Morgaine Kc

Reducing disease burden and health inequalities arising from chronic disease among indigenous children: an early childhood caries intervention in Aotearoa/New Zealand

BackgroundMaaori are the Indigenous people of New Zealand and do not enjoy the same oral health status as the non-Indigenous majority. To overcome oral health disparities, the life course approach affords a valid foundation on which to develop a process that will contribute to the protection of the oral health of young infants. The key to this process is the support that could be provided to the parents or care givers of Maaori infants during the pregnancy of the mother and the early years of the child. This study seeks to determine whether implementing a kaupapa Maaori (Maaori philosophical viewpoint) in an early childhood caries (ECC) intervention reduces dental disease burden among Maaori children. The intervention consists of four approaches to prevent early childhood caries: dental care provided during pregnancy, fluoride varnish application to the teeth of children, motivational interviewing, and anticipatory guidance.Methods/designThe participants are Maaori women who are expecting a child and who reside within the Maaori tribal area of Waikato-Tainui.This randomised-control trial will be undertaken utilising the principles of kaupapa Maaori research, which encompasses Maaori leadership, Maaori relationships, Maaori customary practices, etiquette and protocol. Participants will be monitored through clinical and self-reported information collected throughout the ECC intervention. Self-report information will be collected in a baseline questionnaire during pregnancy and when children are aged 24 and 36 months. Clinical oral health data will be collected during standardised examinations at ages 24 and 36 months by calibrated dental professionals. All participants receive the ECC intervention benefits, with the intervention delayed by 24 months for participants who are randomised to the control-delayed arm.DiscussionThe development and evaluation of oral health interventions may produce evidence that supports the application of the principles of kaupapa Maaori research in the research processes. This study will assess an ECC intervention which could provide a meaningful approach for Maaori for the protection and maintenance of oral health for Maaori children and their family, thus reducing oral health disparities.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000111976.

Patients' perspectives on zirconia and titanium implants with a novel distribution supporting maxillary and mandibular overdentures: a qualitative study.

OBJECTIVES This qualitative study explored the perceptions of edentulous patients regarding their rehabilitation with maxillary and mandibular implant-supported overdentures employing a protocol that featured novel implant sites and distribution. MATERIAL AND METHODS In-depth semi-structured interviews were conducted with 16 participants who have taken part in a randomized controlled trial. Each received implant overdentures supported by either titanium or zirconia one-piece implants. Participants received four implants in the maxilla and three implants in the mandible. The implant distribution was: in the maxilla, a mid-palatal implant, and three anterior implants in the incisor and first premolar regions; in the mandible, a mid-symphseal implant, and bilateral distal implants in the first molar region. All interviews were conducted by a researcher not involved with the clinical aspect of the randomized controlled trial and were transcribed verbatim and analyzed using a thematic inductive analysis approach. RESULTS The perceived advantages of the treatment were functional improvement and increased social confidence. Cost was a significant barrier for edentulous patients seeking implant treatment. Previous experience with complete dentures, age and length of treatment was further factors that influenced decisions regarding prosthodontic rehabilitation. The novel implant protocol was acceptable to patients. CONCLUSIONS Implant overdentures improve the quality of life of edentulous patients. Acceptance of dental implants may be increased by mitigating the cost of treatment. The mid-palatal implant site may be a potential alternative to extensive surgical procedures during the prosthodontic rehabilitation of atrophic maxillary ridges. The mandibular design offers patients the advantages of a removable prosthesis with increased retention.

Design of an oral health information brochure for at-risk individuals

Objective: Our aim was to develop written resource material for use in the Oral Health Information through Community Pharmacists project. Poor oral health is associated with cardiovascular disease and diabetes. Many people do not access dental services on a regular basis; however, they may access community pharmacies for help and advice about oral health problems. Community pharmacists may be a valuable point of oral health information for people with heart disease or diabetes. Design: This paper reports the development of the written resource material for the project groups. Methods: Brochure development was guided by Fishbein and Yzer’s integrative model, and pre-tested with seven focus groups representing the potential target groups. Feedback from the focus groups was analysed concurrently and modified versions of the brochures were presented to subsequent groups. Results: The use of both written and visual messages enhanced the readability of the brochures for the focus groups with attendant Flesch Reading Ease scores of 77.4 and 79.4, while the ‘Make a plan’ section prompted future action planning amongst the participants. Conclusion: Well-designed patient education materials with good content, aesthetics and readability are important to deliver health messages within the context of a planned intervention. The three final brochures will be used in the intervention trial of the project.

