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Background: Early childhood caries remains a public health challenge and many interventions to manage this disease have focused on prevention during early infancy. Promoting oral health during pregnancy may also improve the oral health of children, however, there is limited evidence in Australia. The Midwifery Initiated Oral Health-Dental Service (MIOH-DS) was developed to train midwives to promote maternal oral health and a large trial showed the program substantially improved the oral health status, knowledge and behaviours of pregnant women. This study evaluated the long-term effectiveness of the program (post trial) on maternal oral health knowledge, preventative dental behaviours, and early childhood caries in offspring.Methods: A prospective cohort study was conducted in three large metropolitan health services in Sydney, Australia. The study followed 204 women and their children three to four years after participating in the original MIOH-DS trial (intervention and control groups). The outcome measures included child dental decay (cariogenic bacteria), and a maternal oral health knowledge and behaviours questionnaire. Descriptive statistics were used to analyse the main outcomes and a regression model was constructed to explore predictors of dental decay among children.Results: There were no significant differences across the outcome measures between the MIOH-DS participants (mother/child) and control groups except for a small difference in maternal oral health knowledge. Most mothers across both groups demonstrated high oral health knowledge and positive oral health practices, and the regression model found that these outcomes provided a protective effect (low levels of bacteria and dental caries) among children. Some aspects of oral health remained poorly understood by mothers across both groups―the oral health impact of sugary foods and drinks, at-risk feeding practices, and the recommended age for first dental visits.Conclusions: The long-term impact of the program demonstrates the effectiveness of improving maternal oral health knowledge and preventative behaviours to reduce the risk of early childhood caries, although the specific effect of the MIOH-DS program was not found. Although oral health knowledge was high across participants the findings suggest the need for reinforced education around feeding, diet and dental visiting through postnatal early childhood services to show sustained improvements.

In the evaluation of interdisciplinary interventions for childhood overweight and obesity, behavioural determinants can provide valuable insight into the reasons behind lack of adherence, or ineffectiveness of the intervention. Therefore, it is vital to assess the behavioural determinants of staff when evaluating the implementation of such interdisciplinary interventions. This study aimed to develop and psychometrically evaluate the intention to engage in Children's Healthy Weight guideline (iCHeW) scale, which assesses the behavioural determinants influencing dental staff's intention to conduct children's growth assessments.Initial items were generated based on review of the literature and the dimensions of the integrative model of behavioural prediction (IM). To test this scale, a cross-sectional survey design was undertaken consisting of three phases: (i) face validity; (ii) content validity; and (iii) psychometric evaluation of the iCHeW scale with a national sample of 125 dental staff.The 35 items generated for the iCHeW scale were revised following feedback from a reference group. These 35 items were then appraised by an expert panel, yielding 27 items for psychometric testing. Using exploratory factor analysis, a five-factor solution was extracted, which corresponded to the IM domains, with the deletion of two items. Overall, Cronbach's alpha of the iCHeW scale was 0.95, with the following values for each subscale: (i) attitudes, 0.93; (ii) behavioural constraints, 0.83; (iii) perceived norms, 0.93; (iv) self-efficacy, 0.94; and (v) behavioural intention, 0.95.The iCHeW scale is valid and reliable for assessing dental staff's intention to provide routine growth assessments to children and demonstrates potential for use with non-dental staff.

Objectives The aim of this retrospective study was to evaluate the outcome of preformed metallic crowns (PMC) utilizing the HT in carious primary molars for children treated within public dental clinics across the Sydney region. Materials and Methods A retrospective cohort study was designed, whereby two investigators evaluated 113 primary molars treated with HT PMCs involving 71 participants (aged between 5 and 11 years) after a minimum of 6 months post treatment. The mean time elapsed between crown placement (treatment) and the review was 1.42 years (17 months). The outcome of the HT was assessed by clinical and radiographic criteria. Results One hundred thirteen HT PMCs were reviewed from 71 participants. The overall success rate of PMCs placed utilizing the HT was 99%, with only one case presenting with confirmed failure. Conclusions HT PMCs have an overall high success rate as a treatment option in carious primary molars.

