Using e-learning to train dentists in the development of standardised oral health promotion interventions for persons with disability

BACKGROUND

This study aims to evaluate whether an e-learning curriculum was sufficient to impart the necessary knowledge to dentists to allow them to implement an oral health promotion intervention in an institution for persons with disability.

MATERIALS AND METHODS

Participants were asked to complete a 10-module online training course and to implement a standardised intervention in an institution. The outcome measures were as follows: online tracking of progress; multiple choice questionnaires completed at the end of most modules; self-efficacy questionnaire completed before and after online training; completion of training and calibration in the use of a standardised risk assessment form; initiation and full completion of an oral health promotion intervention in an institution; satisfaction of participants with the online training experience; and evaluation of the impact of the intervention by the institution staff.

RESULTS

The study sample included 26 dentists. The 10 modules were passed by 24 dentists, and the mean value of the highest overall score recorded in the multiple questionnaires was 88.4% (± 4.0). Twenty participants completed the self-efficacy questionnaire before and after training; the mean values of scores after training were statistically different and higher than those at baseline. Questionnaire regarding satisfaction with the online training experience was completed by 22 participants; all of them stated that they were satisfied with the online training experience.

CONCLUSIONS

The results indicate that the online training course helped participants to increase self-efficacy and to provide interventions in institutions. This study could have implications for both undergraduate and postgraduate dental education in France.

[Nasal fossae hemangiopericytoma revealed by acute dacryocystitis]

We report a 42-year-old woman with a hemangiopericytoma tumor located in nasal fossae, revealed by acute dacryocystitis. Clinical rhinoscopic examination and orbitofacial tomodensitometry showed tumefaction of the lacrimal sac and nasolacrimal duct. We removed the tumor by endonasal surgery. The anatomopathology examination confirmed the diagnosis of hemangiopericytoma. The internal canthus area and the maxillary sinus roof were treated with complementary irradiation.

[Syphilitic uveitis]

The incidence of syphilitic uveitis is reportedly increasing, up to 1% uveitis in general, with often polymorphic and atypical manifestations. Three cases of syphilitic uveitis are reported here, at different stages (secondary, latent, late). The bacteriologic sterilization is often unlikely in ocular syphilis, and recurrence is frequent; therefore a high-dose intravenous penicillin G treatment is then to recommend. HIV serology must be systematically associated with syphilitic tests.

Incorporation and turnover of phospholipid precursors in normal and tumoral glial cells in culture

The incorporation and turnover of phospholipid precursors in cultured normal and tumoral glial cells was investigated during the plateau phase of growth. Glycerol was incorporated similarly by all cell types, and was renewed with a half-life of 19-37 hr. Acetate had a much longer half-life in primary cultures (50-75 hr) than in proliferative tumor cells (20-40 hr). Phosphate had a more rapid turnover rate in primary cultures (25 hr) than in proliferative tumor cells (50 hr). For all precursors, inositol- and choline phosphoglycerides had a faster turnover rate than other phospholipids.

Incorporation and metabolism of exogenous fatty acids by cultured normal and tumoral glial cells

We have investigated the transformation of exogenous radioactive free fatty acids by cultured glial cells and their incorporation into complex lipids. The cells were either tumor lines (C6 and NN) or primary cultures from newborn rat hemispheres. The tumor lines could undergo morphological differentiation with dibutyryl cyclic AMP or bromodeoxyuridine. The fatty acid precursors used were palmitic, stearic, oleic, linoleic and linolenic acids. Tumor cells presented a higher incorporation of the precursors in the cell lipid acyl groups than did normal cells. Tumor cells desaturated and/or elongated palmitic, stearic and oleic acid to a higher extent than did normal cells. In contrast, tumor cells transformed linoleic and linolenic acids to their polyunsaturated derivatives to a lower extent than did normal cells. In differentiated tumor cells, these patterns of metabolism were shifted toward the patterns of normal cells. Tumor cells did not exhibit delta 4-desaturase activity, but such activity was restored in the C6 line upon dibutyryl cyclic AMP-induced differentiation. Transformation of linoleic and linolenic acid is likely to proceed through initial delta 6 desaturation. Phospholipids were preferentially labelled with the radioactive fatty acids, and only a little radioactivity was found in the neutral lipid fraction, mainly in diacylglycerols. Each fatty acid precursor label was incorporated in individual phospholipids to a proportion which reflected the typical acyl group composition of glycerophospholipids; we observed high levels of incorporation of palmitic acid and its derivatives into choline glycerophospholipids, and high levels of incorporation of linolenic acid and its derivatives into ethanolamine glycerophospholipids. This pattern was more marked in tumor cells than in normal cells, and the differentiation of tumor cells partially restored the normal pattern, mainly in bromodeoxyuridine-treated NN cells. Both types of differentiation of glial cell lines can be useful as models for the understanding of membrane physiology in normal and tumor cells.