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This article identifies the outcomes from a research platform of three research projects based on the delivery of oral health promotion in Wales, UK. This research attempts to provide an explanation as to why there is continued social division in the distribution of caries in the child population. Current policies from the Welsh Government have the potential to address such a social division. This research platform adds to the literature by identifying weak links in the effective delivery of oral health promotion services. This article helps facilitate changing policy to practice, while observing the inequalities in Welsh communities. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to explore the perceptions of teachers and parents of infant school children in primary schools positioned and servicing affluent and deprived populations as intermediate and end users of oral health promotion services in the Vale of Glamorgan, Wales. Method: Two primary schools within the Vale of Glamorgan were selected each representing different geographical locations within the area as well as different socio-economic profiles. A focus group of parents (n=8 school 1); an individual face-to-face interview with one parent (school 2) and individual face-to-face interviews with both headteachers and one reception teacher from each school. A 12-item interview schedule was devised in which face and content validity was established. A thematic analysis using Nvivo was then undertaken in which themes and sub-themes were identified. Results: Seven themes emerged from the analysis of the data. These included: 'responsibility', 'the dentist', 'the role of the health visitor and school nurse', 'school policy', 'oral health education', 'positive role modelling' and 'Designed to Smile'. Confused messages were reported by both teachers and parents, which suggest that different approaches are needed in the delivery of key oral health messages. Conclusions: There were clear differences in the perceptions of disease experiences of children in the teachers and the parents of each school and clear evidence of dental disease having an impact on some of the children in school 1. Health visitors and school nurses as public health professionals are best placed to take the lead on oral health promotion in pre-school, school children, young people and their families in communicating clear, accurate, consistent and unambiguous evidence-based messages. Working more collaboratively with Designed to Smile, general and community dentists can do much to raise the profile of oral health promotion particularly for those families who need it most. [ABSTRACT FROM AUTHOR]

Dental disease is a preventable condition; however, the most at-risk are the less affluent in society. Governments have responded with programmes to tackle the inequalities. This qualitative study aimed to explore the views of healthcare professionals regarding their role in oral health promotion and their understanding of the issues surrounding the delivery of effective oral health promotion within their practice. Six school nurses and three health visitors currently attending the specialist community public health nursing course took part in the focus group. An interview schedule devised by the authors and peer-reviewed for face and content validity was used. Three main themes generated from the data analysis: role and limitations, barriers and opportunities. The participants were committed to promote oral health, though they had little knowledge and participation in the Welsh Government's scheme, Designed to Smile. The caregivers voiced answers to improve the effectiveness of oral health promotion which included education and a cohesive approach. A greater involvement of the health carers is needed to address inequality; furthermore, at the time of internal review the need for process and outcome evaluation along with the critical appraisal of the evidence is vital to shape programmes that are fit-for-purpose and sustainable. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to explore the views of health professionals with regard to their role in oral health promotion and their understanding of the issues surrounding the delivery of effective oral health promotion within their daily practice. Method: A focus group was conducted with school nurses (n=6) and health visitors (n=3) who had recently completed the 'Evidence Based Public Health' core module as part of their higher degree Specialist Community Public Health Nurse (SCPHN) programme of study (May 2014). A 12-item focus group interview schedule was devised in which face and content validity were established. A thematic analysis was then undertaken in which themes and sub-themes were identified. Results: Three over-arching themes were identified: the 'responsibility' the participants felt they had towards their clients, the responsibility the parents should have towards their children's oral health and the responsibility of the state and its policies; the main 'barriers' encountered in the participants' practice; and the need for a 'cohesive approach' in promoting the communication of key messages on oral health. Conclusions: Although school nurses and health visitors are best placed to take the lead on oral health promotion in children and young people, several barriers were identified, which prevented them from performing this role effectively and confidently. The participants' belief that the consequences of poor oral health is incentive enough for behaviour change may well have been a main contributory factor to their perceived ineffectiveness and frustration. A recommendation is made for more training, which focused on behaviour change principles of concordance and setting realistic targets tailored to the needs of those children and young people who need it most. [ABSTRACT FROM AUTHOR]