Background: People with an intellectual and/or developmental disability are at increased risk of adverse oral health outcomes and often require support from caregivers to assist in maintaining or seeking treatment for their oral health needs. However, caregivers and support workers are often family members with limited formal oral health training. Hence, the aim of this pilot study was to review the outcomes of the ‘Smiles for Life’ oral health education workshop with reference to their knowledge, attitudes, and practices of caregivers of people with an intellectual or developmental disability. Methods: A single group pre-test post-test intervention design was used to explore the preliminary effectiveness and appropriateness of the Smiles for Life oral health education workshop. Results: A total of 244 participants completed both the pre and post knowledge test. Oral health literacy scores decreased following the post test. Those with higher levels of education achieved higher post-training knowledge scores. Overall, caregivers reported satisfaction on the material presented however, it could be improved with more practical demonstrations. Conclusion: Providing an oral health education tool that caters to the diverse caregiver audience presents a unique set of challenges, despite oral health education in this professional group being vital. Future studies may benefit from reviewing the efficacy of a more tailored educational intervention.

Appropriately skilled staff are required to meet the health and care needs of aging populations yet, shared competencies for the workforce are lacking. This study aimed to develop multidisciplinary core competencies for health and aged care workers in Australia through a scoping review and Delphi survey. The scoping review identified 28 records which were synthesized through thematic analysis into draft domains and measurable competencies. Consensus was sought from experts over two Delphi rounds (n = 111 invited; n = 59 round one; n = 42 round two). Ten domains with 66 core competencies, to be interpreted and applied according to the worker's scope of practice were finalized. Consensus on multidisciplinary core competencies which are inclusive of a broad range of registered health professionals and unregistered aged care workers was achieved. Shared knowledge, attitudes, and skills across the workforce may improve the standard and coordination of person-centered, integrated care for older Australians from diverse backgrounds.

Aims and objectives To explore the experiences of food choice and meal service in residential aged care facilities and its impact on autonomy, self-determination and quality of life from the perspectives of both residents and staff. Background Globally, residential aged care is a principal provider of care for older people who can no longer live independently at home. Within this setting, lack of food choice has been identified as a significant factor impacting on residents' self-determination, sense of autonomy and quality of life. Design This study used an exploratory descriptive qualitative approach guided by self-determination theory. Method A total of 14 participants (seven residents and seven staff members) from two Australian residential aged care facilities were recruited through purposive and snowball sampling with assistance from one independent contact nurse at each facility. In-depth, semi-structured interviews were conducted, digitally recorded and transcribed. The COREQ checklist was used in this qualitative study. Results Three main themes were identified from the interview data provided by residents and staff, which were as follows: (a) catering for the masses; (b) organisational barriers to providing choice; and (c) food impacts well-being. Conclusions This study explored the experiences of food choice and service in residential aged care facilities, from the perspectives of both residents and staff. Results of interviews highlighted the importance of providing adequate food choice which has become an enduring issue that requires more attention and commitment to make a positive change for residents living in residential aged care facilities. Relevance to clinical practice Nurses and other staff working in residential aged care facilities need to be aware of the importance of providing adequate food choice, including for residents who require modified diets. As advocates for residents, nursing staff must address the persistent lack of food choice. However, this will require a radical change in organisational culture and strong leadership.

Aim This study aimed to explore the perceptions of residential aged care nursing and management staff regarding oral care, to develop strategies to improve the oral health of aged care residents. Design A qualitative approach was used. Methods Two focus groups were conducted with nursing and management staff at two residential aged care facilities and transcripts were thematically analysed. Results All staff had an awareness of the importance of oral health; however, they highlighted the significant challenges in the current system that affect implementation of oral health training and practice guidelines in the residential aged care facility. High staff turnover, time constraints, difficulties in accessing dental services and working together with residents, their families and external staff were barriers to providing oral health care. Staff highlighted the need for formalized clinical guidelines and processes and efficient dental referral pathways to create a more cohesive system of care.

We aimed to examine the prevalence of obesity among adolescents living in a refugee camp in Jordan and analyze the factors influencing their weight perceptions.Cross-sectional survey.We examined the body weight perception, and the influence of psychological, cultural, and social factors, among Palestinian refugee adolescents living in Jordan using a cross-sectional survey. Univariate, bivariate, and multiple logistic regression analyses were used to investigate the relationships between body weight status, weight perception, satisfaction with weight, screen time, and depression status of these adolescents.A total of 620 adolescents participated in the study, of which 24% were either overweight or obese. Overweight or obese adolescents were more likely to underestimate their weight (p.001), while those with depressive symptoms (Patient Health Questionnaire for Adolescents score14), were more likely to overestimate their body weight (p = .021). Having symptoms indicative of depression (adjusted odds ratio [AOR] = 1.70; 95% confidence interval [CI] = 1.16-2.50) and having a body mass index in the overweight/obese range (AOR = 4.16; 95% CI = 2.73-6.35) were predictors of discordant weight perception.This study showed that excess body weight is a significant issue among Palestinian refugee adolescents living in a refugee camp in Jordan. Underlying depression is an important factor in excess weight and distorted weight perceptions especially among this vulnerable group.The study highlights the importance of addressing discordant body weight perception and depression in weight management in nursing interventions for vulnerable adolescent groups.