An outcome evaluation of a New Zealand farm safety intervention: a historical cohort study.

BACKGROUND There is limited evidence that farm safety-related interventions based solely on an educational element have an effect on injury rates. Our aim was to evaluate a New Zealand national educational program, FarmSafe™ Awareness, for its effect on injury rates. METHODS We used a before-after design followed by a historical cohort study of sheep, beef, and dairy farmers/workers. The outcomes were work-related injuries, identified from workers compensation data. Cox regressions were used to compare intervention with matched control group rates. RESULTS FarmSafe™ Awareness was associated with significantly higher rates of work-related injury, than matched controls. CONCLUSIONS It is difficult to see how FarmSafe™ Awareness could be causing an increased rate of work-related injury. We detected no reporting bias, and selection bias is likely to act in the opposite direction to the observed results. We conclude that there is no evidence that FarmSafe™ Awareness prevents farm injury.

GoodYarn: building mental health literacy in New Zealand’s rural workforce

Purpose “GoodYarn” is a skills-based workshop that focusses on building mental health literacy in rural communities, members of which are known to experience geographic, attitudinal and service configuration barriers to accessing mental health services. The purpose of this paper is to evaluate the impact of the GoodYarn project on raising mental health literacy in the rural community. Design/methodology/approach GoodYarn is primarily for farmers, their families and farm workers, as well as the “farmer facing” workforce. The focus on mental health literacy aligns with the mental health promotion approach of using methods that foster supportive environments. By raising the mental health literacy of those not directly needing help, but in positions to help those that do – such as employers, rural professionals and rural support industries who are well placed to perceive stressors in farmers – GoodYarn builds a community with the knowledge and skills to identify and approach those experiencing mental distress or illness, and direct them to appropriate support and services. All participants in the GoodYarn workshops (n=430) were invited to complete a questionnaire at the end of the workshop. All participants answered the questionnaire, with over 80 per cent answering all questions. Findings Participant feedback affirmed the utility of GoodYarn as an effective vehicle to facilitate the discussion of mental illness in rural farming communities of New Zealand. GoodYarn had a significant positive impact on the three immediate workshop indicators of awareness, confidence and knowledge (p<0.001 for all three indicators). Further, the high level of concordance in workshop outcomes across various organisations’ delivery indicates programme consistency and quality has been maintained throughout the upscaling of the programme. Originality/value The uptake of the GoodYarn programme by rural organisations and communities at a national level, and the positive evaluation results, provide encouragement that building mental health literacy in the rural workforce is a promising mental health promotion strategy.

Impact evaluation of a farm safety awareness workshop in New Zealand

OBJECTIVE Farming is a hazardous occupation, with high rates of injury and death. FarmSafe, a whole-country approach, sought to address work-related injury on New Zealand sheep, beef, and dairy farms. More than 10 000 farmers participated in 630 workshops held over two years. This short communication presents the results of an impact evaluation of the FarmSafe Awareness Workshop (FSAW) in its first two years of operation. METHODS All FSAW participants completed, and received credit for, formal educational assessments. Pass rates were used to assess safety knowledge, and a quasi-experimental design with intervention and comparison groups was applied to assess attitudes, safety behaviors, and environmental determinants of injury. RESULTS An intervention (N=111) and two comparison groups (C1, N=409, and C2, N=78) completed before and after questionnaires. At follow-up, the intervention group (IG) showed a small improvement in attitudes toward safety (IG=79.3, C1=77.4; C2=77.4, P=0.035), but there were no differences between groups for personal safety practice or the safety environment of the farm. However, if a respondent registered their interest in the workshop, but a different person from the same farm attended, there was some improvement in the safety of the farm environment score. CONCLUSION Well-conducted safety training tailored to farmers was still not enough to change safety practice. Future interventions may be more likely to achieve progress if they are comprehensive, include environmental and enforcement features, and target more than one participant per farm.