Collecting standardised oral health data via mobile application: A proof of concept study in the Netherlands

eHealth Tools That Assess and Track Health and Well-being in Children and Young People: Systematic Review

Background

eHealth tools that assess and track health outcomes in children or young people are an emerging type of technology that has the potential to reform health service delivery and facilitate integrated, interdisciplinary care.

Objective

The aim of this review is to summarize eHealth tools that have assessed and tracked health in children or young people to provide greater clarity around the populations and settings in which they have been used, characteristics of digital devices (eg, health domains, respondents, presence of tracking, and connection to care), primary outcomes, and risks and challenges of implementation.

Methods

A search was conducted in PsycINFO, PubMed or MEDLINE, and Embase in April 2020. Studies were included if they evaluated a digital device whose primary purpose was to assess and track health, focused on children or young people (birth to the age of 24 years), reported original research, and were published in peer-reviewed journals in English.

Results

A total of 39 papers were included in this review. The sample sizes ranged from 7 to 149,329 participants (median 163, mean 5155). More studies were conducted in urban (18/39, 46%) regions than in rural (3/39, 8%) regions or a combination of urban and rural areas (8/39, 21%). Devices were implemented in three main settings: outpatient health clinics (12/39, 31%), hospitals (14/39, 36%), community outreach (10/39, 26%), or a combination of these settings (3/39, 8%). Mental and general health were the most common health domains assessed, with a single study assessing multiple health domains. Just under half of the devices tracked children’s health over time (16/39, 41%), and two-thirds (25/39, 64%) connected children or young people to clinical care. It was more common for information to be collected from a single informant (ie, the child or young person, trained health worker, clinician, and parent or caregiver) than from multiple informants. The health of children or young people was assessed as a primary or secondary outcome in 36% (14/39) of studies; however, only 3% (1/39) of studies assessed whether using the digital tool improved the health of users. Most papers reported early phase research (formative or process evaluations), with fewer outcome evaluations and only 3 randomized controlled trials. Identified challenges or risks were related to accessibility, clinical utility and safety, uptake, data quality, user interface or design aspects of the device, language proficiency or literacy, sociocultural barriers, and privacy or confidentiality concerns; ways to address these barriers were not thoroughly explored.

Conclusions

eHealth tools that assess and track health in children or young people have the potential to enhance health service delivery; however, a strong evidence base validating the clinical utility, efficacy, and safety of tools is lacking, and more thorough investigation is needed to address the risks and challenges of using these emerging technologies in clinical care. At present, there is greater potential for the tools to facilitate multi-informant, multidomain assessments and longitudinally track health over time and room for further implementation in rural or remote regions and community settings around the world.

The development of an instrument to predict patients’ adoption of mHealth in the developing world

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Identification of Interleukin-8-Reducing Lead Compounds Based on SAR Studies on Dihydrochalcone-Related Compounds in Human Gingival Fibroblasts (HGF-1 cells) In Vitro

Background: In order to identify potential activities against periodontal diseases, eighteen dihydrochalcones and structurally related compounds were tested in an established biological in vitro cell model of periodontal inflammation using human gingival fibroblasts (HGF-1 cells). Methods: Subsequently to co-incubation of HGF-1 cells with a bacterial endotoxin (Porphyromonas gingivalis lipopolysaccharide, pgLPS) and each individual dihydrochalcone in a concentration range of 1 µM to 100 µM, gene expression of interleukin-8 (IL-8) was determined by qPCR and cellular interleukin-8 (IL-8) release by ELISA. Results: Structure–activity analysis based on the dihydrochalcone backbone and various substitution patterns at its aromatic ring revealed moieties 2′,4,4′,6′-tetrahydroxy 3-methoxydihydrochalcone (7) to be the most effective anti-inflammatory compound, reducing the pgLPS-induced IL-8 release concentration between 1 µM and 100 µM up to 94%. In general, a 2,4,6-trihydroxy substitution at the A-ring and concomitant vanilloyl (4-hydroxy-3-methoxy) pattern at the B-ring revealed to be preferable for IL-8 release inhibition. Furthermore, the introduction of an electronegative atom in the A,B-linker chain led to an increased anti-inflammatory activity, shown by the potency of 4-hydroxybenzoic acid N-vanillylamide (13). Conclusions: Our data may be feasible to be used for further lead structure designs for the development of potent anti-inflammatory additives in oral care products.

Oral Health Status and Treatment Needs of Pregnant Women Attending Antenatal Clinics in KwaZulu-Natal, South Africa

During pregnancy, the oral cavity is characterised by an acidic environment and an inflammatory response brought about by vomiting and changes in hormonal levels, respectively, thereby increasing the mother's risk of developing caries. Although evidence exists to support an association between pregnancy-associated periodontal disease and adverse pregnancy outcomes, there is a paucity of studies which focus on the caries prevalence and other oral manifestations of pregnant women. The aim of this study was to assess the oral health status and treatment needs of pregnant women attending antenatal clinics in KwaZulu-Natal, South Africa. Randomly selected mothers (n=443) attending a maternal obstetrics unit participated in the study. A questionnaire elicited demographic information about the participants, while the measurement of decayed, missing, and filled indices (DMFT) determined their caries status. Oral lesions were noted if present. Descriptive statistics for independent variables described frequencies in the various categories of race, location, pregnancy stage, etc., with the association between 2 independent variables tested by chi-square. Dependent variables such as DMFT were expressed as means and standard deviations, and ANOVA was used to examine whether independent variables significantly influenced the DMFT. The mean DMFT was 7.18 (±4.22) with significant correlations observed between DMFT, D, M, and age. F scores differed significantly between races, location, and educational levels and showed a significant correlation with pregnancy stage. Pregnancy epulis was diagnosed in 38 (8.5%), oral lesions in 65 (14.7%), and tooth mobility in 26 (5.9%) mothers. Early oral health screening during pregnancy can ensure the overall well-being of both the mother and the foetus.