Aim and objectives To examine the factors that influence nursing students' mathematics self-efficacy, the effect of numeracy instruction on self-efficacy, and the association between self-efficacy and numeracy test performance. Background Medication administration errors, including administering incorrect dosages or infusion rates, can result in serious harm to patients. Hence, it is essential that nursing students are adequately prepared with the necessary numeracy skills during their nursing program. Design This quasi-experimental cohort study used a pre- and post-test survey design. The study complied with the STROBE checklist for cohort research. Methods In total, n = 715 undergraduate first year nursing students participated in the study from June to October 2017 at a single multi-campus university in the Western Sydney region of Australia. Data were collected at three time-points: (a) baseline, including assessing pre-instruction mathematics self-efficacy (NSE-Math scale); (b) 6-week follow-up; including assessing post-instruction mathematics self-efficacy; and (c) numeracy test performance was collected at 7-week follow-up. Findings At baseline, those with high NSE-Math scale scores were more likely to be male and have at least high school advanced mathematics level education. Following structured numeracy instruction, NSE-Math scale scores increased significantly, and those who obtained a satisfactory grade in their numeracy assessment were more likely to have high NSE-Math scale scores and high academic performance in the previous semester. Conclusion The study shows that structured numeracy instruction improved mathematics self-efficacy, which in turn influenced numeracy test performance. Relevance to clinical practice Using a structured medication numeracy pedagogical approach, to teach skills in nursing undergraduate programs, provides students with the foundations to improve mathematics self-efficacy and to be successful and safe with medication numeracy calculations and administration in clinical practice.

Aims and objectives To synthesise evidence regarding vaccination intention, identify factors contributing to vaccine hesitancy among healthcare professionals and the general populations globally. Background As COVID-19 vaccine becomes available worldwide, attention is being directed to community vaccine uptake, to achieve population-wide immunity. A number of factors have been reported to influence vaccine intention. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of COVID-19 vaccination intention related literature published on or before 31 December 2020 from seven databases was undertaken. Results Thirty articles were included in this systematic review. Overall COVID-19 vaccination intention during the first year of the pandemic ranged from 27.7% to 93.3%. Findings highlighted that socio-demographic differences, perceptions of risk and susceptibility to COVID-19 and vaccine attributes influenced vaccination intention. Healthcare professionals particularly, nurses have higher vaccine hesitancy reportedly due to concerns regarding vaccine safety and efficacy and mistrust of health authorities. Negative information about COVID-19 vaccines in the social media and low confidence in the health system were associated with lower acceptability among the community. Interestingly, cumulative increase in COVID-19 caseloads of countries over time was not associated with vaccination intention. Conclusions The significant variability in vaccine intention rates worldwide would hamper efforts to achieve immunity against COVID-19. Nurses' concerns about vaccine safety and efficacy need to be addressed to increase vaccine acceptance and maximise their influence on vaccination decision in the community. As misinformation through social media negatively impacts vaccination uptake, authoritative and reliable information on vaccine attributes, disease risks and vaccination benefits are needed. Relevance to clinical practice Concerns about vaccine safety and efficacy including misinformation are important contributors to vaccine hesitancy. Addressing these factors, particularly among nurses who are considered trusted influencers of vaccination decisions in the community is an important strategy for pandemic preparedness.

