Family functioning and frequency of sugar consumption by 3 and 4 year old children in Outer North East London

PhDDental caries is a public health problem affecting over 30% of 3.5 to 4.5 year old children in the UK. One of its most important determinants is frequent consumption of sugary foods, without which plaque bacteria cannot produce sufficient acids to demineralise tooth structure. The aim of this study was to identify the contribution of family functioning in the domains behaviour control, affective responsiveness, affective involvement, communication, problem solving and roles towards the frequent consumption of sugary foods by three and four year old children in Outer North East London. The research questions were explored with data from the Outer North East London Family Study (ONEL-FS), which collected data through home visits, by trained dentists and interviewers, from a representative sample of adults and children living in the London boroughs of Redbridge, Barking and Dagenham and Waltham Forest in 2008-10. This study analysed data (N=698) from three and four year old children and their mothers and included unadjusted and adjusted logistic regression and mediation analysis. The results showed that 17% of the sample consumed sugary foods more than 4/day which was significantly associated with behaviour-control (OR 0.25; 95% CI: 0.11, 0.57), affective-responsiveness (OR 0.29; 95% CI: 0.14, 0.58), affective-involvement (OR 0.32; 95% CI: 0.17, 0.60), communication (OR 0.34; 95% CI: 0.14, 0.85) and roles (OR 0.22; 95% CI: 0.08, 0.62), after adjusting for confounders. The significant association between mother’s education and children’s sugar consumption (OR 0.35; 95% CI: 0.21, 0.58) was partially mediated through behaviour control, affective responsiveness, affective involvement, communication and roles. The significant association between mother’s ethnicity and sugar consumption (OR 3.46; 95% CI: 1.63, 5.25) was also partially mediated through these same five domains. The study findings contribute to the literature on protective influences within the family environment and confirm current knowledge regarding mother’s education and ethnicity

A Longitudinal Study of Changes in New Dental Graduates’ Engagement with Evidence-Based Practice During Their Transition to Professional Practice

Introduction Clinicians' use, interpretation and application of evidence in everyday practice is fundamental to their delivery of appropriate, contemporary, high-quality dentistry. Little is known about whether new dental graduates' (NDGs') perspectives and use of evidence-based practice (EBP) change when they enter professional practice. Aim To explore changes in NDGs' perception of EBP for: self-efficacy; knowledge of EBP principles; attitudes; confidence in appraisal skills; and frequency of accessing evidence. Methods Two pre-validated instruments: knowledge, attitude, confidence and accessing EBP resources, EBP confidence scale, and clinical scenarios. NDGs from one dental school completed the questionnaire upon graduation (R1) and six to nine months into vocational dental training (R2). Results Response rates of R1 were 34 (52%) and R2, 21 (62% of R1, 32% overall). Between R1 and R2, knowledge (median [25th-75th percentiles]: R1 = 4 [2.5-4]; R2 = 3 [2.8-3], p = 0.07), self-efficacy (R1 = 645 [587-782]; R2 = 630 [550-690], p = 0.8) and scores related to knowledge of gold standards were comparable. However, attitude (R1 = 38 [34-39], R2 = 27 [25-30]), confidence in appraisal skills (R1 = 16 [14-20], R2 = 11[8-16]) and frequency of accessing evidence (R1 = 26 [22-28]; R2 = 18 [16-19]) all showed statistically significant reductions. Conclusion After six months in professional practice, NDGs showed statistically significant reductions in the value they place on EBP, their EBP-related skills and their use of reliable evidence sources. There were no differences in their 'self-efficacy' knowledge of EBP principles

A longitudinal qualitative multi-methods study of new dental graduates’ transition journey from undergraduate studies to professional practice

Introduction New dental graduates' (NDGs) transition to professional practice is an important landmark and developmental stage in their career and in the UK it is supported by a formal educational transition process through a one-year salaried practice-based programme. However, little is known about graduates' experiences during this period. As part of a larger mixed-methods project, this study aimed to explore NDGs' experiences during their transition to professional practice, represented by Vocational Dental Practice. Materials and Methods Sixty-six NDGs from one dental school were invited to participate. Two rounds of in-depth interviews were conducted: Interview 1 upon NDGs' graduation and then Interview 2 was a follow-up interview after they had spent six-nine months in vocational dental training (VDT). At Interview 1, a subset of participants agreed to record longitudinal audio-diaries (LADs) and continued these for 6–9 months into VDT. Data from the interviews and LADs were analysed together using a thematic analysis approach. Results Eleven of the 66 invited NDGs agreed to be interviewed at Interview 1 (16.6%), seven at Interview2 (10.6%), and six (9.2%) recorded LADs. Four topic summaries were developed around NDGs transition experiences: (1) conceptualisation of the process; (2) responses to the transition, (3) challenges and support and (4) relationships with stakeholders. Conclusion NDGs' transition to professional practice was perceived as exciting and rewarding on personal and professional levels but carried challenges. VDT and related stakeholders play a vital role of supporting NDGs into their new professional life