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Background: Osteoarthritis (OA) is a prevalent, chronic joint condition that commonly affects the knee and hip causing pain, impaired function, and reduced quality of life. As there is no cure, the main goal of treatment is to alleviate symptoms via ongoing self-management predominantly consisting of exercise and weight loss (if indicated). However, many people with OA do not feel adequately informed about their condition and management options to self-manage effectively. Patient education is recommended by all OA Clinical Practice Guidelines to support appropriate self-management, but little is known about the optimal delivery method and content. Massive Open Online Courses (MOOCs) are free, interactive, e-learning courses. They have been used to deliver patient education in other chronic health conditions but have not been used in OA. Methods: A two-arm parallel-design, assessor- and participant-blinded superiority randomised controlled trial. People with persistent knee/hip pain consistent with a clinical diagnosis of knee/hip OA (n = 120) are being recruited from the Australia-wide community. Participants are randomly allocated into one of two groups i) electronic information pamphlet (control group) or ii) MOOC (experimental group). Those allocated to the control group receive access to an electronic pamphlet about OA and its recommended management, currently available from a reputable consumer organisation. Those allocated to the MOOC receive access to a 4-week 4-module interactive consumer-facing e-Learning course about OA and its recommended management. Course design was informed by behaviour theory and learning science, and consumer preferences. The two primary outcomes are OA knowledge and pain self-efficacy with a primary endpoint of 5 weeks and a secondary endpoint of 13 weeks. Secondary outcomes include measures of fear of movement, exercise self-efficacy, illness perceptions, OA management and health professional care seeking intentions, physical activity levels, and actual use of physical activity/exercise and weight loss, pain medication, and health professional care seeking to manage joint symptoms. Clinical outcomes and process measures are also collected. Discussion: Findings will determine whether a comprehensive consumer-facing MOOC improves OA knowledge and confidence to self-manage joint pain compared to a currently available electronic OA information pamphlet. Trial registration: Prospectively registered (Australian New Zealand Clinical Trials Registry ID: ACTRN12622001490763). [ABSTRACT FROM AUTHOR]

Background: The Matthey Generic Mood Questionnaire (MGMQ) provides a rapid screen of clinically significant emotional difficulties in adults. This study aimed to investigate associations between the MGMQ and Depression Anxiety Stress Scales short-form (DASS-21) and how well the MGMQ detects women scoring high on the DASS-21 in pregnancy and 1 and 2 years postpartum.Methods: Pregnant Australian, English-speaking women were recruited from 10 maternity hospitals across two states (for the "right@home" trial, N=729). Prioritized for their experience of social adversity (2 or more of 10 risk factors), they completed the 2-item MGMQ and 21-item DASS-21 in pregnancy and at 1 and 2 years postpartum. DASS-21 Total and subscale scores were classified "high" based on (a) normed percentiles for top 15% and (b) clinical cut-points.Results: The MGMQ and DASS-21 were completed within 7 days of each other by 296 (41%) women in pregnancy, 625 (86%) at 1 year and 573 (79%) at 2 years. Associations between the measures were weak-to-moderate in pregnancy and moderate-to-strong in the postpartum years. Most women scoring "high" on the DASS-21 could be identified with various thresholds of the MGMQ.Limitations: Pregnant women with 0 or 1 risk factor were excluded; the DASS-21 is not a perinatal specific measure nor a gold standard diagnostic tool.Conclusions: The MGMQ and DASS-21 appeared to assess overlapping but distinct constructs of mental health. These findings can help clinicians and researchers decide whether to use the MGMQ, and which balance of sensitivity, specificity and correct classification will suit their needs. [ABSTRACT FROM AUTHOR]

Background: This study investigated the preferences of dentists in Australia in providing professional implant maintenance and implant‐specific oral hygiene instructions (OHI). Methods: General dentists were surveyed online about their preferences in peri‐implant diagnostics, maintenance provision, armamentarium used, and implant OHI techniques and frequency. Results: Most of the 303 respondents (96%) provided maintenance services; 87.6% reviewed implants regularly while 10.7% only performed diagnostics after detecting clinical signs/symptoms. Supragingival prosthesis cleaning was performed by 77.9% of respondents, 35.0% performed subgingival debridement, 41.9% treated peri‐implant mucositis and 18.2% treated peri‐implantitis. About 15% did not treat nor refer peri‐implant disease, including significantly more non‐implant providers and dentists without implant training. Maintenance armamentarium commonly included floss (76.3%), prophylaxis (73.9%), plastic curettes (43.3%) and stainless‐steel ultrasonics (38.0%). Brushing (86.5%), flossing (73.9%) and interdental brush use (68.3%) were most commonly recommended. Implant OHI was repeated routinely by 57.4% of dentists who provided it. Dentists with greater implant training and experience were more likely to perform reviews and complex maintenance procedures. Conclusions: Peri‐implant diagnostics performed, treatments provided and armamentarium varied among dentists. Implant providers and those with higher levels of training had more preventative approaches to implant OHI. Possible shortcomings in disease management and OHI reinforcement were identified. [ABSTRACT FROM AUTHOR]