Background Oral care is a fundamental nurse-led intervention in the critical care setting that provides patient comfort and prevents adverse outcomes in critically ill patients. To date, there has been minimal focus on nurse-focused interventions to improve adherence to oral care regimens in the adult intensive care unit setting. Objectives The objectives of this study were to (i) identify types and characteristics of interventions to improve oral care adherence amongst critical care nurses and intervention core components, (ii) evaluate the effectiveness of interventions to improve adherence of oral care regimens, and (iii) identify the types of outcome measures used to assess oral care regimen adherence. Design This is a systematic review in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources Key bibliographic databases and platforms, including Scopus, Cochrane, MEDLINE, CINAHL, Embase, PsycINFO, ProQuest, and Web of Science, were searched for studies published before July 2020. The Joanna Briggs Institute's quality appraisal tool was used to assess risk of bias in included studies. Results: A total of 21 original research studies were identified, of which 18 studies used multifaceted interventions. In accordance with the Joanna Briggs Institute's quality appraisal tools, four of the 20 quasi-experimental studies were rated as high quality. The one randomised control trial was of moderate quality. Outcome measures included oral care adherence behaviours, oral care knowledge, self-reported adherence, and documentation. Improved effectiveness in oral care adherence was reported in 20 studies. Conclusions Review findings confirm interventions to change behaviours improve oral care adherence. The most effective interventional approach could not be determined owing to heterogeneity in intervention design and outcome measures. Oral care in the intensive care unit is a vital, nurse-led activity that reduces the risk of hospital-acquired infection. It is recommended that future research adopt implementation science methods to ensure stakeholder engagement and feasibility. Systematic Review Registration Number This review was submitted and subsequently registered on PROSPERO, the International Perspective Register of Systematic Reviews PROSPERO 2019 CRD42019123142.

Patients with oral health problems often attend GPs instead of dentists, particularly in rural areas. There has been little research exploring challenges in providing oral health care in urban general practice. A cross-sectional survey of GPs in Greater Western Sydney explored their experiences, knowledge, confidence, and their oral health educational needs. Descriptive statistics and content analysis was undertaken. Forty-nine GPs reported experience of a wide range of oral health presentations. Approximately 60% were confident to undertake oral health examinations and determine the cause of acute toothache. Although 87% were confident providing preventative oral health advice, most did not include this in routine health assessments. Only 41% were confident explaining eligibility for public dental services. Barriers to providing oral health care were time constraints, lack of equipment and limited oral health training. Our research highlights oral health support and training needs in urban Australian general practice, as well as the need for systems-wide change to oral health training in outer urban settings to tackle health inequity, similar to those advocated in rural Australia.

Refugee youth living in Arab countries have disproportionately higher rates of depression due to the effects of displacement and trauma which makes screening a priority for early intervention. The Patient Health Questionnaire for Adolescents (PHQ-A) is a reliable and valid scale to assess mental health issues, but its psychometric properties in Arabic refugee populations are unknown. This was a cross-sectional study conducted between March and Mid-April 2018, among Arabic refugee adolescents aged 13-18 years living in the Baqa'a United Nations Relief and Works Agency refugee camp in Jordan, to generate an Arabic-language version of the questionnaire and to test its psychometric properties among adolescent refugees. Five hundred and ninety-one adolescents completed the PHQ-A in Arabic. Using SPSS and AMOS version 25, exploratory and confirmatory factor analyses were conducted and Cronbach's alpha coefficient was computed to assess construct validity and instrument reliability. Multivariate logistic regression analyses assessed the discriminant validity of the PHQ-A. Although exploratory factor analysis identified the nine items from the original version and explained only 37% of the variance, confirmatory factor analysis supported the one-factor structure of the PHQ-A. Cronbach's alpha coefficient for the scale was 0.82 and ranged from 0.79 to 0.81 for each item. The Arabic translated version of the Patient Health Questionnaire for Adolescents showed acceptable psychometric properties for use as a screening tool for depression in Arabic adolescent refugees.

© 2020 Australian College of Nursing Ltd Background: Oral health problems among people receiving palliative care are common and can significantly affect quality of life. Nurses are at the frontline of palliative care in Australia. However, how optimal oral health care is addressed in clinical practice by palliative nurses is not known. Aim: To explore the perceptions of nurses working in Australian palliative care settings to determine the acceptability, challenges and recommendations that need to be considered to develop and implement an oral health care model in palliative care settings. Methods: Two focus groups were conducted with community (n = 8) and inpatient nurses (n = 10) working in urban palliative care settings. Findings: Four main themes were developed through consensus: 1) Oral health is important in the palliative care setting; 2) Additional training could enhance what nurses already do; 3) Barriers to receiving oral care: a structural issue; 4) Exploring alternative pathways to dental services. Discussion: Nurses recognised the importance of oral health in palliative care; however, the paucity of set protocols based on existing guidelines meant that oral care was often unstructured. Systemic factors reduced the number of available options for people receiving palliative care to access professional dental treatment. Although alternative solutions, including teledentistry services, were explored, there were some constraints. Conclusion: A palliative care oral health model of care would need to integrate existing formal guidelines into a comprehensive framework specific for palliative care nurses and develop palliative care oral health training for them taking into consideration existing barriers for people to receive professional dental treatment.

