ORCID Profile
0000-0002-5010-6407
Current Organisation
University of Lincoln
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Public Health and Health Services | Community Child Health | Health Economics | Health Promotion | Dentistry not elsewhere classified | Public Health And Health Services Not Elsewhere Classified | Community Child Health
Child health | Dental health | Health related to specific ethnic groups | Health policy economic outcomes | Health policy evaluation |
Publisher: Wiley
Date: 22-07-2013
DOI: 10.1111/CDOE.12058
Abstract: Traditional assessment of research quality addresses aspects of scientific rigor, however, ensuring barriers to participation by people of different cultural backgrounds are addressed requires cultural competence. The aim of this research was to assess the cultural competence of oral health research conducted with migrant children. A protocol was developed with explicit inclusion and exclusion criteria. Electronic databases were searched from 1995 to 2009. Each study was assessed for cultural competence using the assessment criteria and a template developed as a proof-of-concept approach. Of the 2059 articles identified, 58 met inclusion criteria (n = 48 studies). There were four (8.3%) cohort studies, five (10.4%) intervention studies, 37 (77.1%) quantitative cross-sectional studies, and two (4.2%) were qualitative studies. Overall, migrant children had worse oral health outcomes in all studies compared with their host-country counterparts. All studies rated poorly in the cultural competence assessment. Appropriate inclusion of all potentially vulnerable groups in research will result in better estimates and understandings of oral health, and more reliable recommendations for prevention and management.
Publisher: Springer Science and Business Media LLC
Date: 25-07-2020
DOI: 10.1186/S12903-020-01198-0
Abstract: Dental caries is a significant public health problem and one of the most common chronic conditions affecting children. The potential for the non-dental workforce to improve children’s oral health is well documented. For well over a decade, there have been calls for pediatricians to address children’s oral health, but the incorporation of oral health screening, referral, and oral healthcare in pediatric practice remains underdeveloped. Developing action to strengthen the role of pediatricians’ in children’s oral health requires an understanding of their current knowledge and practice. In this scoping review, we aimed to comprehensively map what is known about the knowledge and practice of pediatricians regarding children’s oral health. Arksey & O’Malley’s five-stage review process was used to comprehensively map studies undertaken on pediatrician’s knowledge and practice regarding children’s oral health. Key search terms were developed and a total of 42 eligible articles are included in the review. The studies were conducted in 19 countries. The majority (41/42) were quantitative, with over 90% using self-reported surveys. Only four studies used previously validated survey tools, with most adapting questions from previous studies. Observational designs were used in two studies and one used qualitative methods. S le size ranged from 15 to 862. Oral health knowledge amongst pediatricians was reported to be mostly poor, with many gaps in key areas including age for first dental visit, dental caries and oral health risk assessments. Studies on the translation of oral health knowledge to practice were limited, with wide variation in rates of assessment. Few studies assessed actual practice. This scoping review highlights growing international interest in the role of pediatricians in children’s oral health. Findings demonstrate that pediatricians have limited knowledge and understanding in critical areas, including initial clinical signs of dental caries, recommended age for first dental visit, etiology of dental caries and recommended use of fluorides. Barriers for pediatricians include inadequate education and training, time constraints in practice and lack of referral pathways. Development of a validated tool to assess knowledge and practice is needed. This review provides a starting point to guide future research and areas for systematic reviews.
Publisher: Wiley
Date: 12-12-2018
DOI: 10.1111/IPD.12446
Abstract: At present, there are numerous caries risk assessment tools (CRATs) being promoted for disease management. However, the evidence to inform CRAT selection is unclear. This review aimed to assess the strength of evidence to inform the selection of CRATs for children ages 6 years and less. MEDLINE was the principal search database for this review. Other key databases, the reference lists of included articles, known cariology literature and experts were also consulted. Peer-reviewed papers describing CRATs and their development methodology were included. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist guided the quality assessment. The reporting of the key measurement properties (reliability, validity and responsiveness) informed the quality assessment. The search resulted in ten papers, reporting on eight different CRATs. The identified CRATs were: Caries Management By Risk Assessment (CAMBRA), Cariogram, National University of Singapore CRAT (NUS-CRAT), MySmileBuddy, Dundee Caries Risk Assessment Model, University of North Carolina Risk Assessment Models, University of Michigan pediatric dental clinic caries risk assessment sheet and American Academy of Pediatric Dentistry (AAPD) CRAT. Common across all CRATs was the lack of information to determine the levels of evidence for the measurement properties of reliability and construct validity. Studies on tools that were assessed as having strong evidence for content validity, identified the relevant risk factors for caries in the population being studied, before developing and testing their respective CRATs. The evidence to inform the selection of current CRATs for children is mostly yet to be established. Overall, the NUS-CRAT studies reported the most information to inform the assessment of its measurement properties and as a result this tool attained a higher quality rating than other CRATs studied. This article is protected by copyright. All rights reserved.
Publisher: Wiley
Date: 13-05-2015
DOI: 10.1111/IPD.12169
Publisher: Research Square Platform LLC
Date: 12-04-2022
DOI: 10.21203/RS.3.RS-1520497/V1
Abstract: Background People with poorly managed diabetes are at greater risk of periodontal disease. Periodontal disease that is not effectively managed can affect glycaemic levels. Diabetes care providers, including general practitioners and diabetes educators, are encouraged to promote oral health of their clients. However, valid and reliable oral health screening tools that assess the risk of poor oral health, that are easy to administer among non-dental professionals, currently do not exist. Existing screening tools are difficult to incorporate into routine diabetes consultations due to their length. Thus, this study aimed to develop and pilot a short oral health screening tool that would identify risk of existing oral diseases and encourage appropriate referrals to the dental service. Methods A three-item screening tool was developed after a comprehensive review of the literature and consensus from an expert panel. The tool was then piloted as part of a larger cross-sectional survey of 260 adults with diabetes who were accessing public diabetes clinics at two locations in Sydney, Australia. As part of the survey, participants completed the three-item screening tool and a 14-item validated tool, the Oral Health Impact Profile (OHIP-14), which has been used previously in the preliminary validation of screening tools. Sensitivity and specificity analyses were then undertaken comparing the results of the two tools. Results A statistically significant correlation was found between the shorter screening tool and the OHIP-14 (rho=0.453, p .001), indicating adequate validity. The three-item tool had high sensitivity (90.5%, 95% CI 84.9%, 94.7%), with a specificity of 46.3% (95% CI 37.7%, 55.2%). The negative predictive value was 81.4 % (95% CI 71.3, 89.3). No single item performed as well regarding sensitivity and negative predictive value when compared to the three items collectively. Conclusions The three-item screening tool developed was found to be valid and sensitive in identifying risk of poor oral health, requiring oral health referrals, among people with diabetes in this pilot. This is a simple, accessible tool that diabetes care providers could incorporate into their routine consultations. Further validation against comprehensive dental assessments is needed to reassess the tool’s specificity and sensitivity in erse settings.
