Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: a mixed methods study

Background: The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed. 
Aim: This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services. 
Design: A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice. 
Setting/participants: Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom. 
Results: In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice. 
Conclusion: Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.

Career choices on graduation--a study of recent graduates from University College Cork

INTRODUCTION: Irish dental graduates are eligible to enter general dental practice immediately after qualification. Unlike their United Kingdom counterparts, there is no requirement to undertake vocational training (VT) or any pre-registration training. VT is a mandatory 12-month period for all UK dental graduates who wish to work within the National Health Service. It provides structured, supervised experience in training practices and through organised study days.

AIMS: This study aimed to profile the career choices made by recent dental graduates from UCC. It aimed to record the uptake of VT and associate posts, and where the graduates gained employment.

METHODOLOGY: A self-completion questionnaire was developed and circulated electronically to recent graduates from UCC. An existing database of email addresses was used and responses were returned by post or by email. A copy of the questionnaire used is included as Appendix 1.

RESULTS: Questionnaires were distributed over an eight-week period and 142 were returned, giving a response rate of 68.90%. Responses were gathered from those who graduated between 2001 and 2007; however, the majority came from more recent classes. Overall, the majority of graduates took up associate positions after qualification (71.8%) with smaller numbers undertaking VT (28.2%). Increasing numbers have entered VT in recent years, including 54.3% from the class of 2007. Overall, the majority of graduates initially took up positions in England (43%); however, in recent times more have been employed in Scotland. Subsequent work profiles of the graduates illustrate that the majority are now working as associates in general practice (51.4%) and in Ireland (54.2%).

CONCLUSIONS: There has been an increase in the proportion of UCC graduates undertaking VT. Graduates tended to move away from Ireland initially to gain employment. There has been a shift away from employment in England towards Scotland where the majority of new UCC graduates are now initially employed. The majority of graduates returned to Ireland for employment after the initial move away.

An analysis of the attitudes of dental patients attending general dental practice in Galway

AIM: To describe the patterns of dental attendance and attitudes towards tooth loss of general dental practice patients in Galway.

OBJECTIVES: 1. To determine the pattern of adult dental attendance in general practices in Galway; and, 2. To examine the oral health attitudes of these patients.

METHOD: Questionnaires were distributed to 311 consecutive adult patients in the waiting rooms of ten general dental practices in Galway, which were randomly selected from the telephone directory.

RESULTS: A total of 254 of the 311 questionnaires distributed were fully completed, returned and included in the results, giving a response rate of 81.7%. A total of 59% of dentate participants attended their dentist for annual or biannual examinations compared to 23% of edentate patients. Some 10.5% of medical card holders and 0.5% of non-medical card holders were edentulous.

CONCLUSIONS: The data from the survey indicated that medical card holders in Galway were more likely to be edentulous than nonmedical card holders. Edentate patients were less likely to be regular dental attenders than dentate patients.

A participatory design agenda for ubiquitous computing and multimodal interaction: A case study of dental practice

This paper reflects upon our attempts to bring a participatory design approach to design research into interfaces that better support dental practice. The project brought together design researchers, general and specialist dental practitioners, the CEO of a dental software company and, to a limited extent, dental patients. We explored the potential for deployment of speech and gesture technologies in the challenging and authentic context of dental practices. The paper describes the various motivations behind the project, the negotiation of access and the development of the participant relationships as seen from the researchers' perspectives. Conducting participatory design sessions with busy professionals demands preparation, improvisation, and clarity of purpose. The paper describes how we identified what went well and when to shift tactics. The contribution of the paper is in its description of what we learned in bringing participatory design principles to a project that spanned technical research interests, commercial objectives and placing demands upon the time of skilled professionals. Copyright © 2010 ACM, Inc

Attitudes of Irish dental graduates to vocational training

INTRODUCTION: Vocational training (VT) is a mandatory 12 month period for UK dental graduates after graduation. Graduates of Irish Dental Schools are eligible to enter the general dental service in Ireland or obtain an NHS performers list number in the UK immediately after qualification. Reports would suggest that some graduates of Irish Dental Schools are choosing to take part in VT in the UK and find the experience beneficial. This study aimed to record the uptake of VT amongst recent graduates from University College Cork and to document their experiences. It was designed to compare the attitudes and experiences of graduates of Irish Dental Schools who undertook VT compared with those who entered the general dental service.