Background Pregnant women in Australia seldom seek dental care and are unaware of its importance. To address these gaps the midwifery‐initiated oral health dental service (MIOH ‐DS ) program was comprehensive trialled and found effective. The aim of this study was to undertake a process evaluation of the MIOH ‐DS using the perspectives of pregnant women who participated in the trial. Methods A qualitative research design was utilized, whereby content analysis was undertaken on data from 11 semi‐structured interviews with women who participated in the program. Results All participants were receptive of the MIOH ‐DS intervention, and found it to be an acceptable intervention that met their needs, and encouraged future positive oral health practices and health‐seeking behaviours. They expressed that midwives were an appropriate professional to conduct oral health assessments, education and referrals to affordable dental services. Although some participants were initially apprehensive towards receiving treatment during pregnancy, dental staff members were able to appropriately educate and reassure them during treatment. Conclusions The MIOH ‐DS represents a promising and acceptable intervention strategy for pregnant women to promote their oral health. Findings merit further investigation on whether positive outcomes achieved can be sustained when implemented in other national or international settings similar to the study setting.

Introduction With the growing prevalence of childhood obesity worldwide, there is a need for interventions to identify and address overweight and obesity in childhood. Although guidelines recommend general practitioners routinely screen for overweight and obesity among children, research suggests this is often not done. To address this, dental practitioners may be able to play a role in identifying and addressing overweight and obesity among children. Methods This review aimed to explore the evidence and efficacy of existing obesity and overweight interventions targeting children in the dental setting. A systematic search of nine electronic databases was conducted to identify relevant published and grey literature. This was expanded to also include strategies for promoting oral health in the dental setting. Results A total of 11 records were included in this review, which focussed on the current role and effectiveness of dental practitioners in addressing obesity among children, and the available strategies and resources. Although there was a paucity of research on the training of dental practitioners in this area and their efficacy in identifying and addressing obesity among children, evidence suggests that parents found it acceptable for dental practitioners to promote healthy practices to children who experience overweight or obesity. This review also identified screening tools and strategies for identifying and addressing overweight and obesity among children in dental practice. Conclusion There is a clear role for dental practitioners in addressing overweight and obesity among children, however further research is required to identify the most effective interventions to implement in dental practice.

Background There is increasing concern regarding autonomy and quality of life for older people living in residential aged care. Failure to provide food choices and suitable dining environments has been reported to negatively impact their nutritional status, undermining their sense of autonomy and quality of life. Aim This paper presents an integrative review of studies on food choices in residential aged care and explores the relationships between food choices, autonomy and quality of life. Methods Search of nine databases CINAHL, PubMed, Scopus, PsycINFO, ProQuest, Cochrane, Embase, AMED, and Social Science Citation Index, identified nine primary articles. The Critical Appraisal Skill Program tool was used to examine the quality of these articles. Findings Three key themes were identified: (1) Prevalence of food choices and catering for residents' preference; (2) Importance of food choices to nutritional status; (3) Impact of food choices on autonomy and quality of life. The importance of increasing staff awareness and a need to develop aged care regulation to ensure adequate food choices provided. Discussion The importance of increasing staff awareness regarding the interrelatedness of respecting older people's food choices, autonomy and quality of life is identified. The needs of determining aged care regulation and accreditation standards were also highlighted. Conclusion Failure to provide satisfying food choices impacts older people's quality of life. However, the strength of the relationships between food choices, autonomy and quality of life requires further study.

Background Early childhood caries is the most common chronic childhood disease worldwide. Australian Aboriginal and Torres Strait Islander children are twice more likely to develop dental decay, and contributing factors include poor maternal oral health and underutilisation of dental services. Globally, Indigenous health workers are in a unique position to deliver culturally competent oral healthcare because they have a contextual understanding of the needs of the community. Methods This scoping review aimed to identify the role of Indigenous health workers in promoting maternal oral health globally. A systematic search was undertaken of six electronic databases for relevant published literature and grey literature, and expanded to include non-dental health professionals and other Indigenous populations across the lifespan when limited studies were identified. Results Twenty-two papers met the inclusion criteria, focussing on the role of Indigenous health workers in maternal oral healthcare, types of oral health training programs and screening tools to evaluate program effectiveness. There was a paucity of peer-reviewed evidence on the role of Indigenous health workers in promoting maternal oral health, with most studies focusing on other non-dental health professionals. Nevertheless, there were reports of Indigenous health workers supporting oral health in early childhood. Although some oral health screening tools and training programs were identified for non-dental health professionals during the antenatal period, no specific screening tool has been developed for use by Indigenous health workers. Conclusions While the role of health workers from Indigenous communities in promoting maternal oral health is yet to be clearly defined, they have the potential to play a crucial role in ‘driving’ screening and education of maternal oral health especially when there is adequate organisational support, warranting further research.