Publisher: Wiley
Date: 13-12-2013
DOI: 10.1111/IDH.12008
Abstract: Qualitative research designs are being used increasingly in dental research. This paper describes the extent and range of dental research in which qualitative methods have been employed as well as the techniques of data collection and analysis preferred by dental researchers. A scoping review was conducted to locate studies published in dental journals, which reported the use of qualitative methods. Data concerning the focus of the research and the reported qualitative techniques were extracted. Studies included in the review totalled 197. The majority of qualitative research captured in this scoping study focussed on three main areas: dental education, professional dental and dental educators' activities and experiences and the patient ublic perceptions. Interviews and focus group discussions were the most commonly selected techniques for data collection. The majority of the studies included in the scoping review had a focus on education of dental professionals the activities of dental professionals or the reported perceptions of or experiences with dental services by patients or members of the public. Little research was located, which explored peoples' personal experience of dental conditions. Research reported in dental publications has a heavy bias towards the use of focus groups and interview data collection techniques.
Publisher: Springer Science and Business Media LLC
Date: 27-06-2011
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2022-062026
Abstract: To systematically identify and explore the existing evidence to inform the development of web-based interventions to support people affected by cancer (PABC). A rapid review design was employed in accordance with the guidance produced by the Cochrane Rapid Reviews Methods Group and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A rapid review was chosen due to the need for a timely evidence synthesis to underpin the subsequent development of a digital resource (Shared Lives: Cancer) as part of an ongoing funded project. Keyword searches were performed in MEDLINE to identify peer-reviewed literature that reported primary data on the development of web-based interventions designed to support PABC. The review included peer-reviewed studies published in English with no limits set on publication date or geography. Key outcomes included any primary data that reported on the design, usability, feasibility, acceptability, functionality and user experience of web-based resource development. Ten studies were identified that met the pre-specified eligibility criteria. All studies employed an iterative, co-design approach underpinned by either quantitative, qualitative or mixed methods. The findings were grouped into the following overarching themes: (1) exploring current evidence, guidelines and theory, (2) identifying user needs and preferences and (3) evaluating the usability, feasibility and acceptability of resources. Resources should be informed by the experiences of a wide range of end-users taking into consideration current guidelines and theory early in the design process. Resource design and content should be developed around the user’s needs and preferences and evaluated through usability, feasibility or acceptability testing using quantitative, qualitative or mixed methods. The findings of this rapid review provide novel methodological insights into the approaches used to design web-based interventions to support PABC. Our findings have the potential to inform and guide researchers when considering the development of future digital health resources. The review protocol was registered on the Open Science Framework ( osf.io/ucvsz ).
Publisher: SAGE Publications
Date: 03-2012
Abstract: Dental caries is an extremely debilitating disease with lifelong consequences. In most developed countries significant oral health inequalities exist in disadvantaged communities, including refugee and migrant populations. Addressing these inequalities is becoming increasingly challenging as communities become more culturally erse. An awareness of traditional oral health practices would enable the dental and broader health professions, to understand these differences and consequently better meet the needs of disadvantaged communities. The use of miswak is a common traditional oral hygiene practice used by a number of culturally erse groups. Further research is required into the use and effectiveness of traditional oral health practices within developed countries. Such practices need to be understood, respected and incorporated within oral health care, policies and practices in order to reduce significant inequalities experienced in our communities. This commentary describes the current literature on miswak, its effectiveness and the implications for promoting oral health.
Publisher: Cambridge University Press (CUP)
Date: 28-07-2020
DOI: 10.1017/S1368980020001676
Abstract: To examine associations between childcare type and nutrition and oral health indicators. Cross-sectional data extracted from a longitudinal birth cohort. Parent-completed FFQ and questions regarding oral health and childcare use. The associations between childcare type, classified into four groups: parent care only (PCO), formal childcare only (FCO), informal childcare only (ICO) or combination of care (F& I), and nutrition and oral health indicators were examined. Home and childcare. Families with children aged 3 years ( n 273) and 4 years ( n 249) in Victoria, Australia. No associations were observed between childcare type and core food/beverage consumption or oral health indicators. For discretionary beverages, compared with children receiving PCO at age 3 years, children in FCO or F& I were less likely to frequently consume fruit juice/drinks (FCO: adjusted OR (AOR) 0·41, 95 % CI 0·17, 0·96, P = 0·04 F& I: AOR 0·32, 95 % CI 0·14, 0·74, P = 0·008). At age 4 years, children receiving FCO or ICO were less likely to consume sweet beverages frequently compared with children receiving PCO: fruit juice/drink (ICO: AOR 0·42, 95 % CI 0·19, 0·94, P = 0·03 FCO: AOR 0·35, 95 % CI 0·14, 0·88, P = 0·03) and soft drink (ICO: AOR 0·23, 95 % CI 0·07, 0·74, P = 0·01 FCO: AOR 0·14, 95 % CI 0·03, 0·76, P = 0·02). Associations between childcare type and discretionary beverage intake were observed. Investigation into knowledge, attitudes and activities in formal and informal childcare settings is required to explore different health promotion practices that may influence nutrition and oral health.