METHOD: A self-completion questionnaire was distributed by e-mail to dental graduates from University College Cork who had graduated 2001-2007. Responses were returned by e-mail or post.

RESULTS: The response rate was 68.9%. There has been an increase in the numbers of graduates taking part in VT each year since 2004. 92.5% of Vocational Dental Practitioners (VDPs) found their experience beneficial as they received a guaranteed source of income, had a supportive peer network and worked in a positive learning environment. However, some felt that they earned a lower income than their associate colleagues, others found the pace of practice slow and that the duration of the training period was excessive. Eighty-five per cent of VDPs would choose the same position again after graduation as compared with 61.8% of associates (P < 0.001). Ninety per cent of VDPs would advise current undergraduates to take part in VT as compared with 51% of associates (P < 0.001). A larger proportion of VDPs had taken part in postgraduate studies but there was no significant difference between the two groups.

CONCLUSIONS: Larger proportions of recent graduates are undertaking vocational training.--The majority of VDPs and associates find their initial employment position beneficial.--VDPs benefit from a guaranteed source of income, a supportive peer network and a positive learning environment.--Some associates suffered from a lack of support, feeling isolated and overwhelmed with patients.--The majority of previous VDPs and associates would recommend VT to current undergraduates.--Almost 40% of associates would now choose to take part in VT if given the opportunity.

Pratique dentaire en milieu rural : perspectives des étudiants en médecine dentaire du Québec

Introduction: La répartition de la main-d'oeuvre dentaire à travers le Canada est fortement balancée en faveur des zones urbaines, une situation qui favorise les disparités dans l'accès aux soins de santé buccodentaire. En engageant des professionnels de la santé buccodentaire dans la pratique dentaire en milieu rural, il faut d’abord comprendre leurs opinions personnelles et professionnelles, ainsi que les obstacles et les facteurs motivant leur choix de pratique. Cependant, il existe un manque des connaissances sur la perception des étudiants de soins de santé buccodentaire à l'égard de la pratique rurale. Par conséquent, nous avons voulu vérifier comment les étudiantes en médecine dentaire perçoivent la pratique dentaire en milieu rural. Méthodes: Nous avons effectué une recherche qualitative dans deux grandes facultés de médecine dentaire au Québec. Un échantillonnage intentionnel et la technique boule de neige ont été utilisé pour recruter des étudiants finissants et des résidents en médecine dentaire en tant que participants à l'étude. Des enregistrements sonores des entrevues, d’une durée de 60 à 90 minutes, semi-structurées et face à face ont été colligés jusqu’à atteinte de la saturation. Nous avons procédé à une analyse thématique pour dégager les enjeux. Cela a inclus un compte-rendu des entrevues, l’encodage des transcriptions, la présentation des données et leur interprétation. Résultats: Dix-sept entretiens (10 F et 7 M, âge: 22 à 39) ont été réalisées. Cinq grands thèmes ont émergé des entrevues: niveau des connaissances sur les inégalités de la santé buccodentaire en milieu rural, image de la ruralité, image de la pratique dentaire en milieu rural, obstacles perçus et facteurs mobilisateurs. Les étudiants ont exprimé que l'éducation dentaire, les avantages financiers, le professionnalisme, le soutien professionnel, et les médias sociaux peuvent influencer positivement leur intérêt à l’égard de la pratique dentaire en milieu rural. Conclusion : Les résultats de cette étude soutiennent la mise en place de stratégies connues pour augmenter la connaissance et la motivation des étudiants en médecine dentaire pour choisir leur profession dans une région rurale. Les acteurs des politiques éducatives ont un rôle essentiel dans la promotion de ces politiques et stratégies facilitantes.