Screening of acute stroke patients for signs of dysphagia (swallowing impairment) is recommended within 24 hours of hospitalization owing to increased risk of morbidity and mortality Speech and language therapists (SLTs) are the lead health professionals responsible for assessment of dysphagia. However, increasing demand for assessment and the relative dearth of SLTs in the NHS has resulted in delays in assessment of up to 6 days. Subsequently there is a drive for nurses to perform this screening process using a validated screening method and tool. This paper centres on the exploratory phase of a three-stage programme of research, designed to develop and evaluate a bedside dysphagia screening tool for use by registered nurses. Here the authors focus on a review of the salient professional literature and the findings of a survey of current dysphagia screening practices employed by nurses across 52 NHS trusts in England and Wales. The literature review revealed a lack of consensus on the requisite construct of a dysphagia screening tool and on criteria for determining signs of swallowing difficulties and their complications. These reported findings were echoed in the survey which highlighted wide variation in screening practices and use of screening criteria based on limited or no research-based evidence. The authors describe how this initial work has acted as a springboard for the design and evaluation of a screening tool for use by nurses at the patient's bedside, which employs a minimal combination of evidence-based criteria. [ABSTRACT FROM AUTHOR]

coll a.m., ameen j.r.m. & mead d. (2004) Journal of Advanced Nursing 46(2), 124–133 Postoperative pain assessment tools in day surgery: literature review Postoperative pain is an expected phenomenon. However, its passage beyond acceptable limits is a common and costly experience. This is particularly the case in day surgery, partly because of the increasing demand to reduce waiting lists for elective surgery, and partly because of lack of knowledge about patients’ experiences of postoperative pain and relevant published research. The latter is mainly concerned with different interpretations of the phenomenon of pain that appear to have led to a variety of often inappropriate pain measurement tools. This paper critically reviews some of the available objective and subjective measures of pain and establishes the suitability of a Visual Analogue Scale (VAS) for measuring the intensity of pain after day surgery. Nursing and health care papers published since 1983 were sought using the keywords: postoperative pain, day surgery, ambulatory surgery, rating scales, VAS, severity, assessment, tool, nursing, validity, sensitivity, reliability and their various combinations. The databases used were Medline, CINAHL, Nursing Collection, Embase, Healthstar, BMJ and several on-line Internet journals, specifically Ambulatory Surgery. The search included only papers published in the English language. A range of interpretations of pain have led to the development of various measurement tools that address different components of pain. This inconsistency has led to ineffective pain management. Based on established criteria, the VAS was found to be methodologically sound, conceptually simple, easy to administer and unobtrusive to the respondent. On these grounds, the VAS seems to be most suitable for measuring intensity of pain after day surgery. Common guidelines on the definition and measurement of pain are needed. In day surgery, the availability of a unified and reliable measure of pain that can address its sensory component, such as the VAS, will provide more reliable information about the pain experience and, hence, improve its overall management. [ABSTRACT FROM AUTHOR]

coll a.m., ameen j.r.m. & moseley l.g. (2004) Journal of Advanced Nursing 46(1), 53–65 Reported pain after day surgery: a critical literature review Despite technological advancements in anaesthesia and analgesia, reported pain levels after day surgery remains high. Whilst it is unrealistic to expect no pain, the level that constitutes ‘acceptable’ pain remains unclear because of inconsistencies in reporting. These inconsistencies have resulted from different interpretations of what pain is and the use of different measurement tools. The aim of this paper is to report a study investigating any disparity in reported levels of pain following day surgery, within different specialities and in relation to specific operative procedures. Nursing and health care papers published since 1983 were sought using the keywords: postoperative pain, postoperative complications, pain after day surgery, day surgery, ambulatory surgery, nursing, operation types, operative procedures, surgical procedures, descriptors of pain, pain intensity, verbal descriptor scale, numerical rating scale, visual analogue scale, validity, reliability, design, sample size, data collection methods and their various combinations. Databases searched were Medline, CINAHL , Nursing Collection, Embase, Healthstar, BMJ and several on-line Internet journals, specifically Ambulatory Surgery. The search was restricted to publications in the English language. Twenty-four papers were identified. Inconsistencies in the reported intensity of pain are highlighted, in relation to different operative procedures and specialities. Data in the papers are based on different descriptors, measurement tools and data collection methods. In many cases, sample size, and validity and reliability can also be questioned. There is a disparity in reported levels of pain after day surgery. It is important that a unified day surgery pain measurement strategy is established, so that patients can be informed about the intensity of pain that they are likely to experience following specific procedures. [ABSTRACT FROM AUTHOR]