Publisher: MDPI AG
Date: 15-12-2022
Abstract: The COVID-19 pandemic has caused considerable disruption to cancer care and may have exacerbated existing challenges already faced by cancer survivors from rural areas. This has created a need for a rapid evidence synthesis to inform the development of tailored interventions that address the specific needs of rural cancer survivors who continue to be affected by the pandemic. The review was conducted following guidance from the Cochrane Rapid Review Methods Group. Database searches were performed via the EBSCOHost interface (includes MEDLINE, CINAHL, PsycINFO) on 25 May 2022 and supplemented with searches on Google Scholar. Peer-reviewed articles published after March 2020 that reported primary data on the experiences of cancer survivors residing in rural and remote settings during the pandemic were included. Findings were tabulated and written up narratively. Fourteen studies were included. The COVID-19 pandemic had a mostly detrimental impact on the experiences of rural cancer survivors. People’s in idual coping mechanisms were challenging for a range of reasons. Specifically, the pandemic impacted on their ability to access testing, treatment, check-ups and supportive care, their ability to maintain and access social support with close friends and family, as well as negative consequences to their finances and emotional wellbeing with some reporting feelings of psychological distress including depression and anxiety. This review provides important insight into the experiences of rural cancer survivors that may help inform tailored support in line with the needs and challenges faced because of the pandemic.
Publisher: Wiley
Date: 26-02-2016
DOI: 10.1111/ADJ.12332
Abstract: An important role for parents and caregivers in the prevention of dental caries in children is the early establishment of health promoting behaviours. This study aimed to examine mothers' views on barriers and facilitators to promoting child and family oral health. Semi-structured interviews were undertaken with a purposive s le of mothers (n = 32) of young children. Inductive thematic analysis was conducted. Parental knowledge and beliefs, past experiences and child behaviour emerged as major influences on children's oral health. Child temperament and parental time pressures were identified as barriers to good oral health with various strategies reported for dealing with uncooperative children at toothbrushing time. Parental oral health knowledge and beliefs emerged as positive influences on child oral health however, while most mothers were aware of the common causes of dental caries, very few knew of other risk factors such as bedtime feeding. Parents' own oral health experiences were also seen to positively influence child oral health, regardless of whether these were positive or negative experiences. Understanding parental oral health beliefs is essential to overcoming barriers and promoting enablers for good child oral health. Improving child oral health also requires consideration of child behaviour, family influences, and increasing awareness of lesser-known influencing factors.
Publisher: Wiley
Date: 22-12-2016
Publisher: John Wiley & Sons, Ltd
Date: 15-09-2016
Publisher: Springer Science and Business Media LLC
Date: 06-2013
Abstract: Medline and Embase electronic databases were searched. Papers published between 1996 and 2011 were initially identified by one reviewer, with 10% being independently reviewed by a second reviewer having predefined inclusion and exclusion criteria. Data abstraction was conducted independently and meta-analysis was not attempted because of the heterogeneity of the studies. Inclusion criteria were met by four papers relating to the acquisition and colonisation of the oral cariogenic bacteria and caries outcome in infants, 13 papers were considered in relation to identifying possible determinants of early childhood caries (ECC) during the first year of life. The review confirmed that factors occurring during the first year of life affect ECC experience. Despite heterogeneity, findings indicated maternal factors influence bacterial acquisition, whereas colonisation was mediated by oral health behaviour and practices and feeding habits.
Publisher: SAGE Publications
Date: 03-02-2017
Abstract: Knowledge Transfer Statement: This article will provide a brief overview of the methods in finding barriers and enablers in doing oral health research in India. This mixed-methods approach can be used by researchers in finding barriers and enablers in doing oral health research in other developing countries and building oral health research capacities.
Publisher: Royal College of Psychiatrists
Date: 07-2021
DOI: 10.1192/BJO.2021.973
Abstract: The most immediate response of the research community to COVID-19 has been a focus on understanding the effects, treatment and prevention of infection. Of equal and ongoing importance is elucidating the impact of mitigation measures, such as lockdown, on the well-being of societies. Research about mental health and lockdown in the UK has predominately involved large surveys that are likely to encounter self-selection bias. Further, self-reporting does not constitute a clinical judgement. To (a) compare the age, gender and ethnicity of patients experiencing mental health emergencies prior compared with during lockdown, (b) determine whether the nature of mental health emergencies has changed during compared with before lockdown, (c) explore the utility of emergency medical service data for identifying vulnerability to mental health emergencies in real time during a pandemic. A total of 32 401 clinical records of ambulance paramedics attending mental health emergencies in the East Midlands of the UK between 23 March and 31 July 2020 and the same period in 2019 were analysed using binary logistic regression. People of younger age, male gender and South Asian and Black ethnicity are particularly vulnerable to acute mental health conditions during lockdown. Patients with acute cases of anxiety have increased during lockdown whereas suicide and intentional drug overdose have decreased. Self-reported data may underrepresent the true impact of lockdown on male mental health and ethnic minority groups. Emergency medical data can be used to identify vulnerable communities in the context of the extraordinary circumstances surrounding the current pandemic, as well as under more ordinary circumstances.
Publisher: Wiley
Date: 12-2014
Publisher: Wiley
Date: 26-05-2014
DOI: 10.1111/ADJ.12171
Abstract: Good oral health is an important component of overall health which can help migrants settle in a new country. Infant oral health is intimately associated with maternal oral health knowledge and behaviours and therefore, encounters with dental services. This study aimed to explore the experiences of dental service use from the perspective of migrant mothers living in Melbourne, Australia. A participatory research approach utilizing qualitative methods was adopted. Women from Iraq, Lebanon and Pakistan participated. Semi-structured focus groups and interviews were conducted and thematic analysis of the data was completed. Focus groups (n = 11) and interviews (n = 7) were conducted with 115 women. Despite an understanding that visiting the dentist was important for promoting oral health, the first dental contact for both the women and their children was typically for emergency care. Accessibility, cost and waiting lists were identified as significant barriers to attendance. Problematic interpreter encounters often led to negative experiences which were compounded by a perception that public services provided poorer quality of care. Despite evidence of poorer oral health, migrant women face significant barriers in accessing mainstream dental services. Reorientation of such services, to address the accessibility and experience for migrant communities may help reduce oral health inequalities.