Willingness of Brazilian dentists to treat an HIV-infected patient

A study of the willingness of 363 general dental practices in Brazil to accept a patient infected with human immunodeficiency virus for treatment of dental pain and the provision of routine dental care showed only 44% of dental practices to be willing to provide dental care. Willingness was influenced neither by financial factors nor the local prevalence of human immunodeficiency virus disease. © 1994.

A participatory design agenda for ubiquitous computing : a case study in dental practice

This paper reflects upon our attempts to bring a participatory design approach to design research into interfaces that better support dental practice. The project brought together design researchers, general and specialist dental practitioners, the CEO of a dental software company and, to a limited extent, dental patients. We explored the potential for deployment of speech and gesture technologies in the challenging and authentic context of dental practices. The paper describes the various motivations behind the project, the negotiation of access and the development of the participant relationships as seen from the researchers' perspectives. Conducting participatory design sessions with busy professionals demands preparation, improvisation, and clarity of purpose. The paper describes how we identified what went well and when to shift tactics. The contribution of the paper is in its description of what we learned in bringing participatory design principles to a project that spanned technical research interests, commercial objectives and placing demands upon the time of skilled professionals.

University-industry partnership for pedagogy : some principles for practice

Industries demand a closer alignment of university learning curriculum to real work tasks to better meet the needs of organizations and learners. Both, industries and learners prefer the learning challenges to be based on the exigencies of work to precisely reflect real work circumstances that overtly add to business outcomes. However, such alignment is often complicated and challenging for academics and workplace managers alike. It demands partnerships between universities and industries, similar to arrangements forged for the vocational education and training sector. Such partnerships should allow active participation by learners, academics, workplaces and university administrators to move beyond a teaching orientation to a demonstrably effective learning arrangement through work integrated learning. This paper draws on a case study that negotiated a partnership between a non-government organization and an Australian university to design and facilitate a boutique curriculum that met the needs of learners and their workplace. Data were collected from interviews with participants, a focus group of the interviewees, and feedback from university staff involved in the course delivery. The paper presents a set of principles for universities and industries for partnership to enhance the alignment of academic curriculum to meet organizational and individual learning needs through work integrated learning.

The eLIDA CAMEL nomadic model of collaborative partnership for a community of practice in design for learning

A nomadic collaborative partnership model for a community of practice (CoP) in Design for Learning (D4L) can facilitate successful innovation and continuing appraisals of effective professional practice, stimulated by a 'critical friend' assigned to the project. This paper reports on e-learning case studies collected by the JISC-funded UK eLIDA CAMEL Design for Learning Project. The project implemented and evaluated learning design (LD) tools in higher and further education within the JISC Design for Learning pedagogic programme (2006-07). Project partners trialled professional user evaluations of innovative e-learning tools with learning design function, collecting D4L case studies and LD sequences in post-16/HE contexts using LAMS and Moodle. The project brought together learning activity sequences within a collaborative e-learning community of practice based on the CAMEL (Collaborative Approaches to the Management of e-Learning) model, contributing to international D4L developments. This paper provides an overview of project outputs in e-learning innovations, including evaluations from teachers and students. The paper explores intentionality in the development of a CoP in design for learning, reporting on trials of LD and social software that bridged tensions between formalised intra-institutional e-learning relationships and inter-institutional professional project team dynamic D4L practitioner interactions. Following a brief report of D4L case studies and feedback, the catalytic role of the 'critical friend' is highlighted and recommended as a key ingredient in the successful development of a nomadic model of communities of practice for managing professional e-learning projects. eLIDA CAMEL Partners included the Association of Learning Technology (ALT), JISC infoNet, three universities and five FE/Sixth Form Colleges. Results reported to JISC demonstrated D4L e-learning innovations by practitioners, illuminated by the role of the 'critical friend'. The project also benefited from formal case study evaluations and the leading work of ALT and JISC infoNet in the development of the CAMEL model.