Biomedical subjects

J T Newton

Publications and source records attributed to J T Newton.

At least 19 recordsLinked to original sources

PubMed2006

An evaluation of the quality of commercially produced patient information leaflets.

AIM: A descriptive study was undertaken to assess the quality of a range of patient information leaflets produced by the British Dental Association. METHOD: Twenty-nine leaflets were assessed with regard to presentation, readability and quality. The topic areas covered included: treatment, self-care and disease related information. Presentation was evaluated with regard to layout, font size, typeface, use of illustrations, paper type and print colour. Readability was assessed using the Flesch reading grade and the SMOG reading grade. Quality was assessed using the DISCERN tool. FINDINGS: All leaflets scored quite well for readability, with the average SMOG Reading Grade Level being 9.10 (SD 0.80) and the average Flesch reading Grade Level being 6.18 (SD 0.83). There were, however, some areas of presentation that could be improved, specifically font size, illustration use and paper finish, which did not comply with the RNIB guidelines. Quality ratings using the DISCERN tool were low. In particular most leaflets scored poorly in setting out clear aims in the opening paragraph, in identifying sources and dates of information provided, and other sources of advice and support available. Few leaflets discussed the option of no treatment or how the treatment would affect overall quality of life. The role of shared decision making was rarely mentioned. CONCLUSION: Patient information leaflets produced commercially are of high production quality and good readability but tend not to be patient centred.

Health Education, Dental↗

PubMed2006

A qualitative analysis of the planning, implementation and management of a PDS scheme: lessons for local commissioning of dental services.

AIM: To identify the experiences of primary care trust employees, the dental teams and other key individuals of the planning, implementation and management of a Personal Dental Services scheme. METHOD: A thematic analysis of a series of qualitative interviews with 29 individuals who were involved in the planning, implementation and management of a PDS scheme in South East London. FINDINGS: Nine key themes were analysed from the data. For each theme perspectives could be identified for both the employees of the primary care trusts and the dental team. These perspectives differ in key respects. CONCLUSIONS: Practitioners value the PDS scheme and consider it a positive experience. They suggest that it has led to an increase in quality of care, and a more professional management approach to the practice. The practice team felt that they have benefited from an enhanced working environment. The main concern expressed was that patient registrations were not being accurately assessed. Those involved in the management of the PDS scheme, while endorsing local commissioning arrangements, were concerned that it was not known whether PDS was meeting local needs. There was little quality benchmarking, which would have allowed robust measure of success. The contract model and outcomes should have been more sensitively designed. There was concern expressed that the small number of practices who participated in the pilot scheme prohibits the possibility of thoroughly analysing the impact of local commissioning. Future local commissioning should identify mechanisms for ensuring the effective planning, management and evaluation of the impact of the schemes. A core element of this will be the specification of appropriate goals for commissioning.

Attitude of Health Personnel↗

PubMed2006

How to reduce the stress of general dental practice: the need for research into the effectiveness of multifaceted interventions.

While the practice of dentistry has been demonstrated to be significantly stressful, there have been few published studies describing interventions to reduce the stress of dental practitioners. This article describes research into the prevention and alleviation of stress amongst a variety of healthcare professionals, including dental practitioners, and describes the findings from a small scale study of an intervention aimed at general dental practitioners who reported high levels of work related stress. It is argued that to be effective, interventions should be tailored to the individual needs of the practitioner, within a structured intervention framework. Further research into the effectiveness and cost-effectiveness of stress management for dental practitioners is required.

Burnout, Professional↗

PubMed2006

A controlled trial of the impact of exposure to positive images of dentistry on anticipatory dental fear in children.