Publisher: Research Square Platform LLC
Date: 22-11-2022
DOI: 10.21203/RS.3.RS-2236874/V1
Abstract: Background The purpose of the study was to explore, analyse, and describe the patterns of public dental services utilisation among the refugee populations in Victoria, Australia, and determine their predictors at the in idual and contextual levels. Methods Data on the refugees who attended Victorian public dental services between July 2016 to June 2020 was gathered from the Dental Health Program dataset. Latent profile analysis was used to identify discrete groups among the refugee clientele with similar mean utilisation patterns across six indicator variables describing the attributes of dental services received and the site of care provision, over the study period. Multilevel multinomial logistic regression analysis was performed to examine the in idual and contextual level correlates of the identified utilisation patterns. Results Six distinct profiles of public dental service utilisation were identified among the study population (n = 25542). The largest group comprised refugees predominantly using restorative services under general course of care (38.10%), followed by extraction services under emergency course of care (23.50%). Only a small proportion were estimated as having a higher mean utilisation of preventive services under general course of care (9.10%). Multilevel analysis revealed that the following variables had a significant association with refugee utilisation pattern: at the in idual-level – demographic and ethnic attributes including age, gender, region of birth, preferred language for communication, use of language interpreter services, and type of eligibility card at the contextual-level – characteristics of refugees’ area of residence including urbanicity, area-based socioeconomic disadvantage, delivery of Refugee Health Program at the community health centres, and spatial accessibility to public dental services via driving and public transit modes of travel. Conclusions The study represents a significant step towards the development of an evidence-based knowledge around public dental service utilisation among Victorian refugees. Overall, the study findings reiterate the critical need for targeted strategies to promote the importance of routine dental visits, oral disease prevention, and timely intervention among refugee groups.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JEBDP.2017.05.001
Abstract: Dental Health Services Victoria publishes evidence-based clinical practice guidelines (CPGs) to assist public oral health practitioners to provide high-quality dental care. How well these CPGs are implemented into practice is unknown. The aim of this study was to assess adherence to selected CPGs. An electronic auditing tool was developed using clinical indicators derived for "stainless steel crown (SSC)," "restorative care for children under general anesthetic (GA)," and "direct restorative materials" CPG. Six trained dentists audited a random s le of 204 dental records of children aged 3-12 years from 2 major public dental agencies. In total, 319 material-based treatments were audited, comprising 170 resin composite, 81 glass ionomer cement, 64 SSC, and 4 amalgam restorations. Adherence to the current guidelines varied from 94% of the SSC to none of the amalgam treatments audited. Almost half (47%) of the resin composite restorations and 5% of glass ionomer cement restorations were nonadherent to the relevant guideline. Average adherence was up to 72% of cases. Clinicians need to consider recording the rationale upon which their professional judgment is based when they decide not to follow an appropriate CPG.
Publisher: Wiley
Date: 19-08-2022
DOI: 10.1002/PON.6011
Abstract: To investigate and compare self‐management in people living with cancer following treatment, from rural and urban areas in the United Kingdom where there is a significant evidence gap. A cross‐sectional explanatory sequential mixed methods design. This involved a self‐completion questionnaire that collected data on demographics, self‐management using the PAM‐13 and rural‐urban residence and 34 in‐depth interviews that aimed to explore and compare the barriers and facilitators to self‐management in rural and urban settings. 227 participants completed the questionnaire: mean age 66.86 (±11.22). Fifty‐two percent ( n = 119) were female and 48% ( n = 108) were male. Fifty‐three percent ( n = 120) resided in urban areas and 45 % ( n = 103) in rural areas. Participants had a range of different types of cancer but the three most common were breast ( n = 73), urological ( n = 53), upper and lower gastrointestinal ( n = 41). Rural respondents (63.31 ± 13.66) were significantly ( p 0.05) more activated than those in urban areas (59.59 ± 12.75). The barriers and facilitators to self‐management identified in the interviews were prevalent in both rural and urban settings but some barriers were more explicit in rural settings. For ex le, there was a lack of bespoke support in rural areas and participants acknowledged how travelling long distances to urban centres for support groups was problematic. Equally, there were barriers and facilitators that were not necessarily unique to either geographic setting. Whilst the active treatment phase can present considerable challenges for people living with cancer in rural areas the findings suggest that the rural environment has the potential to increase engagement with self‐management in the transition to survivorship. The rigorous mixed methods design has led to different and complementary conclusions that would not have been possible had either quantitative or qualitative methods been used in isolation.
Publisher: Wiley
Date: 08-2012
DOI: 10.1111/J.1601-5037.2012.00570.X
Abstract: This article describes the aetiology and specific diagnoses of two different children that presented to the dental surgery with a form of dental caries. The management of both cases is being discussed as well as the differences in the prevention of early childhood caries.
Publisher: Wiley
Date: 03-2022
DOI: 10.1111/JEBM.12468
Abstract: The aim of this overview is to identify and collate evidence from existing published systematic review (SR) articles evaluating various methodological approaches used at each stage of an SR. The search was conducted in five electronic databases from inception to November 2020 and updated in February 2022: MEDLINE, Embase, Web of Science Core Collection, Cochrane Database of Systematic Reviews, and APA PsycINFO. Title and abstract screening were performed in two stages by one reviewer, supported by a second reviewer. Full‐text screening, data extraction, and quality appraisal were performed by two reviewers independently. The quality of the included SRs was assessed using the AMSTAR 2 checklist. The search retrieved 41,556 unique citations, of which 9 SRs were deemed eligible for inclusion in final synthesis. Included SRs evaluated 24 unique methodological approaches used for defining the review scope and eligibility, literature search, screening, data extraction, and quality appraisal in the SR process. Limited evidence supports the following (a) searching multiple resources (electronic databases, handsearching, and reference lists) to identify relevant literature (b) excluding non‐English, gray, and unpublished literature, and (c) use of text‐mining approaches during title and abstract screening. The overview identified limited SR‐level evidence on various methodological approaches currently employed during five of the seven fundamental steps in the SR process, as well as some methodological modifications currently used in expedited SRs. Overall, findings of this overview highlight the dearth of published SRs focused on SR methodologies and this warrants future work in this area.
