https://hull-repository.worktribe.com/preview/1797952/1-s2.0-S0140673618322797-main.pdf

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Background Audit and feedback continues to be widely used as a strategy to improve professional practice. It appears logical that healthcare professionals would be prompted to modify their practice if given feedback that their clinical practice was inconsistent with that of their peers or accepted guidelines. Yet, audit and feedback has not been found to be consistently effective. Objectives To assess the effects of audit and feedback on the practice of healthcare professionals and patient outcomes. Search strategy We searched the Cochrane Effective Practice and Organisation of Care Group's register up to January 2001. This was supplemented with searches of MEDLINE and reference lists, which did not yield additional relevant studies. Selection criteria Randomised trials of audit and feedback (defined as any summary of clinical performance over a specified period of time) that reported objectively measured professional practice in a healthcare setting or healthcare outcomes. Data collection and analysis Two reviewers independently extracted data and assessed study quality. Quantitative (meta-regression), visual and qualitative analyses were undertaken. Main results We included 85 studies, 48 of which have been added to the previous version of this review. There were 52 comparisons of dichotomous outcomes from 47 trials with over 3500 health professionals that compared audit and feedback to no intervention. The adjusted RDs of non-compliance with desired practice varied from 0.09 (a 9% absolute increase in non-compliance) to 0.71 (a 71% decrease in non-compliance) (median = 0.07, inter-quartile range = 0.02 to 0.11). The one factor that appeared to predict the effectiveness of audit and feedback across studies was baseline non-compliance with recommended practice. Reviewer's conclusions Audit and feedback can be effective in improving professional practice. When it is effective, the effects are generally small to moderate. The absolute effects of audit and feedback are more likely to be larger when baseline adherence to recommended practice is low.

Audit and feedback: effects on professional practice and healthcare outcomes

Polydopamine and Its Derivative Materials: Synthesis and Promising Applications in Energy, Environmental, and Biomedical Fields

Background: Evidence-based guidelines are often not implemented effectively with the result that best health outcomes are not achieved. This may be due to a lack of theoretical understanding of the processes involved in changing the behaviour of healthcare professionals. This paper reports the development of a consensus on a theoretical framework that could be used in implementation research. The objectives were to identify an agreed set of key theoretical constructs for use in (1) studying the implementation of evidence based practice and (2) developing strategies for effective implementation, and to communicate these constructs to an interdisciplinary audience.

Methods: Six phases of work were conducted to develop a consensus: (1) identifying theoretical constructs; (2) simplifying into construct domains; (3) evaluating the importance of the construct domains; (4) interdisciplinary evaluation; (5) validating the domain list; and (6) piloting interview questions. The contributors were a “psychological theory” group (n = 18), a “health services research” group (n = 13), and a “health psychology” group (n = 30).

Results: Twelve domains were identified to explain behaviour change: (1) knowledge, (2) skills, (3) social/professional role and identity, (4) beliefs about capabilities, (5) beliefs about consequences, (6) motivation and goals, (7) memory, attention and decision processes, (8) environmental context and resources, (9) social influences, (10) emotion regulation, (11) behavioural regulation, and (12) nature of the behaviour.

Conclusions: A set of behaviour change domains agreed by a consensus of experts is available for use in implementation research. Applications of this domain list will enhance understanding of the behaviour change processes inherent in implementation of evidence-based practice and will also test the validity of these proposed domains.

https://qualitysafety.bmj.com/content/qhc/14/1/26.full.pdf

Making psychological theory useful for implementing evidence based practice: a consensus approach

Implementation science has progressed towards increased use of theoretical approaches to provide better understanding and explanation of how and why implementation succeeds or fails. The aim of this article is to propose a taxonomy that distinguishes between different categories of theories, models and frameworks in implementation science, to facilitate appropriate selection and application of relevant approaches in implementation research and practice and to foster cross-disciplinary dialogue among implementation researchers. Theoretical approaches used in implementation science have three overarching aims: describing and/or guiding the process of translating research into practice (process models); understanding and/or explaining what influences implementation outcomes (determinant frameworks, classic theories, implementation theories); and evaluating implementation (evaluation frameworks). This article proposes five categories of theoretical approaches to achieve three overarching aims. These categories are not always recognized as separate types of approaches in the literature. While there is overlap between some of the theories, models and frameworks, awareness of the differences is important to facilitate the selection of relevant approaches. Most determinant frameworks provide limited “how-to” support for carrying out implementation endeavours since the determinants usually are too generic to provide sufficient detail for guiding an implementation process. And while the relevance of addressing barriers and enablers to translating research into practice is mentioned in many process models, these models do not identify or systematically structure specific determinants associated with implementation success. Furthermore, process models recognize a temporal sequence of implementation endeavours, whereas determinant frameworks do not explicitly take a process perspective of implementation.

/pdf/making-sense-of-implementation-theories-models-and-9m1o7axeoi.pdf

Making sense of implementation theories, models and frameworks

This chapter provides an overview of how the detection, assessment, diagnosis and monitoring of caries integrate with personalized caries management. The background includes the continuing burden of preventable disease that dental caries represents on a global scale. Despite this, and evidence that a purely restorative approach will not 'cure' the disease, preventive caries control has been slow to be adopted in many countries. Following a series of initiatives in the last decade, there is now a range of clinical criteria and tools that can be employed to help clinicians plan patient-centred comprehensive and preventively biased care for their patients. At the core is a sound foundation of lesion detection, assessment and diagnosis which, when combined with appropriate patient level risk information and monitoring, enables effective treatment planning. The International Caries Detection and Assessment System (ICDAS) can enable this process. The ICDAS provides clinical criteria and codes, together with a framework to support and enable personalized comprehensive caries management for improved long-term health outcomes. The target audience for this book comprises those with an interest in dental caries and its clinical management; this should in no way detract from the parallel missions in the domains of dental public health, research or education. If progress is to be made in this field, it is important that a compatible series of terms can be shared across the dental domains and across countries. This will ensure better clinical and patient understanding and help facilitate getting research findings into clinical practice in a more efficient way.