Background: People with intellectual disability (ID) experience poor oral health and are at greater risk of dental decay and periodontal diseases. This impacts on their general health and wellbeing...

Background: Maintaining good oral health remains a challenge among those hospitalised after stroke. Stroke nurses and allied health clinicians have a potential role in providing oral care, but no studies in Australia to date have explored their perceptions and needs. Aims: To explore the perspectives of nursing and allied health stroke clinicians regarding oral care for stroke patients across acute care and stroke rehabilitation settings. Methods: This study followed an exploratory qualitative design, using a constructivist approach. Participants from two metropolitan public hospitals were purposively recruited to participate in focus groups. Data was thematically analysed. Results: Twenty-one clinicians participated. Clinicians’ knowledge and practices relating to oral healthcare for stroke patients were inadequate. Most staff felt they did not have adequate knowledge, resources and training to administer oral care in this setting and proposed enhancing education of stroke clinicians, patients and informal caregivers, as well as improving quality point of care resources. There was overall support for the integrated dental care after stroke model of care. Discussion: This study revealed many gaps in current care and highlighted areas for improvement. Patients and their caregivers needed to be actively engaged as partners to improve oral healthcare within acute and rehabilitation stroke settings. Conclusion: This study provided insight into nurses’ and allied health stroke clinicians’ current knowledge and practices of oral care in various stroke settings. The findings from this study will inform development of a model of care to train stroke nurses in providing oral care.

Background: Maintaining good oral health among hospitalized individuals is essential for health outcomes and quality of life. Nurses, being the primary oral care givers require adequate knowledge, attitude and practice in this area to provide effective oral health care. However, limited studies have been undertaken to evaluate this aspect of nursing care in India. Aim: To determine the knowledge, attitude and practices of nurses regarding oral care for hospitalized patients. Design: Cross-sectional survey. Methods: A total of 244 nurses working in a tertiary care hospital in Bangalore, South India were purposively recruited for this study. Data was collected using a structured questionnaire with both closed and open-ended questions about knowledge, attitude and practice regarding oral care. Results: The mean oral health knowledge score was 6.74 out of maximum score of 22. Most nurses were aware of the importance of oral care among inpatients and the effect poor oral hygiene and systemic diseases have on oral health. Deficiencies in knowledge were prevalent in areas including common medications that affect oral health and regarding care of dentures. Nurses, with higher nursing qualifications and working in departments with longer length of stay had higher attitude scores. Most nurses assessed oral health needs within 24hrs of admission. However, there were inconsistencies in the oral health assessment and care protocols followed and documentation. Conclusion: Nurses' attitude towards oral health was positive yet their knowledge in specific aspects of care was inadequate. Their oral health practices needs improvement.

Background People with intellectual and developmental disability (IDD) have poor oral health and need support to maintain optimal oral health outcomes. Little is known about how, when and where to intervene for this population. Thus the aim of this review was to summarise the existing evidence surrounding improving oral health outcomes for people with IDD. Methods A scoping literature review was conducted focusing on ‘oral health’ and ‘intellectual disability’. Systematic searches of five electronic databases were conducted in line with the study aims and two authors independently examined all records for relevance, with consensus achieved by a third author. Results A small number of approaches and interventions were identified to support people with IDD to independently maintain optimal oral hygiene. Identified studies highlighted that caregivers play a vital role in the provision of oral health support, emphasising the effectiveness of educational interventions for caregivers. However, there was uncertainty regarding the efficacy of specific tooth brushing interventions for people with IDD. In cases of more severe IDD and/or dental-related behavioural problems, dental treatment under general anaesthesia was often both a necessary and effective method of oral health care provision. The findings also identified outreach and exclusive oral health services as successful strategies for increasing the limited access of people with IDD to oral care services. Conclusions A uniform approach to supporting oral health for people with IDD is unlikely to succeed. A system-based approach is needed to address the diverse needs of the population of people with IDD, their caregivers and service context. Further high quality evidence is required to confirm these findings.