Publisher: Wiley
Date: 03-2009
Publisher: Wiley
Date: 05-2015
Publisher: Springer Science and Business Media LLC
Date: 12-08-2006
Publisher: Wiley
Date: 28-08-2013
Publisher: Wiley
Date: 28-12-2022
DOI: 10.1111/CDOE.12835
Abstract: To identify, appraise and synthesize the published evidence from quantitative studies on the in idual and contextual‐level factors determining access to dental care among refugees worldwide. A systematic literature search was conducted until the last week of February 2022 in four electronic databases – MEDLINE, Embase, Web of Science (all databases) and APA PsycINFO – without any restrictions. Quantitative studies published in English language and meeting the a priori eligibility criteria were reviewed and data extracted. Quality assessment was conducted using the National Institutes of Health tool. The identified factors were stratified according to the framework of the Behavioural Model of Health Services Use, and the evidence related to each of these factors was summarized in tables. Narrative synthesis of the findings was conducted. The search retrieved 6776 unique records, of which 69 were deemed eligible for full‐text screening and nine studies were included in the final data analysis and synthesis. The studies were rated to be of ‘fair’ quality at best. Self‐reported previous dental visits was the most commonly used measure of access. Associations between in idual‐level factors and dental care access were most frequently examined (predisposing [ n = 6], need [ n = 2] and enabling [ n = 1]), while the contextual‐level factors were rarely examined (predisposing and enabling [ n = 1, each]). In idual‐level predisposing factors, such as English language proficiency, education, health and dental literacy and acculturation and integration, were shown to be significantly associated with refugees' access. There is limited evidence to determine the effect of in idual enabling and need and contextual factors.
Publisher: Wiley
Date: 12-01-2016
DOI: 10.1111/IDH.12192
Publisher: John Wiley & Sons, Ltd
Date: 16-05-2012
Publisher: Elsevier BV
Date: 02-2000
DOI: 10.1111/J.1875-595X.2000.TB00543.X
Abstract: A review of the literature on dental hygienists and their utilisation in the dental workforce is presented. Dental hygienists are employed as part of a dental team in the prevention and management of the two most common and costly oral diseases dental caries and periodontal disease. The potential scope for dental hygienists in the public health sector in Australia is examined in the light of broader issues relating to changing disease patterns, service delivery and the treatment of patients with special needs. Prevention and treatment of oral disease by the dental hygienist in schools, institutions, nursing homes, hospitals and residential facilities is discussed, with emphasis on such issues as legislation, productivity and quality assurance. Implications for the future training of dental hygienists are presented and recommendations made for increasing their utilisation in the public sector.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.RIDD.2017.12.022
Abstract: Children with Intellectual and Developmental Disabilities (IDD) face considerable challenges in participating in dental services. These challenges include resource constraints and inadequate skills of health service providers to work with this population. The aim was to scope published studies that addressed access to dental services for children with IDD in order to determine the extent to which various barriers have been researched, using an access framework derived from the literature. Access was defined to include the six dimensions of accessibility, availability, affordability, accommodation, acceptability, and appropriateness. Arksey and O'Malley's scoping review framework was used. Relevant databases (e.g., Medline) were searched for all empirical studies conducted from January 2000 to February 2017 that met inclusion criteria. Data were extracted along the six dimensions of the access framework. Sixteen international studies were identified which indicated common key barriers to dental service use: the difficulties of physical inaccessibility, lack of access to information among carers, lack of knowledge of disability issues, and low experience and skills in caring for children with IDD among dental practitioners. Key recommendations made were exploring dental practitioners' understanding of disability legislation and developing training for practitioners to expand on issues specific to IDD.
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1111/J.1753-6405.2009.00423.X
Abstract: In Victoria, dental therapists are restricted to treating patients under the age of 26 years. Removing this age restriction from dental therapists' scope of practice may assist significantly in addressing workforce shortages, particularly in rural Victoria. This study aims to assess the capacity of dental therapists to provide direct coronal restorations (dental fillings) to patients older than 25 years, on the prescription of a dentist. Its objectives include determining the success rate of restorations placed by dental therapists six months post placement and patients' and dental therapists' satisfaction with the services provided. The project was carried out in 2007 at the Royal Dental Hospital of Melbourne. Seven dental therapists participated in the study, placed 356 restorations (115 patients) with the support of a dentist. These restorations were reviewed six-months post placement by dentists blinded as to which restorations were placed by the dental therapists. Patients' age ranged from 26 to 82 years (82% were >40 years). At six months post-treatment, 258 restorations (80 patients) were reviewed. At review, 94.6% of the restorations were successful. Patients and dental therapists were satisfied with the experience. The standard of restorations provided by dental therapists was considered to be at least similar to that expected of a newly graduated dentist. Broadening the dental therapists scope of practice would create opportunities to design more flexible 'oral health' clinical teams enabling dentists to provide more complex procedures for patients most in need. This is significant in the public sector and rural areas where workforce shortages are most acute.
Publisher: Wiley
Date: 15-09-2022
DOI: 10.1111/CDOE.12792
Abstract: To examine the spatial accessibility to public dental services (PDS) relative to the estimated oral health needs of refugee populations within the state of Victoria, Australia. The study employed enhanced two‐step floating catchment area method to measure spatial accessibility to PDS by driving and public transit modes at statistical area level 2 (SA2). Principal component analysis of select census‐derived socioeconomic variables specific to the refugee population was conducted to derive an area‐based indicator of refugee oral health needs, also at SA2 level. In idual indices were then developed for each of these components using standardized z ‐scores. Finally, an integrated need‐accessibility index was developed to identify low‐accessibility areas associated with high needs. The results show clear contrast in spatial accessibility to PDS for the refugee populations between metropolitan and rural areas as well as between driving and public transit modes. There are critical limitations in accessibility for refugees living in the rural areas and those dependent on public transit mode for travel. Also, there is evident disparity between the estimated oral health needs of refugees in metropolitan and rural areas. Overall, approximately 29% of all SA2s with refugee population are in the ‘High’ needs category, which comprise 19.8% of the total Victorian refugee population. Integrating accessibility and oral health needs measures revealed that about 30% and 18% of refugee population are identified as under‐serviced, when considering driving and public transit modes respectively. The findings provide implications for researchers and policy makers to address the inequalities in access to PDS among the refugee population in Victoria. The methodology outlined in this study provides a complementary approach in planning oral health service provision in the absence of population level data at a small‐area scale on access to dental services or need for oral health care.
