Developing a national dental education research strategy:priorities, barriers and enablers

Objectives: This study aimed to identify national dental education research (DER) priorities for the next 3-5 years and to identify barriers and enablers to DER. Setting: Scotland Participants: In this two-stage online questionnaire study we collected data with multiple dental professions (e.g. dentistry, dental nursing, dental hygiene) and stakeholder groups (e.g. learners, clinicians, educators, managers, researchers, academics). Eighty-five participants completed the Stage 1 qualitative questionnaire and 649 participants the Stage 2 quantitative questionnaire. Results: Eight themes were identified at Stage 1. Of the 24 DER priorities identified, the top three were: role of assessments in identifying competence; undergraduate curriculum prepares for practice; and promoting teamwork. Following exploratory factor analysis, the 24 items loaded onto four factors: teamwork and professionalism, measuring and enhancing performance, dental workforce issues, and curriculum integration and innovation. Barriers and enablers existed at multiple levels: individual, interpersonal, institutional structures and cultures, and technology. Conclusion: This priority setting exercise provides a necessary first step to developing a national DER strategy capturing multiple perspectives. Promoting DER requires improved resourcing alongside efforts to overcome peer stigma and lack of valuing and motivation

Victim/survivor-focused justice responses and reforms to criminal court practice: implementation, current practice and future directions

Abstract: Reforms have been underway over the last three decades to address the disadvantages that victim/survivors of sexual assault face within the criminal justice system in Australia. Such reforms include expansion of advocate services, specialisation of police, alternative provisions for giving evidence at trial, and changes to jury instructions. This report was commissioned to examine the implementation of these reforms and their impact on the victim/survivor experience. Drawing on interviews with 81 criminal justice professionals including counsellors, lawyers, and judges, it looks at victim/survivor-focused approaches, promising and innovative practices, the take up of reforms, the factors that enable or inhibit victim-focused reforms being embedded in court practices, and the potential for future reform

Future internet enablers for VGI applications

This paper presents the authors experiences with the development of mobile Volunteered Geographic Information (VGI) applications in the context of the ENVIROFI project and Future Internet Public Private Partnership (FI-PPP) FP7 research programme.FI-PPP has an ambitious goal of developing a set of Generic FI Enablers (GEs) - software and hardware tools that will simplify development of thematic future internet applications. Our role in the programme was to provide requirements and assess the usability of the GEs from the point of view of the environmental usage area, In addition, we specified and developed three proof of concept implementations of environmental FI applications, and a set of specific environmental enablers (SEs) complementing the functionality offered by GEs. Rather than trying to rebuild the whole infrastructure of the Environmental Information Space (EIS), we concentrated on two aspects: (1) how to assure the existing and future EIS services and applications can be integrated and reused in FI context; and (2) how to profit from the GEs in future environmental applications.This paper concentrates on the GEs and SEs which were used in two of the ENVIROFI pilots which are representative for the emerging class of Volunteered Geographic Information (VGI) use-cases: one of them is pertinent to biodiversity and another to influence of weather and airborne pollution on users’ wellbeing. In VGI applications, the EIS and SensorWeb overlap with the Social web and potentially huge amounts of information from mobile citizens needs to be assessed and fused with the observations from official sources. On the whole, the authors are confident that the FI-PPP programme will greatly influence the EIS, but the paper also warns of the shortcomings in the current GE implementations and provides recommendations for further developments

Towards a Layered Architectural View for Security Analysis in SCADA Systems

Supervisory Control and Data Acquisition (SCADA) systems support and control the operation of many critical infrastructures that our society depend on, such as power grids. Since SCADA systems become a target for cyber attacks and the potential impact of a successful attack could lead to disastrous consequences in the physical world, ensuring the security of these systems is of vital importance. A fundamental prerequisite to securing a SCADA system is a clear understanding and a consistent view of its architecture. However, because of the complexity and scale of SCADA systems, this is challenging to acquire. In this paper, we propose a layered architectural view for SCADA systems, which aims at building a common ground among stakeholders and supporting the implementation of security analysis. In order to manage the complexity and scale, we define four interrelated architectural layers, and uses the concept of viewpoints to focus on a subset of the system. We indicate the applicability of our approach in the context of SCADA system security analysis.Comment: 7 pages, 4 figure

Implementation of repeat HIV testing during pregnancy in Kenya: a qualitative study.