OBJECTIVES: Dental anxiety is common in children. This study sought to determine the impact of viewing positive images of dentistry prior to a dental appointment on the anticipatory dental anxiety levels of children attending for dental treatment. METHODS: Controlled trial. Assessment of anxiety and analysis of data were conducted blind to experimental condition. Assessment of anxiety was carried out in the waiting room postintervention but before the patient entered the dental surgery for treatment. PARTICIPANTS: Thirty-eight children and young adults attending a dental clinic in South West England. INTERVENTION: Participants were randomly assigned to one of two conditions. In both conditions the participant was asked to look at photographs for 2 min in the waiting area prior to their appointment. The intervention consisted of viewing positive images of dentistry and dental treatment, the control condition consisted of dentally neutral images. Positive and neutral images were validated independently by four paediatric dentists. The assessment of anticipatory dental anxiety was made blind to experimental condition and statistical analysis was conducted blind to group membership. OUTCOME MEASURE: Anticipatory anxiety assessed by the Venham Picture Test. FINDINGS: A significant difference in anticipatory dental anxiety was found between the two groups (median-positive images = 0, median-neutral images = 3; P < 0.001). Anticipatory anxiety was not correlated to age (rho = 0.04 P > 0.05), there was no difference between male and female participants in their level of anticipatory anxiety (median-males = 0.5, median-females = 1 P > 0.05). CONCLUSIONS: Viewing positive images of dentistry and dentists results in short-term reductions in anticipatory anxiety in children.

Adolescent↗

PubMed2006

Undergraduate and postgraduate dental students' 'reflection on learning': a qualitative study.

The aim of this study was to explore undergraduate and postgraduate dental students' understanding of a good learning experience by using 'reflection on learning' as described by Schon. Four groups of Year 4 BDS students and one group of postgraduate students in dental public health took part in a series of focus group discussions. The responses were grouped into four broad themes (a) active, practical and positive learning; (b) interactive/together learning; (c) personal learning; (d) theory into practice. Six educational models of good learning proposed by the students are described.

Association Learning↗

PubMed2006

Patients' expectations of orthodontic treatment: part 1 - development of a questionnaire.

OBJECTIVE: The development of a questionnaire to measure patients' and their parents' expectations before orthodontic treatment, and to test the reliability and validity of this measure. DESIGN: A two-stage methodology, with open-ended interviews to identify themes and concepts followed by development and testing of the questionnaire. SETTING: GKT Orthodontic Department, King's College Dental Hospital. SUBJECTS: The sample consisted of 140 participants, 70 patients aged 12-14 years, who had been referred to the orthodontic department for treatment. One parent of each patient was also recruited. MATERIALS AND METHODS: The study was in two phases. In the first phase 30 participants (15 new patients and their 15 parents) participated in open-ended interviews, which were analysed qualitatively. Information from these interviews was used to construct a questionnaire. During the second phase, the questionnaire was piloted on 10 participants, five new consecutive patients and their parents. The questionnaire was then distributed to 174 subjects (87 new patients and their 87 parents). Seventy-eight subjects (39 new patients and their 39 parents) completed the questionnaire before their orthodontic consultation. Another 96 subjects (48 new patients and their 48 parents) were invited to complete the questionnaire prior to and at their orthodontic consultation. Test-retest analysis was conducted on 22 participants (11 patients and their 11 parents), who completed the questionnaire previous to and at their orthodontic consultation, and contributed to the psychometric validation of this questionnaire. MAIN OUTCOME MEASURES: A questionnaire was devized using the key themes and concepts identified in the open-ended interviews. As a result, 10 questions, some with sub-questions were constructed using a visual analogue scale as the response format. RESULTS: The questionnaire developed had good face validity. Internal consistency of the questionnaire using Cronbach's alpha, produced an overall inter-item reliability > 0.7 along with item-total correlations > 0.3 in over 50% of questions. Test-retest reliability was statistically significant using Spearman's correlation. CONCLUSION: This study provides a valid and reliable measure of orthodontic expectations in participants aged 12-14 years and their parents.

Adolescent↗

PubMed2005

Views and experiences of parents and siblings of adults with Down Syndrome regarding oral healthcare: a qualitative and quantitative study.

