A study of patient attitudes towards fasting prior to intravenous sedation for dental treatment in a dental hospital department

INTRODUCTION: Intravenous sedation is the most commonly used method of sedation for the provision of adult dental care. However, disparity exists in pre-operative fasting times in use for patients throughout the United Kingdom.

AIMS: The aims of the study were to obtain information on the effects of existing extended pre-operative fasting regimens, to canvas patient opinions on the fasting process, and to record their positive and negative experiences associated with it.

METHODS: A prospective cross-sectional descriptive study using survey methodology was conducted of adult patients attending a dental hospital for operative treatment under intravenous sedation. Sixty-four questionnaires were distributed over a four-month period, beginning 2nd October 2007.

RESULTS: The surveyed patient pool consisted of 38 females and 14 males with a mean age of 32.4 years. The response rate achieved was 81.2%. Seventy-one per cent of patients indicated that normally they consumed something for breakfast, the most common items being tea and toast. Fifty-one per cent of patients indicated that they would wish to eat the same as normal prior to their appointment and 59% wished to drink as normal. Only 19% of respondents reported that they did not wish to eat anything, with 8% preferring not to drink anything at all. Seventy-nine per cent of the patients reported that they had experienced at least one adverse symptom after fasting and 42% had experienced two or more such symptoms. In general, those patients with more experience of sedation found fasting less unpleasant than those attending for the first time (P<0.05). In addition, one-quarter of all patients indicated that the fasting process had made them feel more nervous about their sedation appointment.

CONCLUSIONS: The extended fasting regimen prior to intravenous sedation appeared to affect patients' wellbeing, as the majority reported adverse symptoms.

Preschool Children's Awareness of and Attitudes Toward Difference: A Study of 3- and 4-Year-Old Children in Northern Ireland

This paper presents the findings of a large-scale survey (n = 1,049) of the ethnic awareness and attitudes of 3-4 year old children in Northern Ireland. In drawing upon and applying Bourdieu’s notion of habitus, the paper demonstrates how even at this age, the children are already beginning to embody and internalize the cultural habits and dispositions of their respective ethnic groups. This was found in relation to the children’s: friendships choices; preferences for particular national flags; and dispositions towards specific sports associated with their respective communities. Informed by the work of Bourdieu, the paper concludes by arguing for the need for greater use of quantitative methods employing multivariate and multilevel statistical analyses and for these to be based on a more open and meaningful engagement with the findings of indepth qualitative and ethnographic research in this area.

When opportunity matters: Comparing the risk taking attitudes of prisoners and recently released ex-prisoners

Risk-taking tendencies and environmental opportunities to commit crime are two key features in understanding criminal behavior. Upon release from prison, ex-prisoners have a much greater opportunity to engage in risky activity and to commit criminal acts. We hypothesized that ex-prisoners would exhibit greater risk-taking tendencies compared to prisoners who have fewer opportunities to engage in risky activity and who are monitored constantly by prison authorities. Using cumulative prospect theory to compare the risky choices of prisoners and ex-prisoners our study revealed that ex-prisoners who were within 16 weeks of their prison release made riskier choices than prisoners. Our data indicate that previous studies comparing prisoners behind bars with nonoffenders may have underestimated the risk-taking tendencies of offenders. The present findings emphasize the central role played by risk-taking attitudes in criminal offending and highlight a need to examine offenders after release from prison.

Graduate Attitudes towards Vocational Training

Introduction: Vocational training (VT) is a mandatory requirement for all UK dental graduates prior to entering NHS practice. The VT period provides structured, supervised experience supported by study days and interaction with peers. It is not compulsory for Irish dental graduates working in either Ireland or the UK to undertake VT but yet a proportion voluntarily do so each year.

Objectives: This study was designed to explore the choices made by Irish dental graduates. It aimed to record any benefits of VT and its impact upon future career choices.

Method: A self-completion questionnaire was developed and piloted before being circulated electronically to recent dental graduates from University College Cork. After collecting demographic information respondents were asked to indicate if they pursued vocational training on graduation, give their perception of their post-graduation experience, describe their current work profile and detail any formal postgraduate studies.

Results: 35% of respondents opted to undertake VT and 79% did so in the UK. Those who completed VT regarded it as a very positive experience with benefits including: working in a positive learning environment, help on demand and interaction with peers. Of those who chose VT, 49% have pursued some form of further formal postgraduate study as compared to 40% of those who did not. All of the respondents who completed VT indicated they would recommend it to current Irish graduates. The majority of those who took up an associate position immediately after graduation reported that this was beneficial but up to three quarters would recommend current graduates undertake VT and 45% would now chose to do so themselves.

Conclusions: Increasing numbers of Irish graduates are moving to the UK to undertake VT and they find it a beneficial experience. In addition, those who undertook VT were more likely to undertake formal postgraduate study.

