The mental health of Australians bereaved during the first two years of the COVID-19 pandemic: a latent class analysis.

BACKGROUND: The COVID-19 pandemic disrupted many areas of life, including culturally accepted practices at end-of-life care, funeral rites, and access to social, community, and professional support. This survey investigated the mental health outcomes of Australians bereaved during this time to determine how these factors might have impacted bereavement outcomes. METHODS: An online survey indexing pandemic and bereavement experiences, levels of grief, depression, anxiety, and health, work, and social impairment. Latent class analysis (LCA) was used to identify groups of individuals who shared similar symptom patterns. Multinomial regressions identified pandemic-related, loss-related, and sociodemographic correlates of class membership. RESULTS: 1911 Australian adults completed the survey. The LCA identified four classes: low symptoms (46.8%), grief (17.3%), depression/anxiety (17.7%), and grief/depression/anxiety (18.2%). The latter group reported the highest levels of health, work, and social impairment. The death of a child or partner and an inability to care for the deceased due to COVID-19 public health measures were correlated with grief symptoms (with or without depression and anxiety). Preparedness for the person's death and levels of pandemic-related loneliness and social isolation differentiated all four classes. Unemployment was associated with depression/anxiety (with or without grief). CONCLUSIONS: COVID-19 had profound impacts for the way we lived and died, with effects that are likely to ricochet through society into the foreseeable future. These lessons learned must inform policymakers and healthcare professionals to improve bereavement care and ensure preparedness during and following future predicted pandemics to prevent negative impacts.

An innovative approach to address homelessness in regional Australia: Participant evaluation of a co-payment model.

OBJECTIVES: Homelessness is not only about lack of secure housing, it is sometimes caused by simple reasons such as lack of money to travel home. The purpose of this study was to investigate whether the participant co-funded assistance program ('Return to Country' [R2C]), when offered to low socio-economic individuals experiencing homelessness, represented an effective use of scarce resources. STUDY DESIGN: In northern Australia, a remote and sparsely populated area, Indigenous persons who travel to regional centres cannot always afford airfares home; they therefore become stranded away from their 'country' leading to rapidly deteriorating health, isolation and separation from family and kin. The R2C program was designed to facilitate travel for persons who were temporarily stranded and were voluntarily seeking to return home. The program provided operational support and funding (participants co-funded AU$99) to participants to return home. METHODS: Using a descriptive, case series research design, university researchers independently evaluated the R2C program using semi-structured interviews with 37 participants. RESULTS: An investment of AU$970 per participant in the program with partial co-payment was associated with high participant acceptability and satisfaction in-line with harms reduction around substance and criminal abuse, which is suggestive of long-term success for the model. CONCLUSIONS: Findings from this study can contribute to the development of best practice guidelines and policies that specifically address the needs of this unique population of stranded persons, who are seeking to return home. The acceptance of the co-payment model can be adopted by policy makers involved in homelessness prevention in other locations in Australia or internationally as an add-on service provision to mainstream housing support.

Threshold concepts in dental education.

The paper presents a conceptual framework to inform dental education. Drawing from a vast body of research into student learning, the simple model presented here has an explanatory value in describing what is currently observed to happen and a predictive value in guiding future teaching practices. We introduce to dental education the application of threshold concepts that have a transformative role in offering a new vision of the curriculum that helps to move away from the medieval transmission model of higher education towards a dual processing model that better reflects the way in which professionals operate within the discipline. Threshold concepts give a role for the student voice in offering a novice perspective which is paradoxically something that is out of reach of the subject expert. Finally, the application of threshold concepts highlights some of the weaknesses in the competency-based training model of clinical teaching.

An introduction to concept mapping in dental education: the case of partial denture design.

The aim of this paper is to present concept mapping as a tool for enhancing clinical dental education and develops the authors' argument for the use of concept mapping presented previously in the pages of this journal. Materials presented are based on data gathered from extensive observation of learning and teaching in a UK dental school, and upon a case study of student learning of removable partial denture design. Using examples developed with students and teachers, critical elements of the approach are illustrated which can be used to support dialogue between the two parties. This approach can be used to develop active teaching strategies and engaged learning approaches that support the development of clinical expertise.

Using concept mapping principles in PowerPoint.

The use of linear PowerPoint templates to support lectures may inadvertently encourage dental students to adopt a passive approach to learning and a narrow appreciation of the field of study. Such presentations may support short-term learning gains and validate assessment regimes that promote surface learning approaches at the expense of developing a wider appreciation of the field that is necessary for development of clinical expertise. Exploitation of concept mapping principles can provide a balance for the negative learning behaviour that is promoted by the unreflective use of PowerPoint. This increases the opportunities for students to access holistic knowledge structures that are indicators of expertise. We illustrate this using the example of partial denture design and show that undergraduates' grasp of learning and teaching issues is sufficiently sophisticated for them to appreciate the implications of varying the mode of presentation. Our findings indicate that students understand the strategic value of bullet-pointed presentations for short-term assessment goals and the benefits of deep learning mediated by concept mapping that may support longer term professional development. Students are aware of the tension between these competing agendas.

Dental vocational training: identifying and developing trainer expertise.

AIMS: The aims of the study were two fold: to determine the influence of trainer expertise on the Vocational Training (VT) experience, particularly in terms of providing Vocational Dental Practitioners (VDPs) with positive role models; and to ascertain if it is possible to identify attributes of expertise that can signpost a successful path for new/less expert trainers. PARTICIPANTS: Thirty-five VDPs and each of their Vocational Trainers participated in the study. All training took place in the South East of England. DESIGN: The participants were followed through the 12 months of their VT year. Semi-structured interviews were conducted with both trainers and VDPs on two occasions, during the year and once VT had been completed. It was also possible to observe practice sessions and VT Study Day teaching. The descriptive analysis of the training partnerships has been previously described. The original data were revisited through a constant comparative analysis of the interview transcripts and observation notes. RESULTS: The influence of training expertise is identified and discussed as is the VDP view of the trainer as a role model. Attributes of training expertise are highlighted and presented as a guiding path for new/inexpert trainers. CONCLUSION: The training expertise of a trainer has a significant influence on the VT experience for both trainer and VDP. Expertise has the potential to be harnessed and used to good effect in VT.