AIMS: To investigate experiences and expectations of parents/siblings of adults with Down Syndrome (DS) regarding oral healthcare, and explore factors impacting on access and experience of dental care for this group. DESIGN: A two phase qualitative and quantitative study using in-depth interviews with a convenience sample of six parents/siblings, and a postal questionnaire of 200 parents/siblings of adults with DS who are members of the Down Syndrome Association. RESULTS: The main themes elicited from the qualitative interviews related to concern, experiences, parents'/siblings' attitudes, preferences and information. The response rate from the postal questionnaire was 63.5%. Adults with DS attended the dentist regularly but received little restorative treatment. Experience of oral healthcare was influenced by the attitudes and skills of dental health professionals; stigma; and relatives' expectations of dentists, their oral health beliefs, information and support received, knowledge and priorities. Parents/siblings wanted dentists to be proactive in providing more information on oral health issues in collaboration with other health and social care professionals. CONCLUSIONS: Whilst most adults with DS visited the dentist regularly, relatively little treatment had been provided. Parents highlighted a need for appropriate and timely oral health information early in their child's life, and access to dentists who were sympathetic, good communicators and well-informed about DS.

Adult↗

PubMed2005

An appraisal of options of the training and education of Professionals Complementary to Dentistry.

The training and education of Professionals Complementary to Dentistry (PCDs) has become a topic of close scrutiny and much debate in the recent past, particularly with the introduction of enhanced duties and compulsory registration of some groups. This paper will describe the background to, the conduct of and the findings from a workshop held to explore innovative approaches to the education and training of PCDs in the United Kingdom. Existing systems of training and education of PCDs will be reviewed through the exploration of published literature and through the collection of primary data from interviews with key personnel both in the UK and internationally. An option appraisal is described which identified the elements common to all training approaches, used the elements as the basis for innovative training options, and explored the perceived advantages and disadvantages of each option through focus group discussions at a one-day workshop. A model for the training and education of PCDs is described that maintains existing PCD roles, but offers a broader range of entry points to training, settings for training and that builds upon existing skills to facilitate progression through the PCD roles.

Dental Auxiliaries↗

PubMed2005

Antibiotic use for irreversible pulpitis.

BACKGROUND: Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the root canal. However, a significant minority of dentists continue to prescribe antibiotics to stop the pain of irreversible pulpitis. OBJECTIVES: The objective of this review was to provide reliable evidence regarding the effectiveness of prescribing systemic antibiotics for irreversible pulpitis by comparing clinical outcomes expressed as pain relief. SEARCH STRATEGY: We searched the following databases: Cochrane Oral Health Group Trials Register and Pain, Palliative Care and Supportive (PaPaS) Care Group Trials Register to 6th September 2004; the Cochrane Central Register of Controlled Trials (CENTRAL) The Cochrane Library Issue 3 2004; MEDLINE (1966 to 6th September 2004); EMBASE (1980 to week 36 2004). SELECTION CRITERIA: This review includes one randomised controlled trial which compared pain relief with systemic antibiotics and analgesics, against placebo and analgesics in the acute preoperative phase of irreversible pulpitis. DATA COLLECTION AND ANALYSIS: Only one trial is included in this review, therefore pooling of data from studies was not possible and a descriptive summary is presented. MAIN RESULTS: One trial involving 40 participants was included in this review. There was a close parallel distribution of the pain ratings in both the intervention and placebo groups over the 7 day study period. The between-group differences in sum pain intensity differences (SPID) for the penicillin group were (6.0+/-10.5), and for placebo (6.0+/-9.5) P = 0.776. The sum pain percussion intensity differences (SPPID) for the penicillin group were (3.5+/-7.5) and placebo (2.0+/-7.0) P = 0.290, with differences as assessed by the Mann-Whitney-Wilcoxon test considered to be statistically significant at P < 0.05. There was no significant difference in the mean total number of ibuprofen tablets (P = 0.839) and Tylenol tablets (P = 0.325), in either group over the study period. The administration of penicillin over placebo did not appear to significantly reduce the quantity of analgesic medication taken (P > 0.05) for irreversible pulpitis. AUTHORS' CONCLUSIONS: This review which was based on one methodologically sound but low powered small sample trial provided some evidence that there is no significant difference in pain relief for patients with untreated irreversible pulpitis who did or did not receive antibiotics in addition to analgesics.