BackgroundRepeat HIV testing in late pregnancy has the potential to decrease rates of mother-to-child transmission of HIV by identifying mothers who seroconvert after having tested negative for HIV in early pregnancy. Despite being national policy in Kenya, the available data suggest that implementation rates are low.MethodsWe conducted 20 in-depth semi-structured interviews with healthcare providers and managers to explore barriers and enablers to implementation of repeat HIV testing guidelines for pregnant women. Participants were from the Nyanza region of Kenya and were purposively selected to provide variation in socio-demographics and job characteristics. Interview transcripts were coded and analyzed in Dedoose software using a thematic analysis approach. Four themes were identified a priori using Ferlie and Shortell's Framework for Change and additional themes were allowed to emerge from the data.ResultsParticipants identified barriers and enablers at the client, provider, facility, and health system levels. Key barriers at the client level from the perspective of providers included late initial presentation to antenatal care and low proportions of women completing the recommended four antenatal visits. Barriers to offering repeat HIV testing for providers included heavy workloads, time limitations, and failing to remember to check for retest eligibility. At the facility level, inconsistent volume of clients and lack of space required for confidential HIV retesting were cited as barriers. Finally, at the health system level, there were challenges relating to the HIV test kit supply chain and the design of nationally standardized antenatal patient registers. Enablers to improving the implementation of repeat HIV testing included client dissemination of the benefits of antenatal care through word-of-mouth, provider cooperation and task shifting, and it was suggested that use of an electronic health record system could provide automatic reminders for retest eligibility.ConclusionsThis study highlights some important barriers to improving HIV retesting rates among pregnant women who attend antenatal clinics in the Nyanza region of Kenya at the client, provider, facility, and health system levels. To successfully implement Kenya's national repeat HIV testing guidelines during pregnancy, it is essential that these barriers be addressed and enablers capitalized on through a multi-faceted intervention program

Chronic illness care for Aboriginal and Torres Strait Islander people: final report

This project engage a range of stakeholders across different levels of the primary health care system, including service providers, management, policy-makers and researchers and capture their knowledge on the barriers and enablers to addressing the identified priority-evidence practice gaps and their suggestions on strategies for improvement. Overview The purpose of this project is to engage key stakeholders in the use of aggregate continuous quality improvement (CQI) data to identify and address system-wide evidence-practice gaps in Aboriginal and Torres Strait Islander chronic illness care. We aimed to engage a range of stakeholders across different levels of the primary health care (PHC) system, including service providers, management, policy-makers and researchers and capture their knowledge on the barriers and enablers to addressing the identified priority-evidence practice gaps and their suggestions on strategies for improvement. Our research has highlighted the wide variation in performance between different aspects of care and between health centres. While many aspects of care are being done well in many health centres, there are important gaps between evidence and practice in some aspects of PHC. System-wide gaps are likely to be due to deficiencies in the broader (PHC) system, indicating that system-level action is required to improve performance. Such system-level action should be developed with a deep understanding of the holistic nature of Aboriginal and Torres Strait islander wellbeing beyond just physical health (including healthy connections to culture, community and country), of the impact of Australian colonist history on Aboriginal and Torres Strait Islander people, and of how social systems – including the health system - should be shaped to meet the needs of Aboriginal and Torres Strait Islander people. This project aims to build on the collective strengths within PHC services in order to continue improving the quality of care for Aboriginal and Torres Strait Islander communities

A brief report on the development of a theoretically-grounded intervention to promote patient autonomy and self-management of physiotherapy patients: Face validity and feasibility of implementation

Background Clinical practice guidelines for the treatment of low back pain suggest the inclusion of a biopsychosocial approach in which patient self-management is prioritized. While many physiotherapists recognise the importance of evidence-based practice, there is an evidence practice gap that may in part be due to the fact that promoting self-management necessitates change in clinical behaviours. Evidence suggests that a patient’s motivation and maintenance of self-management behaviours can be positively influenced by the clinician’s use of an autonomy supportive communication style. Therefore, the aim of this study was to develop and pilot-test the feasibility of a theoretically derived implementation intervention to support physiotherapists in using an evidence-based autonomy supportive communication style in practice for promoting patient self-management in clinical practice. Methods A systematic process was used to develop the intervention and pilot-test its feasibility in primary care physiotherapy. The development steps included focus groups to identify barriers and enablers for implementation, the theoretical domains framework to classify determinants of change, a behaviour change technique taxonomy to select appropriate intervention components, and forming a testable theoretical model. Face validity and acceptability of the intervention was pilot-tested with two physiotherapists and monitoring their communication with patients over a three-month timeframe. Results Using the process described above, eight barriers and enablers for implementation were identified. To address these barriers and enablers, a number of intervention components were selected ranging from behaviour change techniques such as, goal-setting, self-monitoring and feedback to appropriate modes of intervention delivery (i.e. continued education meetings and audit and feedback focused coaching). Initial pilot-testing revealed the acceptability of the intervention to recipients and highlighted key areas for refinement prior to scaling up for a definitive trial. Conclusion The development process utilised in this study ensured the intervention was theory-informed and evidence-based, with recipients signalling its relevance and benefit to their clinical practice. Future research should consider additional intervention strategies to address barriers of social support and those beyond the clinician level