Background: This study aimed to understand trends in dentists' implant training attendance and correlation to treatment provision. Implant-specific oral hygiene instruction coverage in training programs was investigated.Methods: A cross-sectional web-survey of dentists registered in Australia was conducted. Respondents were asked about their background, implant training history and treatment provision. Results were analysed by implant provision characteristics and graduation decade.Results: Three hundred and three responses from general dental practitioners (GDPs) were received and analysed. The highest implant training levels attained post-graduation were postgraduate non-specialist qualification (7.9% of respondents), continuing professional development (CPD) (73.6%) versus none (18.5%), with differences between implant providers and non-providers (P < 0.001), different graduation decades (P < 0.001) and those restoring implants or performing surgery as well (P < 0.001). University-based CPD was attended less than dental association/society or implant company CPD. Non-providers were significantly less likely to recall implant oral hygiene instruction sources (P < 0.001). Most GDPs (74.9%) provided implant services, with younger GDPs beginning earlier after graduation. About 16% of respondents did not provide implants once established career-wise.Conclusions: Dentists might be providing implant treatments increasingly earlier in their careers. Respondents with more training were significantly more likely to perform more complex procedures, while implant training attendance trends varied by graduation decade. [ABSTRACT FROM AUTHOR]

Background: A phase-down of amalgam in Australia is possible given the Australian Government intends to ratify the Minamata Convention. There is little research as to the influence of a dentist's knowledge on decision-making, which may be of use when determining the impact of any change.Methods: An online survey relating to aspects of and attitudes to use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association or Members or Fellows of the Royal Australasian College of Dental Surgeons.Results: There were 408 respondents. Fifty-eight per cent agreed that there was consistency in undergraduate teaching. Fifty-two per cent stated that there was a difference between undergraduate teaching and the 'real world'. Postgraduate education was ranked the most important influence on decision-making. Ninety-six per cent stated that knowledge of the evidence base is important and 89% believed that they practised evidence-based dentistry.Conclusions: Dental schools need to maintain teachers' and students' understanding of the evolving technology of direct restorative materials. There is a perceived disconnect between undergraduate teaching and the 'real' world. The evidence base is viewed as confusing, contradictory and not readily understandable. The creation of clinical guidelines would be useful. [ABSTRACT FROM AUTHOR]

Background: The Minamata Convention embodies a worldwide reduction in the production and use of mercury and mercury-containing products and processes, including a phase-down of dental amalgam. This will change the approach to the use of direct restorative materials in the near future. There is little research as to the influence of clinical factors on dentists' decision-making which may be of use when determining the impact of any change.Methods: An online survey relating to aspects of and attitudes to the use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association and/or members or fellows of the Royal Australasian College of Dental Surgeons. Data were statistically analysed.Results: There were 408 respondents to the survey. Eighty-seven per cent of respondents (strongly) disagreed that amalgam was a technically more difficult material to place compared with resin composite, 82% (strongly) disagreed that placement time for amalgam was longer than that for resin composite and 69% (strongly) disagreed that amalgam was more difficult to finish than resin composite. Eighty-three per cent of respondents stated they were confident in their ability to place amalgam restorations. Where physical properties were of importance, indirect restorations were preferred (e.g. parafunction) 54%. The factors considered most important when choosing a direct restorative material included moisture control and aesthetics; least important factors were cost and time to place.Conclusions: There is consensus that amalgam is not more technically difficult to use, place or finish than resin composite and vice versa. There is recognition that both amalgam and resin composite have limitations in terms of physical properties. When choosing a direct restorative material, clinical factors considered to be of greatest importance are moisture control, aesthetics and the need to apply minimally invasive approaches. There is little difference in the opinions of users and non-users of amalgam with respect to these findings. [ABSTRACT FROM AUTHOR]

Background: The Minamata Convention has agreed to a worldwide reduction in the production and use of mercury-containing products and processes. This will change the approach to use of direct restorative materials in the future. There is little research exploring the attitudes of dentists to any change.Methods: A survey relating to the use of direct restorative materials was distributed to dentists who were members of the Australian Dental Association or Members and Fellows of the Royal Australasian College of Dental Surgeons. Data were statistically analysed.Results: There were 408 respondents. Responses to statements concerning attitudes toward a phase-down of amalgam depended on whether the respondent used amalgam, year of primary dental qualification and association with academia. Thirty per cent of respondents indicated they do not use amalgam. The mean use of amalgam for all direct restorative procedures was 18%.Conclusions: Dentists are concerned over potential implications of a phase-down of amalgam and much should be done to address these concerns. Many dentists are undecided as to what are the implications, which may reflect a lack of understanding of the issues. It is incumbent on policy-makers to produce and disseminate information relating to the issues identified by this research. [ABSTRACT FROM AUTHOR]