Analgesics↗

PubMed2005

A cohort investigation of the changes in vocational dental practitioners' views on repairing defective direct composite restorations.

OBJECTIVE: To investigate changes in vocational dental practitioners (VDPs) views on repairing direct composite restorations (DCRs) during the vocational training (VT) year 2002-2003. DESIGN: A questionnaire-based cohort study. METHOD: Data on the repair of DCRs, including indications and details of operative techniques were collected by a questionnaire sent at the beginning of the VT year (September 2002) to all 12 Postgraduate Dental Deans in England. A follow-up questionnaire was sent to the Deans near the end of the VT year (May 2003). They were asked, on both occasions, to distribute the questionnaires among their VDPs and to return the completed questionnaires. RESULTS: Ten deaneries participated in the study. The September 2002 and May 2003 findings (306 respondents [66%] and 313 respondents [67%] respectively) were analysed using Chi-square statistic and t-test to identify any significant differences (P<0.05). Significant changes in the attitudes of the VDPs during the VT year included a shift to viewing reduction in treatment time (30% to 48%), cost to patient (12% to 20%) and the management of the partial loss of a restoration (57% to 70%) as indications for repairs. In contrast, there was a significant change in viewing secondary caries as an indication for repair (46% to 29%). In addition, there was a significant, worrisome shift in relation to the use of bonding systems and finishing instruments, together with a reduction in the anticipated longevity of composite repairs. CONCLUSION: Aspects of VDPs' attitudes to the repair of DCRs were found to change significantly during the VT year. Not all aspects of the changes observed were considered to be positive. Knowledge and understanding of repairs to DCRs need to be strengthened.

Administrative Personnel↗

PubMed2005

Dental emergencies presenting to a university-based paediatric dentistry clinic in the West Indies.

OBJECTIVES: The aims of the present study were to investigate the type and prevalence of dental emergencies presenting at a teaching hospital paediatric emergency clinic in Trinidad, and to describe the socio-demographic factors related to the use of the service. DESIGN AND METHODS: The authors used a prospective study of consecutive dental patients presenting to a paediatric emergency clinic. Data recorded included type of presenting emergency and socio-demographic variables. RESULTS: Data were available for 309 participants; 47% were male and 53% female. The average age of the participants was 8.66 years (SD = 3.75 years; range = 1-16 years). Seventy-three per cent of the participants' parents were involved in manual work or unemployed, and 21% were in nonmanual/professional employment; the occupation was not known in 6% of cases. Caries-related problems accounted for 74% of emergencies. Dental trauma mostly affected the upper permanent incisor teeth, with concussion, subluxation and intrusion being the most common injuries. CONCLUSION: Dental emergencies presenting to this university-based clinic were predominantly related to caries and trauma. The service was more frequently utilized by children in the mixed dentition stage, children from lower socioeconomic groups and those living in the local area. The frequency of caries-related problems indicates the need for more community-based preventive strategies, including encouraging greater attendance for routine dental care and dental health education. Strategies for oral health promotion should also be developed to prevent dental trauma.

Adolescent↗

PubMed2005

Perceptions of the use of compulsory detention in treatment of people with eating disorders.

To examine the perceived acceptability of compulsory detention in treatment of an individual with severe anorexia nervosa amongst a sample of members of the general population, 151 participants read vignettes describing the compulsory detention of a female patient with a Body Mass Index of 12.4. The vignettes systematically varied along three dimensions: patients' reaction, immediate outcome (psychological state), and long-term outcome (attendance at out-patient appointments). Acceptability was measured using the Treatment Evaluation Inventory. There were significant main effects of psychological outcome and the long-term treatment outcome. The main effect of the patients' reaction to the detention was not significant, but there was a significant interaction for psychological outcome and long-term outcome, such that good attendance at out-patient appointments increased ratings of acceptability more markedly when a good psychological outcome had been secured. The outcome of treatment exerts a strong influence on ratings of acceptability. Individuals who have no direct experience with eating disorders endorse treatments that are effective irrespective of the patients' feelings about the treatment.