Publisher: MDPI AG
Date: 05-07-2022
Abstract: Purpose: Rural cancer survivors have poorer experiences and health outcomes compared to their urban counterparts. There is limited research on the post-treatment experiences of UK cancer survivors residing in rural areas. This study aimed to provide an understanding of the specific challenges and opportunities faced by rural cancer survivors and to provide insight into how rurality influences experiences post-primary treatment, ultimately to inform service provision. Methods: A secondary analysis of in-depth interview transcripts (n = 16) from a wider study on self-management in cancer survivors was conducted. An adapted version of Foster and Fenlon’s recovery of health and wellbeing in cancer survivorship framework informed the data coding. Results: Health and wellbeing were interrupted by a variety of problem incidents, and the subsequent steps to recovery were influenced by pre-existing, personal, environmental, and healthcare factors. A prominent theme was support, both from local communities and family as well as from healthcare professionals, with many survivors feeling that their rural setting had a positive influence on their health and wellbeing. Close relationships with local GPs were seen as fundamental to supporting recovery. Access to healthcare was frequently mentioned as a challenge with an emphasis on lengthy travel times and limited bespoke support in rural areas. Conclusions: This study is novel in that it applied a well-established theoretical framework to a rich qualitative dataset on the lived experiences of rural cancer survivors. Rural residency influenced recovery from cancer both positively and negatively. Implications for Cancer Survivors: Future practitioners and policy makers should consider working with local communities to tailor interventions to the specific characteristics of the rural environment.
Publisher: Wiley
Date: 17-05-2016
DOI: 10.1111/IDH.12228
Publisher: BMJ
Date: 03-2014
Publisher: Wiley
Date: 11-02-2011
DOI: 10.1111/J.1440-1754.2010.01988.X
Abstract: Australian pre-school children living in rural areas experience higher levels of dental caries than those in metropolitan areas. This may be because of a lack of community water fluoridation. The aim of this study was to evaluate the effectiveness of a community-based intervention to improve the oral health of children in non-fluoridated rural Victoria, Australia. The study was conducted across three local government areas in Victoria, with two receiving the intervention and one remaining with standard care. Although multifaceted, the primary strategy of the intervention was the promotion of early exposure to fluoridated toothpaste, including the distribution, by maternal and child health nurses (MCHNs), of an oral health starter kit including toothpaste, toothbrush and information to parents at their child's 7-8-month health check. Children were followed up annually to the age of three. Infants in the intervention arm experienced less caries (cavitated and pre-cavitated lesions included) than infants in the control arm at the first and second examinations (3.1% with caries in the intervention vs. 6.9% in the control group at exam 1 (adjusted P= 0.07) and 10.8% vs. 19.5% at exam 2 (adjusted P= 0.11), respectively). However potential benefits disappeared at the third examination (29.5% vs. 28.9%, adjusted P= 0.67). This study suggests that an oral health promotion intervention delivered via local MCHNs promoting early exposure to fluoride may be successful in reducing caries in the second year of life but less so in older children when participants have less contact with MCHNs.
Publisher: SAGE Publications
Date: 04-05-2010
Abstract: Dental caries, periodontal diseases, tooth loss and oral cancers have significant burden of disease effects * , quality of life and cost implications for the Australian community. Oral health promotion is a key approach to addressing these conditions endorsed as part of the National Oral Health Plan. Understanding the evidence for effectiveness of oral health promotion is integral to strategic planning for both oral and general health settings. Objective: The objective of this article is to report the key findings of a systematic review of the evidence for oral health promotion commissioned by the Victorian Department of Human Services in 2006. Methods: Evidence was collected and evaluated using a combined approach incorporating the Cochrane Public Health and Health Promotion Field Handbook and the Health Gains Notation in order to a develop a synthesis approach to reporting, framed around the Ottawa Charter. Findings: Findings included evidence supporting the continued fluoridation of water supplies, interventions aimed at early childhood and aged care settings, smoking cessation and capacity building with non-oral health care providers. Emerging evidence supporting multi-strategy community based approaches is also reported along with gaps in the evidence. General Conclusions: The authors conclude that, while there is good support for the incorporation of oral health into general health promotion, it will be important to monitor the outcomes in oral health terms.
Publisher: Springer Science and Business Media LLC
Date: 31-01-2018
Publisher: MDPI AG
Date: 25-01-2023
DOI: 10.3390/CURRONCOL30020122
Abstract: Aim: To compare health-promoting behaviours among rural and urban residents following primary treatment for cancer. Methods: A cross-sectional survey collecting demographic variables and data pertaining to health-promoting behaviours, documented using the 52-item Health Promotion Lifestyle Profile II (HPLP-II) measure, which is categorised into six subscales: (1) health responsibility, (2) spiritual growth, (3) physical activity, (4) interpersonal relations, (5) nutrition, and (6) stress management. Residence was defined using the U.K. Office for National Statistics RUC 2011 Rural Urban Classifications. The Index of Multiple Deprivation (IMD) Decile was used to measure deprivation. Quantitative data were analysed using independent s les t-test and multiple linear regression. Qualitative data from open-ended questions were analysed thematically. Results: In total, 227 participants with a range of cancer types completed the questionnaire. Fifty-three percent were residents in urban areas and forty-five percent in rural areas. Rural participants scored significantly higher on health responsibility (p = 0.001), nutrition (p = 0.001), spiritual growth (p = 0.004), and interpersonal relationships (p = 0.001), as well as on the overall HPLP-II (p = 0.001). When controlling for deprivation, age, marital status, and education, rural–urban residence was a significant predictor of exhibiting health-promoting behaviours. A central theme from the qualitative data was the concept of “moving on” from cancer following treatment, by making adjustments to physical, social, psychological, spiritual, and emotional wellbeing. Conclusions: This research revealed, for the first time, differences in health-promoting behaviours among rural and urban U.K. populations who have completed primary cancer treatment. Rural residence can provide a positive environment for engaging with health-promoting behaviours following a cancer diagnosis and treatment.
