Factors influencing implementation and sustainability of interventions to improve oral health and related health behaviours in adults experiencing severe and multiple disadvantage: a mixed-methods systematic review

OBJECTIVES: Among people experiencing severe and multiple disadvantage (SMD), poor oral health is common and linked to smoking, substance use and high sugar intake. Studies have explored interventions addressing oral health and related behaviours; however, factors related to the implementation of these interventions remain unclear. This mixed-methods systematic review aimed to synthesise evidence on the implementation and sustainability of interventions to improve oral health and related health behaviours among adults experiencing SMD. METHODS: Bibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, EBSCO, Scopus) and grey literature were searched from inception to February 2023. Studies meeting the inclusion criteria were screened and extracted independently by two researchers. Quality appraisal was undertaken, and results were synthesised using narrative and thematic analyses. RESULTS: Seventeen papers were included (published between 1995 and 2022). Studies were mostly of moderate quality and included views from SMD groups and service providers. From the qualitative synthesis, most findings were related to aspects such as trust, resources and motivation levels of SMD groups and service providers. None of the studies reported on diet and none included repeated offending (one of the aspects of SMD). From the quantitative synthesis, no difference was observed in programme attendance between the interventions and usual care, although there was some indication of sustained improvements in participation in the intervention group. CONCLUSION: This review provides some evidence that trust, adequate resources and motivation levels are potentially important in implementing interventions to improve oral health and substance use among SMD groups. Further research is needed from high quality studies and focusing on diet in this population. PROSPERO REGISTRATION NUMBER: CRD42020202416

Investigating the effectiveness and acceptability of oral health and related health behaviour interventions in adults with severe and multiple disadvantage:Protocol for a mixed-methods systematic review

Increasing numbers of people in England experience homelessness, substance use, and repeated offending (known as ‘severe and multiple disadvantage’; SMD). Populations experiencing SMD often have extremely poor oral health, which is closely inter-linked with high levels of substance use, smoking, and poor diet. This study aims to undertake an evidence synthesis to identify the effectiveness, resource requirements, and factors influencing the implementation and acceptability of oral health and related health behaviour interventions in adults experiencing SMD. Two systematic reviews will be conducted using mixed-methods. Review 1 will investigate the effectiveness and resource implications of oral health and related health behaviours (substance use, smoking, diet) interventions; Review 2 will investigate factors influencing the implementation of such interventions. The population includes adults (≥18 years) experiencing SMD. Standard review methods in terms of searches, screening, data extraction, and quality appraisal will be conducted. Narrative syntheses will be conducted. If feasible, a meta-analysis will be conducted for Review 1 and a thematic synthesis for Review 2. Evidence from the two reviews will then be synthesised together. Input from people with experience of SMD will be sought throughout to inform the reviews. An initial logic model will be iteratively refined during the review.</jats:p

Effective practice with e-portfolios: How can the UK experience inform practice?

&lt;span&gt;This paper introduces the background to the JISC work within the e-portfolio domain in the UK and presents an overview of past and current activities and the drivers for these developments. This is followed by a review of JISC's approach to drawing out the learning and implications for e-portfolio practice from this extensive collection of work and its dissemination. The analysis of twenty one recently funded projects involving the use of e-portfolios in the UK is introduced. The findings suggest that e-portfolio implementation is particularly complex in part due to the number of stakeholders involved, the contexts in which e-portfolios can be applied and the number of purposes they can have. This research suggests that there are threshold concepts related to e-portfolio implementation and that developing an understanding of effective practice is not straightforward. However a means of supporting this understanding is suggested.&lt;/span&gt

Sur l'écran et les propriétés magnétiques d'une impureté en mouvement au sein d'un métal

The screening of a charged impurity which moves in a metal is studied by means of the phase-shift method ; we suppose that the self-consistent scattering potential is not changed by the motion. Next we analyse, in the Hartree-Fock approximation, the consequences of the motion on the possibility of existence of a magnetic moment localized on the impurity. The results show a tendency towards demagnetization of the impurity. The implications of these results for secondary ionic emission phenomena from targets such as A1M (where M is a transition element) is also mentioned.La charge d'écran d'une impureté chargée en mouvement dans un métal est étudiée à l'aide de la méthode des déphasages ; on suppose pour ce calcul que le potentiel self-consistent de diffusion reste inchangé par le mouvement de la particule. On analyse ensuite, dans l'approximation Hartree-Fock, l'effet du mouvement sur la possibilité d'existence de moment magnétique localisé sur l'impureté. Le résultat de cette étude fait apparaître une tendance à la démagnétisation de l'impureté. L'utilisation de ces résultats pour l'analyse des phénomènes d'émission ionique secondaire d'alliages de type A1M (où M est un élément de transition) est aussi évoquée

Understanding the complex health needs of people with problematic drug/alcohol use: a qualitative enquiry

\ua9 2024 The Author(s). Published with license by Taylor &amp; Francis Group, LLC.Background: The Northeast of England faces severe health disparities, increased drug and alcohol use, and significant inequality impacts. This study aimed to extend understanding of the health needs of people associated with drug and alcohol misuse and to identify the barriers and facilitators to meeting these specific needs. Method: A mixed method approach was used, which included a tailored behavioral insights survey (n = 38) and semi-structured interviews with eight service users recruited via a Treatment and Recovery service in the Northeast of England. Quantitative data was analyzed descriptively, and qualitative data with thematic analysis. Findings: The study highlighted several health priority areas, with acute mental health issues being a primary difficulty for service users. The thematic analysis generated four themes illustrating the central barriers and facilitators affecting the fulfillment of health and wellbeing needs among service users: Positive environments and supportive relationships facilitated engagement, whilst stigma, internalized norms, and practicality issues were pertinent barriers. Conclusion: The results suggest the critical need for strategic changes, including the co-location of services at user-preferred centers, reducing economic challenges. While also addressing the issue of stigma, focusing on raising professional awareness and addressing personal beliefs among service users regarding healthcare services