Extending dental nurses' duties: a national survey investigating skill-mix in Scotland's child oral health improvement programme (Childsmile)

Background: Childsmile is Scotland’s national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses’ ability to fully deliver their extended roles is necessary to ensure nurses’ potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs’ roles by EDDNs, in general dental practice across Scotland. Methods: A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses’: role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. Results: Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). Conclusions: This study has provided insight into EDDNs’ experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs’ roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement

Communicating Ethical Arguments to Organic Consumers: A Study Across Five European Countries

Additional ethical claims were tested with mock organic egg labels in five EU countries. The attitudes towards the advertising labels were assessed by multiple copy testing measures. A total of 156 individual responses were analysed. The study confirms the difficulty of conducting advertising research in a multicultural framework, and shows that additional local/ regional claims can reinforce the appeal of organic products

Virtual patient design : exploring what works and why : a grounded theory study

Objectives: Virtual patients (VPs) are online representations of clinical cases used in medical education. Widely adopted, they are well placed to teach clinical reasoning skills. International technology standards mean VPs can be created, shared and repurposed between institutions. A systematic review has highlighted the lack of evidence to support which of the numerous VP designs may be effective, and why. We set out to research the influence of VP design on medical undergraduates. Methods: This is a grounded theory study into the influence of VP design on undergraduate medical students. Following a review of the literature and publicly available VP cases, we identified important design properties. We integrated them into two substantial VPs produced for this research. Using purposeful iterative sampling, 46 medical undergraduates were recruited to participate in six focus groups. Participants completed both VPs, an evaluation and a 1-hour focus group discussion. These were digitally recorded, transcribed and analysed using grounded theory, supported by computer-assisted analysis. Following open, axial and selective coding, we produced a theoretical model describing how students learn from VPs. Results: We identified a central core phenomenon designated ‘learning from the VP’. This had four categories: VP Construction; External Preconditions; Student–VP Interaction, and Consequences. From these, we constructed a three-layer model describing the interactions of students with VPs. The inner layer consists of the student's cognitive and behavioural preconditions prior to sitting a case. The middle layer considers the VP as an ‘encoded object’, an e-learning artefact and as a ‘constructed activity’, with associated pedagogic and organisational elements. The outer layer describes cognitive and behavioural change. Conclusions: This is the first grounded theory study to explore VP design. This original research has produced a model which enhances understanding of how and why the delivery and design of VPs influence learning. The model may be of practical use to authors, institutions and researchers

The Effects of Linguistic Features and Evaluation Perspective on Perceived Difficulty of Medical Text

Millions of laypersons need more medical information than they are customarily provided during their doctor’s visit. Health websites can help fill this knowledge gap, but the text is believed to be too difficult to understand for many laypersons. To help write text that is not perceived as too difficult and leads to better comprehension (actual difficulty), we study how linguistic structures influence text difficulty. Since perceived difficulty has been shown to be a barrier to self-education, evaluating perceived difficulty is an essential first step to take. In this study, we evaluated the impact of noun phrase complexity and of function word density in four sentence structures (active, passive, sentential or extraposed subject). Complex noun phrases significantly increased perceived difficulty while using more function words significantly decreased perceived difficulty. Furthermore, laypersons judge text differently when they perform the evaluation on behalf of themselves compared to evaluating on behalf of other readers

Coupling: the implicit assumption behind sunk cost effect and related phenomena

Coupling is the degree to which thoughts of consumption evoke thoughts of payment and vice versa. This mental association is crucial for diverse phenomena like sunk costs but has rarely been addressed in the literature. This article provides a framework for the phenomenon, highlights its theoretical and practical relevance, compiles existing literature, adds empirical findings, and comes up with directions for future research.coupling, sunk costs, consumer psychology

Overview of methods used in cross-culturalcomparisons of menopausal symptoms and their determinants: Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies

This paper reviews the methods used in cross-cultural studies of menopausal symptoms with the goal of formulating recommendations to facilitate comparisons of menopausal symptoms across cultures. It provides an overview of existing approaches and serves to introduce four separate reviews of vasomotor, psychological, somatic, and sexual symptoms at midlife. Building on an earlier review of cross-cultural studies of menopause covering time periods until 2004, these reviews are based on searches of Medline, PsycINFO, CINAHL and Google Scholar for English-language articles published from 2004 to 2010 using the terms “cross cultural comparison” and “menopause.” Two major criteria were used: a study had to include more than one culture, country, or ethnic group and to have asked about actual menopausal symptom experience. We found considerable variation across studies in age ranges, symptom lists, reference period for symptom recall, variables included in multivariate analyses, and the measurement of factors (e.g., menopausal status and hormonal factors, demographic, anthropometric, mental/physical health, and lifestyle measures) that influence vasomotor, psychological, somatic and sexual symptoms. Based on these reviews, we make recommendations for future research regarding age range, symptom lists, reference/recall periods, and measurement of menopausal status. Recommendations specific to the cross-cultural study of vasomotor, psychological, somatic, and sexual symptoms are found in the four reviews that follow this introduction

A survey on first-year students’ opinions concerning causes of their low performance in listening in the English II course at Thaksin University, Phatthalung

This study attempts to survey Thaksin University’ (Phatthalung Campus) first-year students’ opinions concerning the causes of their low performance in the listening component of the English II course. Two hundred and sixty-four students of the Faculties of Science, Public Health and Sport Science, and Technology and Community Development were chosen as the research subjects. A student questionnaire, the only instrument for gathering the data, was used to explore the students’ opinions by considering six factors that may have caused low listening performance: students’ L2 prior knowledge, students’ motivation, students’ learning strategies, the teachers’ teaching methods,classroom environment, and classroom facilities. The SPSS program was used to analyze the quantitative data while the teaching researcher’s discussion was used to describe the qualitative data. The findings revealed that from the total results or the means of the six factors, the students disagreed with the six factors causing their low listening performance. However, considering the mean of each sub factor, there were other six sub-factors, under the students’ prior L2 knowledge and the students’ learning strategies factors, the students agreed as the causes of their low listening performance. Moreover, the majority of the students, 29.11%, agreed that the native speakers’ rate of speech in the CD-ROM was the other additional factor causing their low listening performance. As a result, the English II course teachers should realize the two factors and additional factor above before the rest of the four factors when teaching listening skills in order to solve the students’ listening problems in the right way

Job disamenities, job satisfaction, and on-the-job search: is there a nexus?

This study explores the potential role of adverse working conditions at the workplace in the determination of on-the-job search in the Finnish labour market. The results reveal that workers currently facing adverse working conditions have greater intentions to switch jobs and they are also more willing to stop working completely. In addition, those workers search new matches more frequently. There is evidence that adverse working conditions consistently increase the level of job dissatisfaction and, in turn, it is job dissatisfaction that drives workers’ intentions to quit and intensifies actual job search.working conditions, job satisfaction, on-the-job search, quit intentions