Decision Making in the Sciences: Understanding Heuristic Use by Students in Problem Solving

The purpose of this study was to examine the use of heuristics by students and gain insight into the thought process behind their problem-solving skills. The study used an adaptive narrative as the information delivery medium. An adaptive narrative was chosen because it could be designed to simulate decision making processes encountered in real world situations. Students enrolled in an introductory biology major class were chosen for the study because their fields of interest all require complex problem solving and decision-making skills. It was of interest to investigate what decisions were made when heuristics were given and how that may influence their rationale in the decision-making process. The results of this study indicate that: heuristics can enable students to make correct decisions when the heuristics are based on already familiar concepts; although students self-reported low cognitive load challenges in the NASA TLX, most of the explanations were deemed poor when graded by rubrics; students had difficulty transferring information learned in the narrative and synthesizing a complete and complex explanation past three data points. This study provides evidence that greater practice in the transfer of information to novel settings is important in education in order for students to become proficient in complex decision-making

The Utility of Storytelling Strategies in the Biology Classroom

Conveying scientific information with high intrinsic cognitive load to students is a challenge. Often, students do not have the existing schema to incorporate the information in a comprehensive manner. One method that has shown promise is storytelling. Storytelling has been successfully used to convey public health information to non-experts. Therefore, it was of interest to determine whether storytelling could be used in the classroom to present information with high intrinsic load to students in a meaningful manner. This study used a post-test only quasi-experimental study design to explore the utility of storytelling as an instructional strategy in anatomy and physiology classes at a community college. Students in the treatment group received instruction that used storytelling to present examples of application. Both control and experimental groups were assessed through the use of a proximal formative quiz, distal multiple-choice questions, and a novel critical thinking exercise administered after the instruction. Results suggest that storytelling was as effective as the instructional methods delivered to the control group. These findings suggest that storytelling may be used as a means to convey complex scientific information in the classroom

Factors that influence delivery of tobacco cessation support in general dental practice: A narrative review

Objectives: To review the literature reporting factors that are associated with the delivery of lifestyle support in general dental practice. Methods: A systematic review of the quantitative observational studies describing activities to promote the general health of adults in primary care general dental practice. Behaviour change included tobacco cessation, alcohol reduction, diet, weight management and physical activity. Tooth brushing and oral hygiene behaviours were excluded as the focus of this review was on the common risk factors that affect general health as well as oral health. Results: Six cross sectional studies met the inclusion criteria. Five studies only reported activities to support tobacco cessation. As well as tobacco cessation one study also reported activities related to alcohol usage, physical activity and Body Mass Index. Perceptions of time availability consistently correlated with activities and beliefs about tobacco cessation, alongside the smoking status of the dental professional. Dentists who perceive having more available time were more likely to discuss smoking with patients, prescribe smoking cessation treatments and direct patients towards (signpost to) lifestyle support services. Dental professionals who smoke were less likely to give smoking cessation advice and counselling than non-smokers. Finally, the data showed that professional support may be relevant. Professionals who work in solo practices or those who felt a lack of support from the wider professional team (peer support) were more likely to report barriers to delivering lifestyle support. Conclusion: Organisational changes in dental practices to encourage more team working and professional time for lifestyle support may influence delivery. Dental professionals who are smokers may require training to develop their beliefs about the effectiveness of smoking cessation interventions

The views and experiences of general dental practitioners (GDP's) in West Yorkshire who used the International Caries Detection and Assessment System (ICDAS) in research.

OBJECTIVE:To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries. METHODS:This qualitative study involved one on one interviews with eight GDP's who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis. RESULTS:GDP's indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care. CONCLUSION:The GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals' caries management, including appropriate recording of diagnosis and risk assessment

Whose Responsibility Is It Anyway? Exploring Barriers to Prevention of Oral Diseases across Europe

Introduction: Dental caries, gum disease, and tooth loss are all preventable conditions. However, many dental care systems remain treatment oriented rather than prevention oriented. This promotes the treatment of oral diseases over preventive treatments and advice. Exploring barriers to prevention and understanding the requirements of a paradigm shift are the first steps toward delivering quality prevention-focused health care. Objectives: To qualitatively explore perceived barriers and facilitators to oral disease prevention from a multistakeholder perspective across 6 European countries. Methods: A total of 58 interviews and 13 focus groups were undertaken involving 149 participants from the United Kingdom, Denmark, Germany, the Netherlands, Ireland, and Hungary. Interviews and focus groups were conducted in each country in its native language between March 2016 and September 2017. Participants were patients (n = 50), dental team members (n = 39), dental policy makers(n = 33), and dental insurers (n = 27). The audio was transcribed, translated, and analyzed via deductive thematic analysis. Results: Five broad themes emerged that were both barriers and facilitators: dental regulation, who provides prevention, knowledge and motivation, trust, and person-level factors. Each theme was touched on in all countries; however, cross-country differences were evident surrounding the magnitude of each theme. Conclusion: Despite the different strengths and weaknesses among the systems, those who deliver, organize, and utilize each system experience similar barriers to prevention. The findings suggest that across all 6 countries, prevention in oral health care is hindered by a complex interplay of factors, with no particular dental health system offering overall greater user satisfaction. Underlying the themes were sentiments of blame, whereby each group appeared to shift responsibility for prevention to other groups. To bring about change, greater teamwork is needed in the commissioning of prevention to engender its increased value by all stakeholders within the dental system. Knowledge Transfer Statement: The results from this study provide an initial first step for those interested in exploring and working toward the paradigm shift to preventive focused dentistry. We also hope that these findings will encourage more research exploring the complex relationship among dental stakeholders, with a view to overcoming the barriers. In particular, these findings may be of use to dental public health researchers, dentists, and policy makers concerned with the prevention of oral diseases. Keywords oral health, dental public health, qualitative, preventive dentistry, health services research, European Unio