Publisher: Wiley
Date: 26-02-2008
DOI: 10.1111/J.1834-7819.2007.00010.X
Abstract: Little is known about the oral health of children under the age of four years. The determinants of early childhood caries (ECC) in this young age group are also not well understood despite a growing recognition that early interventions may deliver the greatest benefits. The aim of this study was to examine the oral health-related knowledge, attitudes and reported behaviours of parents of children aged 12-24 months living in rural areas of Victoria, Australia. A robust theoretical model was utilized to identify oral health-related behaviours and their antecedent and reinforcing conditions within the context of this specific population group. Two hundred and ninety-four parent/child dyads were recruited through their maternal and child health nurses as part of a larger intervention trial. Parents completed a self-report questionnaire. Knowledge regarding risk and protective factors amongst parents was variable and sometimes at odds with contemporary evidence. Knowledge of the role of early infection with S. mutans was very low, with high levels of behaviours that may promote early transmission reported. Tooth cleaning was reported by most parents at least sometimes, however a large proportion lacked confidence and this was significantly related to the frequency of the cleaning. Parents were confused about the fluoride status of their water supplies. Most parents believed fluoride toothpaste reduced the risk of ECC but did not know whether it should be used with toddlers. The results of this study have implications for efforts to prevent dental decay in this very young age group. Health care professionals other than dentists need support to provide information and promote confidence with regard to optimal fluoride exposure. Attention should also be given to the contribution of early contact with particular bacteria in oral health education and promotion programmes.
Publisher: Wiley
Date: 12-12-2017
DOI: 10.1111/IDH.12260
Abstract: The purpose of this study was to scope the literature that exists about factors influencing oral health workforce planning and management in developing countries (DCs). The Arksey and O'Malley method for conducting a scoping review was used. A replicable search strategy was applied, using three databases. Factors influencing oral health workforce planning and management in DCs identified in the eligible articles were charted. Four thousand citations were identified 41 papers were included for review. Most included papers were situational analyses. Factors identified were as follows: lack of data, focus on the restorative rather than preventive care in practitioner education, recent increase in number of dental schools (mostly private) and dentistry students, privatization of dental care services which has little impact on care maldistribution, and debates about skill mix and scope of practice. Oral health workforce management in the eligible studies has a bias towards dentist-led systems. Due to a lack of country-specific oral health related data in developing or least developed countries (LDCs), oral health workforce planning often relies on data and modelling from other countries. Approaches to oral health workforce management and planning in developing or LDCs are often characterized by approaches to increase numbers of dentists, thus not ameliorating maldistribution of service accessibility. Governments appear to be reducing support for public and preventative oral healthcare, favouring growth in privatized dental services. Changes to professional education are necessary to trigger a paradigm shift to the preventive approach and to improve relationships between different oral healthcare provider roles. This needs to be premised on greater appreciation of preventive care in health systems and funding models.
Publisher: Wiley
Date: 20-02-2019
DOI: 10.1111/IPD.12470
Abstract: Diet cariogenicity plays a major role as both a protective and risk factor in the development of early childhood caries (ECC). Develop a scale measuring the cariogenicity of foods and beverages and employ it to describe the cariogenicity of young children's diets and predict dental caries outcomes. Scores of cariogenicity and consumption frequency were applied to food frequency questionnaire (FFQ) collected from an Australian children's cohort study with three time-points of data. One-way ANOVA, with post hoc Tukey test compared mean cariogenic scale measured at 18 months between the subs le of children with caries classification at age 5 years. At 6 months, children's mean cariogenic score was 10.05, increasing to 34.18 at 12 and 50.00 at 18 months. Mean cariogenic scale score at 18 months was significantly higher in children with advanced disease at 5 years (mean scale score: 59.0 ± 15.9) compared to those that were healthy (mean score 47.7 ± 17.5, P = 0.007) or had mild-moderate disease (mean score 48.2 ± 17.3, P = 0.008). The cariogenic diet scale provides a useful indication of the increasing cariogenicity of children's diets with age and highlights the incorporation of discretionary choice foods and beverages into the diets of young children much earlier than nutritionally recommended.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2023
Publisher: Springer Science and Business Media LLC
Date: 04-2012
DOI: 10.1007/BF03262720
Publisher: Springer Science and Business Media LLC
Date: 05-07-2014
Publisher: Wiley
Date: 29-06-2006
Publisher: Oxford University Press (OUP)
Date: 02-05-2017
DOI: 10.1093/IJE/DYW024
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: Cold Spring Harbor Laboratory
Date: 12-07-2023
DOI: 10.1101/2023.07.12.23292547
Abstract: Digital exclusion leads to marginalization and inequality. A lack of tools to measure local exclusion h ers targeted interventions. In this study a composite indicator for digital exclusion and associated toolkit was developed. Indicator variables were normalised and aggregated. Factor analysis determined indicator weightings. Local levels of claiming Guaranteed Pension Credit, unemployment and low socioeconomic status showed strong mutual correlation. Underlying constructs were identified related to socioeconomic deprivation, poor academic qualifications, lack of activity and barriers to digital access. In general, coastal areas in Lincolnshire, UK had higher levels of digital exclusion, with significant local disparities within urban areas. The Lincolnshire Digital Health toolkit assists decision-makers in understanding and addressing digital exclusion.
Publisher: SAGE Publications
Date: 30-01-2017
Abstract: Cultural competence is an important aspect of health service access and delivery in health promotion and community health. Although a number of frameworks and tools are available to assist health service organizations improve their services to erse communities, there are few published studies describing organizational cultural competence assessments and the extent to which these tools facilitate cultural competence. This article addresses this gap by describing the development of a cultural competence assessment, intervention, and evaluation tool called the Cultural Competence Organizational Review (CORe) and its implementation in three community sector organizations. Baseline and follow-up staff surveys and document audits were conducted at each participating organization. Process data and organizational documentation were used to evaluate and monitor the experience of CORe within the organizations. Results at follow-up indicated an overall positive trend in organizational cultural competence at each organization in terms of both policy and practice. Organizations that are able to embed actions to improve organizational cultural competence within broader organizational plans increase the likelihood of sustainable changes to policies, procedures, and practice within the organization. The benefits and lessons learned from the implementation of CORe are discussed.
