Dental caries experience in children of a remote Australian Indigenous community following passive and active preventive interventions

OBJECTIVES:To report on changes in dental caries experience in children of a remote Indigenous community following 6 years of passive preventive intervention (PPI) and 2 years of active preventive intervention (API). METHODS:Five consecutive cross-sectional surveys were conducted on 4- to 15-year-old school going children between 2004 and 2017 following phases of Community Water Fluoridation (CWF), post-cessation of CWF and API. Following treatment of any cavities present, API included selective placement of fissure sealants (FS) and an annual application of povidone-iodine (PI) and fluoride varnish (FV). The World Health Organization's (WHO) "Oral Health Surveys - Basic Methods (4th Edition)" methodology was used in the first two and the International Caries Detection and Assessment System (ICDAS-II) in the latter three surveys. ICDAS-II codes of 3-6, representing advanced caries, were combined to allow comparison to the decayed component of the DMF caries index. RESULTS:Age-weighted mean dmft decreased by 37.7% in the deciduous (DD) and DMFT by 35% in the permanent (PD) dentitions between the pre- and post-CWF surveys, followed by increases of 25% and 7.7%, respectively, between the 1-year and 4-year post-CWF surveys. After 2 years of API, mean dmft decreased by 14.3% and DMFT by 7.1%. Untreated dental caries however remained a concern in the DD and PD during both phases of PPI and of API. The decline in caries experience for both dentitions following 2 years of API exceeded that for the 6-year period of PPI. CONCLUSIONS:The annual reductions in caries experience of 7.2% (DD) and 8% (PD) during the phase of API exceeded annual decreases of 4.7% (DD) and 4.6% (PD) during the phase of PPI. Due to remoteness, cost and logistics in ensuring long-term viability of API programmes, CWF remains necessary in this type of community.Jeroen Kroon, Ratilal Lalloo, Santhosh K. Tadakamadla, Newell W. Johnso

Family day care educators : an exploration of their understanding and experiences promoting children\u27s social and emotional wellbeing

This study aimed to explore family day care (FDC) educators&rsquo; knowledge of child social and emotional wellbeing and mental health problems, the strategies used to promote children&rsquo;s wellbeing, and barriers and opportunities for promoting children&rsquo;s social and emotional wellbeing. Thirteen FDC educators participated in individual semi-structured interviews. FDC educators were more comfortable defining children&rsquo;s social and emotional wellbeing than they were in identifying causes and early signs of mental health problems. Strategies used to promote children&rsquo;s mental health were largely informal and dependent on educator skills and capacities rather than a systematic scheme-wide approach. Common barriers to mental health promotion were limited financial resources, a need for more training and hesitance raising child mental health issues with parents. There is a need to build FDC educators&rsquo; knowledge of child social and emotional wellbeing and for tailored mental health promotion strategies in FDC.<br /

The discursive practices of nurse practitioner legislation in Australia

Aim.&ensp; The aim of this paper was to examine the nurse practitioner legislative framework in Australia from a critical social theory perspective. Background.&ensp; National regulation for nurses and midwives has superseded all previous state legislation with effect from July 2010. The aim of this change was to streamline regulation processes across all health professionals requiring regulation, in order to eliminate diverse state-based regulatory policies that were identified as hindering transferability of the workforce across Australia. This paper explores the changes with reference to nurse practitioners. Since their introduction to Australia different legislative practices between states have presented difficult endorsement procedures which have affected employment. Data sources.&ensp; Information for the paper is drawn from a doctoral study which examined the politics of advancing nursing in Australia, with particular reference to the discourses of nurse practitioners. This is augmented by more recent legislative documents and policies, as well as media reports, to examine the process of change in legislation and the unfolding discourses on employment and practice. Implications to nursing.&ensp; Nurse practitioner endorsement may be more complicated, defeating the original premise of transferability of a skilled workforce across state jurisdictions. Conclusion.&ensp; This paper exposes the influence that powerful discourses can have on a major change to professional practice

Planning estimates for the provision of core mental health services in Queensland 2007 to 2017

Objective: To derive planning estimates for the provision of public mental health services in Queensland 2007-2017

Building resilience in regional youth: Impacts of a universal mental health promotion programme.

Mental health is a leading health issue facing young people today, particularly those living in rural and regional areas. Although public policy supports schools-based health promotion, there is limited evidence of the efficacy of such programmes and the elements that enhance successful implementation in rural and regional areas. A study was designed to evaluate a mental health promotion programme, delivered collaboratively by nurses, guidance officers, and teachers, to 850 young people from 23 rural and regional high schools in Queensland, Australia. The study aims were to determine what effect the intervention had on young peoples' resilience, coping, and self-efficacy, and to understand the implications of delivering the programme in the regional Queensland school setting. Students completed self-report measures of self-efficacy, resilience, and coping strategies pre- and postprogramme, as well as at 8-week follow-up. We found that after programme completion there was a significant increase in self-efficacy and in the number of positive coping strategies used by the participating young people. Qualitative data indicated that participants benefited from the collaboration between health and education sectors; that is, nurses, guidance officers, and teachers delivered the programme together in ways that were perceived to be respectful of young people and effectively discussion-based, and engaging