The COVID-19 pandemic has resulted in many changes, including restrictions on indoor gatherings and visitation to residential aged care facilities, hospitals and certain communities. Coupled with potential restrictions imposed by health services and academic institutions, these changes may significantly impact the conduct of population health research. However, the continuance of population health research is beneficial for the provision of health services and sometimes imperative. This paper discusses the impact of COVID-19 restrictions on the conduct of population health research. This discussion unveils important ethical considerations, as well as potential impacts on recruitment methods, face-to-face data collection, data quality and validity. In addition, this paper explores potential recruitment and data collection methods that could replace face-to-face methods. The discussion is accompanied by reflections on the challenges experienced by the authors in their own research at an oral health service during the COVID-19 pandemic and alternative methods that were utilised in place of face-to-face methods. This paper concludes that, although COVID-19 presents challenges to the conduct of population health research, there is a range of alternative methods to face-to-face recruitment and data collection. These alternative methods should be considered in light of project aims to ensure data quality is not compromised.

Although guidelines recommend antenatal care providers such as midwives promote oral health during pregnancy, oral health training is not routinely provided in undergraduate midwifery curricula. The aim of this study was to implement an oral health module into an Australian undergraduate midwifery program, and evaluate its effectiveness in improving the oral health knowledge and confidence of midwifery students.Pre-test post-test study (2015-2017).An undergraduate midwifery program within an Australian university.All first-year undergraduate midwifery students enrolled in two core units at the above university (N = 56).Oral health modules were implemented into each of the two core units within the first year of the Bachelor of Midwifery course. Changes in knowledge and confidence were measured using a standardised questionnaire, administered at baseline, immediately following module completion, and at 2 and 3 years following module completion.44 students participated in the baseline survey (79% response rate), of which 41 completed the first post-module questionnaire, 21 completed the second post-questionnaire, and 24 completed the third post-questionnaire. Knowledge scores significantly increased from baseline (mean 13.12) to follow-up (mean 17.78, p 0.001), with increases being retained through to the 3-year mark (mean 18.29, p 0.001). Confidence scores also showed a sustained increase following the module, particularly regarding introducing oral health in the first antenatal appointment (62.1% increase, p 0.001) and referring pregnant women to a dentist (48.2% increase, p 0.001). However, the 48.2% increase (p 0.001) in confidence in conducting a visual mouth check on a pregnant woman following the module was not sustained at subsequent time points, reducing to a 31.5% increase (p = 0.118) by the third year post-module.The module is effective in improving and sustaining the knowledge and confidence of midwifery students to promote maternal oral health. Ongoing updates may be required to keep confidence high regarding visual mouth checks.

Objective This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Background Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. Materials and methods This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. Results The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. Conclusion This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services.

In residential aged care (RAC), malnutrition and unplanned weight loss among residents is an important quality indicator. A contributing factor is limited access to food choices in the facility that meet their personal food preferences.

Issue addressed Australian Aboriginal children have a higher risk of dental caries yet there is limited focus on oral health risk factors for urban Aboriginal preschool children. This study examined the oral health behaviours and fluid consumption practices of young children from an urban Aboriginal community in south-western Sydney, Australia. Methods In total, 157 Aboriginal children who were recruited to the "Gudaga" longitudinal birth cohort participated in this study. A survey design was employed and parents responded to the oral health questions when their child was between 18 and 60 months. Results Few parents (20%) were concerned about their child's oral health across the time period. By 60 months, only 20% of children had seen a dentist while 80% were brushing their teeth at least once daily. High levels of bottle use were seen up to 30 months. Consumption of sugary drinks was also very high in the early years, although this was replaced by water by 36 months. Conclusions While there are some encouraging findings, such as the rates of tooth brushing and increasing rates of water consumption, the findings do highlight the poor uptake of dental services and high levels of bottle usage among urban aboriginal children during their early years. SO WHAT?: Targeted oral health promotional programs are needed in the urban Aboriginal community to better support parents understanding of good oral health practices in the early years and engagement with dental health services.

Due to an ageing workforce, there is a growing need for greater numbers of nurses to work in areas, such as mental health and alcohol and other drugs (AOD) rehabilitation. These practitioners need to approach their work as ‘recovery-oriented practitioners’. Positive experiences and preceptorship during clinical placement in AOD rehabilitation settings might influence students’ later career choices and address some of the workforce shortage issues. The aim of the present concurrent, mixed-methods study was to explore students’ perceptions of their clinical placement experience in a community-based AOD rehabilitation setting, and to examine attitude, career intention, and satisfaction with the placement. Fifty-eight students completed pre–post-test surveys, with closed and open-ended questions, which included standardized measures. A small sample of survey respondents also agreed to participate in a semistructured interview. The quantitative results revealed two predictors for higher intention to pursue a career in AOD: (i) a high satisfaction with their clinical placement (β = 0.29, P = 0.008); and (ii) a high baseline attitude to recovery-oriented practice (β = 0.28, P = 0.013). The qualitative findings identified five factors influencing placement experience: (i) educational factors; (ii) students’ background factors; (iii) placement factors; (iv) client factors; and (v) staff factors. A model that synthesizes the quantitative and qualitative findings was also developed. In conclusion, clinical placement in a community-based AOD rehabilitation centre improved students’ intention to work in that setting.