Publisher: Informa UK Limited
Date: 17-04-2014
DOI: 10.1080/13557858.2014.907391
Abstract: Australia is an increasingly multicultural nation. Never before has the dental workforce been exposed to such language, cultural, religious and ethnic ersity. There is evidence that refugee and migrant children experience significantly poorer oral health than the nonmigrant population. However, little is known about the oral health knowledge, practices and beliefs of parents with young children from refugee and migrant backgrounds. The aim of this study was to identify the sociocultural influences on child oral health in these communities. Participatory and qualitative research methods were utilised. Partnerships were established with community agencies representing migrants from Iraq, Lebanon and Pakistan. Focus group discussions and semi-structured interviews were conducted with community members. Qualitative data were analysed thematically, combining focus group and interview data. Over 100 women participated in focus groups (n = 11) and semi-structured interviews (n = 7). Key findings included the knowledge, beliefs and practices concerning: caries risk factors, oral health practices and oral health literacy. Despite mothers' knowledge of the major causes of poor oral health - dietary changes, confusion about child oral hygiene practices and limited oral health literacy all influenced child oral health outcomes. This culturally competent qualitative study explores the sociocultural factors influencing child oral health in refugee and migrant communities. Understanding and acknowledging these factors are a prerequisite to determining where and how to intervene to improve oral health. Furthermore, it has implications for both dental and non-dental health professionals working to reduce health inequalities within such communities.
Publisher: BMJ
Date: 11-06-2015
Publisher: Springer Science and Business Media LLC
Date: 04-04-2023
DOI: 10.1186/S12903-023-02886-3
Abstract: The purpose of the study was to explore, analyse, and describe the patterns of public dental service utilisation among the refugee populations in Victoria, Australia, and determine their predictors at the in idual and contextual levels. Data on the refugees who attended Victorian public dental services between July 2016 to June 2020 was gathered from the Dental Health Program dataset. Latent profile analysis was used to identify discrete groups among the refugee clientele with similar mean utilisation patterns across six indicator variables describing the attributes of dental services received and the site of care provision, over the study period. Multilevel multinomial logistic regression analysis was performed to examine the in idual and contextual level correlates of the identified utilisation patterns. Six distinct profiles of public dental service utilisation were identified among the study population (n = 25,542). The largest group comprised refugees predominantly using restorative services under general course of care (38.10%), followed by extraction services under emergency course of care (23.50%). Only a small proportion were estimated as having a higher mean utilisation of preventive services under general course of care (9.10%). Multilevel analysis revealed that the following variables had a significant association with refugee utilisation pattern: at the in idual-level – demographic and ethnic attributes including age, gender, region of birth, preferred language for communication, use of language interpreter services, and type of eligibility card at the contextual-level – characteristics of refugees’ neighbourhood of residence including urbanicity, socioeconomic disadvantage, delivery of Refugee Health Program at the community health centres, and spatial accessibility to public dental services via driving and public transit modes of travel. The study represents a significant step towards the development of an evidence-based knowledge around public dental service utilisation among Victorian refugees. Overall, the study findings reiterate the critical need for targeted strategies to promote the importance of routine dental visits, oral disease prevention, and timely intervention among refugee groups.
Publisher: Springer Science and Business Media LLC
Date: 25-02-2010
Publisher: Informa UK Limited
Date: 05-07-2022
Publisher: Oxford University Press (OUP)
Date: 08-2023
Publisher: Wiley
Date: 2006
DOI: 10.1111/J.1440-1754.2006.00777.X
Abstract: Background: Despite the fact that it is largely preventable, dental caries (decay) remains one of the most common chronic diseases of early childhood. Dental decay in young children frequently leads to pain and infection necessitating hospitalization for dental extractions under general anaesthesia. Dental problems in early childhood have been shown to be predictive of not only future dental problems but also on growth and cognitive development by interfering with comfort nutrition, concentration and school participation. Objective: To review the current evidence base in relation to the aetiology and prevention of dental caries in preschool‐aged children. Methods: A search of MEDLINE, CINALH and Cochrane electronic databases was conducted using a search strategy which restricted the search to randomized controlled trials, meta‐analyses, clinical trials, systematic reviews and other quasi‐experimental designs. The retrieved studies were then limited to articles including children aged 5 years and under and published in English. The evidence of effectiveness was then summarized by the authors. Conclusions: The review highlighted the complex aetiology of early childhood caries (ECC). Contemporary evidence suggests that potentially effective interventions should occur in the first 2 years of a child's life. Dental attendance before the age of 2 years is uncommon however, contact with other health professionals is high. Primary care providers who have contact with children well before the age of the first dental visit may be well placed to offer anticipatory advice to reduce the incidence of ECC.
Publisher: Wiley
Date: 18-07-2006
DOI: 10.1111/J.1601-5037.2006.00190.X
Abstract: Globalization and concurrent development in computer and communication technology has increased interest in collaborative online teaching and learning for students in higher education institutions. Many institutions and teachers have introduced computer-supported programmes in areas including dental hygiene. The potential for the use of this technology is exciting however, its introduction should be careful and considered. We suggest that educators wanting to introduce computer-supported programmes make explicit their pedagogical principles and then select technologies that support and exploit these principles. This paper describes this process as it was applied to the development of an international web-based collaborative learning programme for dental hygiene students.
Publisher: Wiley
Date: 03-03-2016
DOI: 10.1111/CCH.12323
Abstract: Examining the experiences of parents making food choices for infants is important because ultimately this influences what infants eat. Infancy is a critical period when food preferences and eating behaviour begin to develop, shaping dietary patterns, growth and health outcomes. There is limited evidence regarding what or why foods are chosen for infants. To describe the experiences of mothers making food choices for their infant children. Semi-structured interviews with 32 Australian mothers of infants aged four to 15 months from a range of socioeconomic backgrounds. An inductive thematic analysis through a process of constant comparison was conducted on transcribed interviews. Mothers described many ideas and circumstances which influenced food choices they made for infants. Themes were developed which encapsulate how the wider environment and in idual circumstances combine to result in the food choices made for infants. Beliefs, values, norms and knowledge were a central influence on choices. Cost, quality and availabilities of various foods were also key factors. Related to this, and combined with inherent factors such as perishability and infant acceptability, fresh fruits and vegetables were often singled out as an easy or difficult choice. Influences of time, parents' capacities, social connections and different information sources were clearly apparent. Finally infants' own preferences and how parents helped infants with learning to eat were also key influences on food choices. Choosing foods for infants is a complex social practice. An ecological framework depicting the multiple influences on what people eat and sociological theory on food choice regarding the role of 'social structure' and 'human agency' are both applicable to the process of choosing foods for infants. Equity issues may be key regarding the degree to which mothers can choose particular foods for infants (e.g. choosing foods which promote health).
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 09-2010
End Date: 12-2014
Amount: $491,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 05-2009
End Date: 05-2015
Amount: $662,000.00
Funder: Australian Research Council
View Funded Activity