One of the biggest challenges currently facing the dental profession in Australia is the provision of quality and timely dental care to the elderly. Adults aged 65+ years are an exponentially growing section of the community with rapidly changing dental needs, thanks in part to improvements in oral health over the past 60 years that have resulted in a dramatically decreased rate of edentulism and subsequently an increased number of teeth present. This is a challenge not only for the public dental services, but also public health policy makers, private dental practitioners, professional organizations and dental education providers. It is an issue that crosses a range of dental care providers, not only dentists but also dental prosthetists and dental hygienists, whose role in the provision of dental services has been slowly growing in Australia. Furthermore, with evidence of links between oral and systemic health, this issue has significant impacts for the broader health system. [ABSTRACT FROM AUTHOR]

Public dental patients suffer from poorer oral health than the general population. Management of dental caries tends to focus on surgical interventions, such as restorations and extractions, rather than prevention and early intervention of the disease process. The current public dental system struggles to address the lifestyle and broader health issues affecting oral health and although an immediate dental problem can usually be alleviated, it can often be through the unnecessary removal of tooth structure, which invariably leads to other health and quality of life problems. There is widespread recognition by oral health clinicians that the restorative approach to the management of dental caries in the public sector is failing to improve oral health outcomes for many public patients. Oral health experts have recently adopted a national consensus statement on minimum intervention dentistry indicating their intention to work together to develop ways to implement this approach across the public dental sector. It is clear that, despite some significant challenges and required changes, the momentum for minimum intervention dentistry continues to grow across Australia. There is an urgent need to undertake research to assess the cost-effectiveness of this approach in the public sector. [ABSTRACT FROM AUTHOR]

Studies have described the value of international clinical placements from the student perspective. However, little has been reported on the experiences of clinical facilitators during international clinical placements. This study is part of a larger study that explored shared learning experiences of Australian and Balinese midwifery students and clinical facilitators during a two-week international clinical placement in Bali, Indonesia. This paper reports on the experiences of clinical facilitators from both visiting and host countries in facilitating Australian and Balinese midwifery students whilst on clinical placement in Bali. A qualitative research design using focus group discussion was used to gain insight into the experience of the clinical facilitators. Data was analysed using thematic analysis and three broad themes emerged, those being "new experiences", "differences in midwifery practice" and "revised learning approach". New experiences included learning together and English language challenges. Working together allowed the exploration of midwifery practice differences between countries and an appreciation of the different approaches to teaching and learning practices. These findings suggest that international midwifery placements benefit clinical facilitators from host and visiting countries through learning together, creating new experiences and exploring different midwifery and facilitation practices. • International midwifery placements benefit clinical facilitators from host and visiting countries. • Clinical facilitators experience themselves as learners on international placement. • Immersion in the placement formed relationships that overcame language barriers. • Clinical facilitators appreciate shared learning about teaching and student support. [ABSTRACT FROM AUTHOR]

Background: Articaine is a new local anaesthetic drug introduced to the Australian dental market. The aim of this study was to elicit information regarding the use of articaine in Australia, and factors that influence attitudes towards adoption of new technology. Methods: A self-administered postal questionnaire was sent to a stratified systematic sample of dentists who were members of the Australian Dental Association, with questions regarding details about articaine use and how influences such as education and scientific literature affect their adoption of new technology. Results: Of the sample, 53% responded and over 70% of dentists surveyed used articaine, with 95% and 97% of respondents identifying scientific literature and continuing professional development courses respectively as influencing factors in their adoption of new technology. The most common reason for not using articaine was no perceived advantage and the most influential factor that would encourage non-users to start using articaine was a scientifically proven advantage. Senior clinicians, specialists and public sector dentists were less likely to use articaine. Conclusions: A majority of Australian dentists were using articaine and cited continuing professional development courses, scientific literature and anecdotal peer reports as being influential in their adoption of new technology. [ABSTRACT FROM AUTHOR]

The assessment of cognition in Indigenous populations is often complicated by cultural and language differences and unfamiliarity with the assessment process. Cognitive tasks are being developed that reduce the impact of these factors. These processes need to be evaluated in different cultural and ethnic groups to determine whether they are appropriate. Such an assessment was recently used in two studies of cognition of 237 Indigenous Australian adolescents (age: M = 16.06 ± 2.16 years). The tasks were completed appropriately, with response times and error rates increasing for difficult tasks. Duration and error rates decreased for the round-based tasks, in line with performance in non-Indigenous samples. There were no gender effects. Age associations occurred in some tasks, but significant correlations were only of a small magnitude. Although the battery appeared to be completed appropriately in this study, more work needs to be conducted examining the influence of demographic factors to ensure that control data can be most appropriately matched in future studies. [ABSTRACT FROM AUTHOR]