Construction Industry Attitudes to Global Environmental Change: A Comparison with the United Kingdom and Japan

With the continued diffusion of global boundaries coupled with the onset of increased environmental pressure, construction industry attitudes are also shifting. The aim of this paper is to evaluate the construction industry attitudes to global environmental change in both the United Kingdom and Japan. In order to achieve this goal, a qualitative mixed method approach is adopted, encompassing a desk based critique of the literature coupled with an industry interview from both regions. This methodology is adopted with the objective of ascertaining if there are any geographical similarities or differences with the regions in question. The resulting information is analyzed and the results deciphered utilizing mind mapping techniques in the dissemination of the data obtained with the objective of identifying various traits within the data. The results indicate that the United Kingdom and Japan both illustrate various attributes in relation to attitudes towards the global environment. In particular, research indicates that in the Japanese construction industry, there is a distinct lack of enthusiasm shown in construction industry attitudes to counteract environmental challenges currently being faced by implementing sustainable practices, compared to attitudes in the UK construction industry. One of the reasons identified for this, is the lack of leadership provided by the corresponding government, thus resulting in the lack of promotion of sustainable practices in the region. The benefit of this research is that it enables various industry leaders, regardless of geographical location, to actively consider the attitudes and perceptions of those around them, particularly in relation to the sensitive topic of global environmental change within the industry. Where the findings are acknowledged and also utilized, the results should aid in the improvement of the industry on an international scale, while also improving the overall persona of environmental change within the sector.

Reconstructing the Social Fabric amid On-going Violence: Attitudes toward Reconciliation and Structural Transformation in Colombia

Given the increase of reconciliation processes initiated amid on-going violence, this study focuses on community reconciliation and its relation to structural transformation, or social reconstruction through reforming unjust institutions and practices that facilitate protracted violent conflict. Drawing lessons from the Caribbean coast of Colombia, mixed method analyses include eight in-depth interviews and 184 surveys. Four key dimensions of reconciliation – truth, justice, mercy, peace – are examined. In the interviews, participants prioritize reconstructing the truth and bringing perpetrators to justice as essential aspects of reconciliation. Notions of mercy and forgiveness are less apparent. For the participants, sustainable peace is dependent on structural transformation to improve livelihoods. These data, however, do not indicate how this understanding of reconciliation may relate to individual participation in reconciliation processes. Complementing the qualitative data, quantitative analyses identify some broad patterns that relate to participation in reconciliation events. Compared to those who did not participate, individuals who engaged in reconciliation initiatives report higher levels of personal experience with violence, live alongside demobilized paramilitaries, are more engaged in civic life, and express greater preference for structural transformation. The paper concludes with policy implications that integrate reconciliation and structural transformation to deepen efforts to rebuild the social fabric amid violence.

Decision making in child protection: An international comparative study on maltreatment substantiation, risk assessment and interventions recommendations, and the role of professionals’ child welfare attitudes

Child welfare professionals regularly make crucial decisions that have a significant impact on children and their families. The present study presents the Judgments and Decision Processes in Context model (JUDPIC) and uses it to examine the relationships between three indepndent domains: case characteristic (mother’s wish with regard to removal), practitioner characteristic (child welfare attitudes), and protective system context (four countries: Israel, the Netherlands, Northern Ireland and Spain); and three dependent factors: substantiation of maltreatment, risk assessment, and intervention recommendation.
The sample consisted of 828 practitioners from four countries. Participants were presented with a vignette of a case of alleged child maltreatment and were asked to determine whether maltreatment was substantiated, assess risk and recommend an intervention using structured instruments. Participants’ child welfare attitudes were assessed.
The case characteristic of mother’s wish with regard to removal had no impact on judgments and decisions. In contrast, practitioners’ child welfare attitudes were associated with substantiation, risk assessments and recommendations. There were significant country differences on most measures.
The findings support most of the predictions derived from the JUDPIC model. The significant differences between practitioners from different countries underscore the importance of context in child protection decision making. Training should enhance practitioners’ awareness of the impact that their attitudes and the context in which they are embedded have on their judgments and decisions.

Socioeconomic inequalities in attitudes towards cancer: An international cancer benchmarking partnership study

Socioeconomic status (SES) differences in attitudes towards cancer have been implicated in the differential screening uptake and the timeliness of symptomatic presentation. However, the predominant emphasis of this work has been on cancer fatalism, and many studies focus on specific community subgroups. This study aimed to assess SES differences in positive and negative attitudes towards cancer in UK adults. A population-based sample of UK adults (n=6965, age≥50 years) completed the Awareness and Beliefs about Cancer scale, including six belief items: three positively framed (e.g. 'Cancer can often be cured') and three negatively framed (e.g. 'A cancer diagnosis is a death sentence'). SES was indexed by education. Analyses controlled for sex, ethnicity, marital status, age, self-rated health, and cancer experience. There were few education-level differences for the positive statements, and overall agreement was high (all>90%). In contrast, there were strong differences for negative statements (all Ps<0.001). Among respondents with lower education levels, 57% agreed that 'treatment is worse than cancer', 27% that cancer is 'a death sentence' and 16% 'would not want to know if I have cancer'. Among those with university education, the respective proportions were 34, 17 and 6%. Differences were not explained by cancer experience or health status. In conclusion, positive statements about cancer outcomes attract near-universal agreement. However, this optimistic perspective coexists alongside widespread fears about survival and treatment, especially among less-educated groups. Health education campaigns targeting socioeconomically disadvantaged groups might benefit from a focus on reducing negative attitudes, which is not necessarily achieved by promoting positive attitudes.