Adolescent↗

PubMed2005

Psychometric properties of the modified dental anxiety scale: an independent replication.

AIM: To estimate the internal consistency, test-retest reliability, discriminant and concurrent validity of the Modified Dental Anxiety Scale (MDAS). METHOD: Survey of a cohort of 135 dental patients in three equal groups (non-anxious; treated anxious; highly anxious). The average age of the total sample was 39.2 years (SD = 13.21), 101 patients (75%) were female. All patients were asked to complete the MDAS, together with the brief form (six items) of the Speilberger Trait Anxiety Inventory (STAI). Thirty-three participants completed the MDAS on a second occasion 2-3 months after the first testing session. FINDINGS: The MDAS is highly internally consistent (Cronbach alpha = 0.93) and shows good reliability over time (Intra-class correlation coefficient = 0.93). The MDAS was found to discriminate between the three groups of participants defined by self-reported anxiety level, and correlates highly with the Speilberger Trait Anxiety Inventory. CONCLUSIONS: The MDAS is a highly consistent and reliable measure which has good discriminant and concurrent validity.

Adult↗

PubMed2004

Research in primary dental care. Part 7: writing up your research.

Writing up your research for publication is an important part of the research process, since it is through publication in all its forms that the wider community becomes aware of your contribution to knowledge. How the research is written up will depend to a large degree on your target audience; in this final paper we discuss writing up your research for members of your practice, funders of your research, and for publication in academic journals.

Dental Care↗

PubMed2004

A national survey of dental technicians: career development, professional status and job satisfaction.

OBJECTIVE: To investigate the career development, perception of status within the dental team, and level of job satisfaction of dental technicians in the United Kingdom. DESIGN: Cross-sectional postal questionnaire survey of 1,650 dental technicians registered with the Dental Technicians Association. Replies were received from 996 (60%). RESULTS: Eighty two per cent respondents had a qualification in dental technology and 21% also had an advanced level qualification. Almost two thirds of the respondents had undertaken no verifiable continuing professional development in the previous year. Only 27% of respondents expected to develop their career over the next five years. Less than 50% of the respondents felt adequately valued as individuals and as a professional group in the dental team. Job satisfaction was significantly related to age, attendance at one or more courses in the last year, working shorter hours, feeling valued in the dental team, and future career plans. CONCLUSIONS: Plans for the registration and role expansion of dental technicians provide opportunities for career development which have yet to be realised. The low levels of continuing professional development currently undertaken indicate the need for a review of the provision and funding of training at a strategic level. Whilst levels of job satisfaction are satisfactory, many dental technicians feel insufficiently valued in the dental team.

Attitude of Health Personnel↗

PubMed2004

Research in primary dental care Part 6: Data analysis.

The analysis of data from a research project seeks to answer the research question which the investigators set at the outset of the study. This article provides information on data analysis for both quantitative and qualitative data, always referring the reader back to their initial research question. Advice is also given on software which can be used for the analysis of data. A guide is provided to the choice of appropriate statistics for studies involving quantitative data.

Data Interpretation, Statistical↗

PubMed2004

Research in primary dental care. Part 5: devising a proposal, obtaining funding and ethical considerations.

In previous articles, we have considered how to formulate a research question and choose an appropriate methodological approach to answer that question, including the use of evidence-based research instruments or measurement scales. In this article, we put this information together in the form of a research proposal and consider how to obtain funding for the research project, as well as fulfil ethical requirements.

Confidentiality↗

PubMed2004

Research in primary dental care part 4: measures.

An important part of the design process for any study is deciding how to assess and measure the phenomena you are aiming to research. In this article we will use the term outcome measure to indicate the tool or index that can be used to quantify, in an accurate and predictable way, the phenomenon under investigation. This might, for example, be a patient's opinion, the effect of a treatment, the outcome of an intervention, or the prevalence of an oral disease. The paper presents an overview of outcome measures which can be used in research. We will discuss the properties to look for in a measure, suggest suitable evidence-based measures and briefly introduce how to go about developing new measures, in particular, questionnaires.

Costs and Cost Analysis↗