How the detection, assessment, diagnosis and monitoring of caries integrate with personalized caries management.

This study examined the feasibility, acceptability and potential diagnostic value of using a 'blanket' technique for placing elastomeric separators as a diagnostic aid in a general practice situation. Five practices were visited and 211 children between 5 and 15 years were examined. All 211 children accepted the 'clinical without separators' examination, 37 children were unwilling to have the radiographic examination and 12 of the 146 children who required separators refused or removed them. The use of the technique as a routine aid was acceptable to the host practitioners, the parents, most of the patients and to the clinician conducting the study. The method was shown to be valuable in revealing additional approximal lesions. A total of 703 lesions were disclosed by the 'clinical with separators' method, compared with 479 diagnosed by routine clinical examination alone. As many of the additional lesions were at the precavitation stage, this information could be used to target those patients with special needs for preventive care. While the larger dentinal lesions revealed by temporary elective tooth separation were confirmed by bitewing radiographs, many of the small precavitation lesions were not. The results showed, however, that bitewing radiographs were still an important diagnostic aid, especially in the deciduous dentition. Elastomeric separators may have a role as a diagnostic aid in conjunction with bitewings, rather than as a replacement for them.

Temporary elective tooth separation as a diagnostic aid in general dental practice.

This paper reports the results of standardised clinical caries examinations of 172,659 five-year-old children from across the United Kingdom. These 1995/96 coordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating Health Authorities and Boards and caries was diagnosed at the caries into dentine (d3) threshold using a visual method without radiography or fibre-optic transillumination. The results demonstrated once again a wide variation in prevalence across the United Kingdom, with mean values for d3 mft for the current English regions (of the National Health Service) and the other UK territories ranging from 1.08 in the West Midlands to 3.04 in Northern Ireland. The mean value for d3mft across the United Kingdom was 1.84 (d3t = 1.32, mt = 0.30, ft = 0.22). Overall, 44 per cent of children had evidence of caries experience at the dentinal level of detection (d3mft > 0), although the means ranged between 33 per cent (West Midlands) and 63 per cent (Northern Ireland). Trends over time demonstrate a modest improvement of 6.7 per cent in overall d3mft for Great Britain since 1993/94, compared with the modest deterioration seen two years previously. Over recent years the overall trend in this age group seems to be flat, with evidence that there are minor deviations above and below a plateau value. However, there have been some changes. Both dt and the proportion with d > 0 have increased while ft and care index have fallen. The number of fillings provided in 1995/96, and thus the care index, remain low (UK mean care index = 12 per cent, regional/country means range from 8-20 per cent). These findings demonstrate the continuing need for more effective preventive and treatment services for this important age group.

The dental caries experience of 12-year-old children in the united kingdom. surveys coordinated by the british association for the study of community dentistry in 1996/97

The aim of this study was to compare in vitro diagnostic performance of three electrical methods for occlusal caries diagnosis with that of visual inspection and bite–wing radiography. One hundred and seven extracted molar and premolar teeth were subjected to the diagnostic methods by 2 operators and subsequently sectioned for histological validation. Electrical measurements were made at site level and at surface level using two different instruments. The diagnostic parameters calculated from the results were: sensitivity, specificity, diagnostic accuracy at a theoretical caries prevalence of 10% and area under the ROC curve. The electrical methods and bite–wing radiography showed higher sensitivity and lower specificity than visual inspection. Diagnostic accuracy was significantly lower for bite–wing radiography and one electrical method than for visual inspection. Overall diagnostic performance of two electrical methods was superior.

Electrical Methods in Occlusal Caries Diagnosis: An in vitro Comparison with Visual Inspection and Bite–Wing Radiography

Caries diagnosis by the measurement of electrical resistance is hampered by polarization effects when dc or single-low-frequency ac currents are used. Electrical impedance spectroscopy, measuring impedance over a large range of frequencies, will provide more detailed information about the electrical characteristics of teeth. It was the aim of this study (a) to characterize the complex impedance behavior of whole extracted teeth, measured at the approximal surface, and (b) to identify parameters of the complex impedance behavior of the teeth which would be useful in distinguishing between degrees of carious involvement. Thirty-nine extracted premolar teeth with 59 unrestored and undamaged (excepting caries) approximal surfaces were selected. The tooth surfaces were divided into three groups according to their macroscopic appearance: sound (group S, n = 16), white- or brown-spot lesion present (group L, n = 33), or cavitated (group C, n = 10). The teeth were inserted into a jig which allowed for counter-ele...

/pdf/impedance-spectroscopy-of-teeth-with-and-without-approximal-38tpsgheho.pdf

Nigel Pitts

Papers

How the detection, assessment, diagnosis and monitoring of caries integrate with personalized caries management.

Temporary elective tooth separation as a diagnostic aid in general dental practice.

The dental caries experience of 12-year-old children in the united kingdom. surveys coordinated by the british association for the study of community dentistry in 1996/97

Electrical Methods in Occlusal Caries Diagnosis: An in vitro Comparison with Visual Inspection and Bite–Wing Radiography

Impedance Spectroscopy of Teeth with and without Approximal Caries Lesions-an in vitro Study