Using High Fluoride Concentration Products in Public Policy – A Rapid Review of Current Guidelines for High Fluoride Concentration products

Despite improvements in dental caries levels since the widespread introduction of fluoride toothpastes, it is still a disease which is considered to be a priority in many countries around the world. Individuals at higher risk of caries can be targeted with products with a high fluoride concentration to help reduce the amount and severity of the disease. This paper compares guidance from around the world on the use of products with a high fluoride concentration and gives examples of how guidance has been translated into activity in primary care dental practice. A rapid review of electronic databases was conducted to identify the volume and variation of guidance from national or professional bodies on the use of products with a high fluoride concentration. Fifteen guidelines published within the past 10 years and in English were identified and compared. The majority of these guidelines included recommendations for fluoride varnish use as well as for fluoride gels, while a smaller number offered guidance on high fluoride strength toothpaste and other vehicles. Whilst there was good consistency in recommendations for fluoride varnish in particular, there was sometimes a lack of detail in other areas of recommendation for other vehicles with a high fluoride concentration. There are good examples within the UK, such as the Childsmile project and Delivering Better Oral Health, which highlight that the provision of evidence-based guidance can be influential in directing scarce resources towards oral health improvements. Policy can be influenced by evidence-based national recommendations and used to help encourage dental professionals and commissioners and third-party payers to adopt higher levels of practices aimed at oral health improvement

A qualitative exploration of preventive dental advice for parents of children with congenital heart disease

Background/Aims Children with congenital heart disease are at an increased risk of developing oral disease, which can negatively impact their general health and increase the risk of infective endocarditis. This study explored the preventive oral health advice given to parents of children with congenital heart disease and any barriers that exist to the implementation of this advice. Methods Four semi-structured interviews were conducted with parents of children with congenital heart disease, which followed a topic guide that explored personal experiences of oral healthcare provision and the advice received. Interviews were audio recorded and transcribed verbatim. Thematic analysis was undertaken by one researcher, with themes reviewed by a second. Results Improving awareness of oral health was highlighted as being important to participants. The prioritisation of the child's heart condition was also discussed, and participants felt that there were opportunities to develop the multidisciplinary collaboration between dental and cardiac teams. The consistency of messages could also be enhanced, as health advice sometimes contradicted oral health guidance, which could unintentionally increase the child's risk of tooth decay. Conclusions Enhancing collaboration between the various disciplines involved in the care of children with congenital heart disease is needed to ensure that appropriate advice and support is given to parents regarding oral health

Knowledge, attitude and practice among Health Visitors in the United Kingdom toward children's oral health

Objectives: The purpose of this study was to determine knowledge, attitude, and practical behavior of health visitors regarding children's oral health in the United Kingdom (UK). Methods: A web-based self-administered survey with 18 closed and 2 open ended questions was distributed to a convenience sample of approximately 9,000 health visitors who were currently employed in the United Kingdom and a member of the Institute of Health Visiting. Results: A total of 1,088 health visitors completed the survey, resulting in a response rate of 12%. One-third of the health visitors reported that they had not received oral health training previously. Almost all agreed that oral health advice/promotion should be included in their routine health visiting contacts. Previous oral health training/education was associated with an increase in oral health knowledge; confidence in entering a discussion with parents/caregivers and willingness to be involved in dental referral process. Conclusions: The results of our study support the need for health visitors to receive oral health training in oral health promotion including oral health risk assessment, guidance on evidence based up-to-date prevention measures, increasing the dental attendance prevalence at early stages and awareness of including specific oral health guidelines/fact sheets into their regular practice

A systematic review of school-based student peer-led oral health interventions to promote the oral health of school children

Background Poor oral health in children highlights the need for prevention and effective interventions. During late childhood and adolescence, peer relationships can play a vital role in adopting and maintaining positive health behaviours. Aim To identify the oral health outcomes of school-based student peer-led delivery of oral health interventions. Methods A search strategy was developed, piloted, and run in four electronic databases: Medline via Ovid, Web of Science, CINAHL via EBSCO, and CENTRAL (Cochrane Central Register of Controlled Trials) using key concepts of peer, oral health and adolescent in the school context. Methodological quality was assessed using QuaDs quality assessment tool. All articles were independently screened by two researchers and data was analysed using narrative data synthesis. The PRISMA checklist complemented by aspects of the Synthesis Without Meta-analysis (SWiM) was used to report this systematic review. Results There were 7572 identified, 24 studies progressed to full-text review, ten studies met the eligibility criteria and were included in the review. Only six studies based their interventions on psychological & behavioural theory. Intervention delivered by peers showed improvements in both clinical and self-reported outcomes when compared to other delivery methods (e.g., professionals). Quality of included studies was reported according to QuaDs guidance. Conclusion Peer-led interventions were more effective in improving oral health status and behaviours when compared to other modes of delivery. Future research should assess if a bi-directional impact of peer-led interventions can be seen. Specifically, if there is added value for school-based student peer-leader's including their own oral health knowledge, skills, attitude and preventative behaviours