Inappropriate behaviours in a dental training environment: pilot of a UK-wide questionnaire.

Incivility and inappropriate behaviour in the workplace are topics of growing interest due to their impact on patient care and safety. Several surveys and campaigns have emerged highlighting the existence of a problem. However, the true scale is difficult to ascertain. The aim of this study is to determine the existence of inappropriate behaviours within the UK dental training environment.An anonymous pilot questionnaire was distributed across multiple platforms reaching out to dental professionals within training environments, inviting responses between July 2022 and October 2022. A total of 215 responses were received. The vast majority (73.2%) felt that inappropriate behaviour is a problem within UK dental training. Senior colleagues were identified as perpetrators in 88% of responses. Most respondents (66%) reported feeling uncomfortable raising the issue, and when raised, 30% felt unsupported. Only 9% felt confident that action was taken after the issue was reported. Belittling was experienced and witnessed most commonly.The feedback received reveals the existence of inappropriate behaviours within dental training environments. Qualitative feedback indicates that if left unaddressed, the impact of such behaviour may persist long-term. Further research is required to address this issue, improve dental training conditions and job satisfaction.

Dentofacial injuries and domestic abuse.

DATA SOURCES: Ovid, Medline, EMBASE, PsycINFO, CINAHL, LILACS, CENTRAL, bibliographies of identified RCTs, Current Controlled Trials, domestic violence organisations, handsearching of a number of articles. STUDY SELECTION: This is an update of a review reported in 2004. Randomised controlled trials in any language that included adults (persons >16 years of age) presenting with facial or dental injuries to dental or healthcare settings. Eligible interventions were: referral to support services or screening for domestic violence. Eligible outcomes were: frequency of physical assault by self-report, severity of injury by self-report and proportion of victims of domestic violence detected by self-report. DATA EXTRACTION AND SYNTHESIS: Two reviewers screened potential reports and would have data extracted had suitable RCTs been included. RESULTS: No RCTs met the inclusion criteria. CONCLUSIONS: There is also no evidence from RCTs to suggest that screening for domestic violence in adults with dental or facial injury in any health setting is beneficial or harmful.

Management of patients at risk of adrenal crisis in the dental setting: a review of current practice in UK dental teaching hospitals.

Introduction Patients with impaired corticosteroid response due to Addison's disease or systemic glucocorticoid use are at risk of adrenal crisis when undergoing dental treatment. There is a lack of conclusive evidence to support dental teams in identifying patients at risk and their management to prevent an adrenal crisis.Aim To review the current practice in UK dental teaching hospitals regarding the management of patients at risk of adrenal crisis in the dental setting.Methods An electronic survey focused on patients who may be at risk of adrenal crisis due to systemic glucocorticoid therapy was sent to all 18 UK dental teaching hospitals. Information on the use of a policy or guidance was requested. Responses were evaluated for clinical decision-making, patient risk assessment and steroid cover dosing regimens.Results A 78% response rate was achieved. Only 29% of institutions had a written policy or guidance document. Variation exists in the threshold of steroid dose and duration of treatment in identifying patients at risk of adrenal suppression. Furthermore, the dose regime for steroid cover varied.Conclusion Further evidence on the management of patients at risk of adrenal crisis is required to inform national guidance and reduce variation in patient management.

Medics against violence--the development of a new violence prevention intervention for schools.

UNLABELLED: This article outlines the rationale, evidence base and development of a new anti-violence intervention for schools delivered in the school setting by healthcare professionals. It is an example of multi-professional and mutli-disciplinary working and demonstrates how all healthcare professionals can be involved in wider healthcare issues. CLINICAL RELEVANCE: The majority of victims of violence are young men. Most incidents of interpersonal violence involve injury to the head and neck area, including the dentition. The Medics against Violence Schools Project is very relevant to Oral and Maxillofacial Surgeons, Oral Surgeons and General Dental Practitioners all of whom may have to deal with the sequelae of such injuries.

Preliminary research informing policy on remote alcohol monitoring in criminal justice: the Scottish experience.

OBJECTIVES: To explore the views of Scottish offenders on the impact of alcohol on their experience of offending and their lives in general. Furthermore, to explore their views on the concept of remote alcohol monitoring (RAM) as a way to address alcohol misuse upon liberation from prison. METHODS: A convenience sample of 12 serving offenders participated in one of three focus groups. Data were analysed using the principles of thematic analysis. RESULTS: Analysis of the data revealed the significant impact of alcohol on the lives of the participants. Key themes included the amount and frequency of alcohol consumption; the association of alcohol with harm; the association of alcohol with offending; the previous attempts to reduce alcohol consumption and possible reasons for failure; and the views of participants on the utility of RAM in relation to crime prevention. CONCLUSIONS: Participants had significant issues with alcohol misuse prior to incarceration that had impacted on their offending and resulted in both health and social harms. Participants were generally positive but pragmatic about RAM, recognising that technology alone may not be enough to change deeply ingrained and addictive behaviours.

An experimental trial exploring the impact of continuous transdermal alcohol monitoring upon alcohol consumption in a cohort of male students.

OBJECTIVE: To examine the impact of continuous transdermal alcohol monitoring upon alcohol consumption in male students at a Scottish university. METHOD: Using a within-subject mixed-methods design, 60 male university students were randomly allocated into three experimental conditions using AUDIT score stratified sampling. Participants in Conditions A and B were asked not to consume alcohol for a 14-day period, with those in Condition A additionally being required to wear a continuous transdermal alcohol monitoring anklet. Condition C participants wore an anklet and were asked to continue consuming alcohol as normal. Alcohol consumption was measured through alcohol timeline follow-back, and using data collected from the anklets where available. Diaries and focus groups explored participants' experiences of the trial. RESULTS: Alcohol consumption during the 14-day trial decreased significantly for participants in Conditions A and B, but not in C. There was no significant relative difference in units of alcohol consumed between Conditions A and B, but significantly fewer participants in Condition A drank alcohol than in Condition B. Possible reasons for this difference identified from the focus groups and diaries included the anklet acting as a reminder of commitment to the study (and the agreement to sobriety), participants feeling under surveillance, and the use of the anklet as a tool to resist social pressure to consume alcohol. CONCLUSIONS: The study provided experience in using continuous transdermal alcohol monitors in an experimental context, and demonstrated ways in which the technology may be supportive in facilitating sobriety. Results from the study have been used to design a research project using continuous transdermal alcohol monitors with ex-offenders who recognise a link between their alcohol consumption and offending behaviour.