Background Studies internationally show a lack of consensus among dentists regarding perinatal oral health yet no study in Australia has explored the perceptions of dentists in this area. This study aims to determine the knowledge, perceptions and practises of dentists in New South Wales (NSW), Australia, about perinatal oral health. Methods An online survey was distributed to 1357 members of the Australian Dental Association (NSW) and 185 (13.4%) completed surveys were returned. Results Most dentists (99%) stated that pregnant women should receive a dental check, yet only 20% agreed that there was a good understanding among health professionals on this topic. Dentists were aware of safe dental practises during pregnancy but had limited knowledge about the association between periodontal disease and birth outcomes. Dentists were more likely to advise pregnant women to delay dental visits when there was a perceived lack of knowledge of the risks involved (odds ratio, 2.157) or were concerned about providing treatment without consent from their general practitioner (odds ratio, 2.449). Most dentists (95.7%) stated that they wanted further information about dental care during pregnancy. Conclusions Findings suggest a need for continuing education for dentists and practise guidelines on perinatal oral health. Further research with a national sample is recommended to confirm these findings.

Background There is mounting evidence to support the lack of awareness among pregnant women about health consequences and long term risks associated with poor oral hygiene during pregnancy. A recognised and important point of influence is their interaction with health professionals, particularly when receiving Antenatal Care. However, there is limited evidence about the perceptions of ANC providers in Australia toward the provision of perinatal oral healthcare. This study was undertaken to explore the knowledge, attitudes and practices of Antenatal Care ( ANC ) providers in New South Wales ( NSW ), Australia providing perinatal oral healthcare and to identify barriers to and predictors of their practices in this area. Methods: A cross sectional survey was undertaken of ANC providers ( general practitioners, obstetricians/gynaecologists and midwives ) practising in NSW, Australia. Participants were recruited through their professional organisations via email, postal mail, and networking at conferences. The survey addressed the domains of knowledge, attitude, barriers and practices towards oral healthcare, along with demographics. Data was entered into SPSS software and analysed using descriptive and inferential statistics. Results: A total of 393 surveys ( 17.6% response rate ) were completed comprising 124 general practitioners, 74 obstetricians/gynaecologists and 195 midwives. The results showed limited knowledge among ANC providers regarding the impact of poor maternal oral health on pregnancy/infant outcomes. Most ( 99% ) participants agreed that maternal oral health was important yet few were discussing the importance of oral health or advising women to visit a dentist ( 16.4–21.5% ). Further, less than a third felt they had the skills to provide oral health advice during pregnancy. ANC providers who were more knowledgeable about maternal oral health, had training and information in this area and greater experience, were more likely to engage in practices addressing the oral health of pregnant women. Conclusion: The findings suggest that ANC providers in NSW are not focussing on oral health with pregnant women. ANC providers seem willing to discuss oral health if they have appropriate education/training and information in this area. Further research at a national level is required to confirm whether these findings are similar in all Australian states.

Background The collection of sensitive data can arouse emotional reactions and researchers may have difficulty distancing themselves from personal stories. Debriefing can address the emotional effect of an experience on researchers. Aim To explore the debrief responses of three research assistants who were involved in the review of retrospective charts and medical notes in a study that examined the risk factors for readmission in young people with anorexia nervosa. Discussion Based on a review of the responses, the principal research team reflected on the value and effectiveness of a debrief tool for research assistants entering sensitive quantitative data. The paper highlights these reflections. Conclusion The use of an electronic debrief tool, while not without its challenges, provides an opportunity for individual reflection and a platform for emotional release for researchers engaged in sustained and intensive collection of sensitive data. This type of tool may serve as a guide for research teams and assist them in monitoring the well-being of those collecting sensitive data. We also advocate that a debriefing tool may contribute to closure for research assistants who become emotionally invested and affected by meticulous quantitative data entry. Implications for practice This paper provides recommendations for future use of an electronic debrief tool for researchers collecting sensitive data.