results reveal that further progress in synthesis, handling, and cleaning of graphene is required to advance electronic and optoelectronic applications.