Developing and Pretesting Case Studies in Dental and Dental Hygiene Education: Using the Diffusion of Innovations Model

Evolution and development of methodologies in social and behavioural science research in relation to oral health

The aim of this introductory paper is to provide an overview of key methodological developments in social and behavioural research in oral health. In the first section, we provide a brief historical perspective on research in the field. In the second section, we outline key methodological issues and introduce the seven papers in the theme. Conceptual models can contextualize research findings and address the 'why' and 'how' instead of 'what' and 'how many'. Many models exist, albeit they need to be evaluated (and adapted) for use in oral health research and in specific settings. The increasing availability of big data can facilitate this with data linkage. Through data linkage, it is possible to explore and understand in a broader capacity the array of factors that influence oral health outcomes and how oral health can influences other factors. With advances in statistical approaches, it is feasible to consider casual inferences and to quantify these effects. There is a need for not only individual efforts to embrace causal inference research but also systematic and structural changes in the field to yield substantial results. The value of qualitative research in co-producing knowledge with and from human participants in addressing 'the how' and 'the why' factors is also key. There have been calls to employ more sophisticated qualitative methods together with mixed methods approaches as ways of helping to address the complex or Wicked Problems in population oral health. In the final section, we outline possible future methodological directions in social and behavioural oral health research including participatory approaches and the development of core outcome sets. Our overriding goal in the paper is to facilitate a critical debate in relation to methodological issues which can be used to improve understanding and generate knowledge in population oral health and that this, in turn, will help inform oral health policy and practices.

Quality of Root Canals Performed by the Inaugural Class of Dental Students at Libyan International Medical University

Objective. The purpose of this study was to radiographically evaluate technical quality of root canal fillings performed by dental undergraduates at Libyan International Medical University in Libya. Methods. Root canal cases were treated at university dental clinic from the fall of 2012 to the fall of 2013 by the fourth and fifth year dental students. Students used step-back preparation and cold lateral compaction in the treatment. Radiographs were reviewed over a two-year period from initial procedure to final restoration. Radiographs were evaluated for adequacy or inadequacy by length, density, and taper. Length inadequacy was classified as short or overextended. Overall quality was considered "adequate" based on all three variables. Chi-square tested differences between teeth groupings and adequacy classification. Significant p value results were adjusted by Bonferroni correction. Results. Adequate length of root canal fillings were observed in roughly half of all samples (48.6%). Density was adequate in 75.8% of the samples. Taper was observed as adequate in 68.8%. Higher quality was evident in anterior teeth (plus premolars) versus molars (65.6% versus 43.3%, resp.; p < 0.04). Conclusion. Overall quality of endodontic treatment performed by undergraduate dental students was adequate in 53.9% of the cases. Significant opportunity exists to improve the quality of root canals provided by dental students.

Application of a model for delivering occupational safety and health to smaller businesses: Case studies from the US

Smaller firms are the majority in every industry in the US, and they endure a greater burden of occupational injuries, illnesses, and fatalities than larger firms. Smaller firms often lack the necessary resources for effective occupational safety and health activities, and many require external assistance with safety and health programming. Based on previous work by researchers in Europe and New Zealand, NIOSH researchers developed for occupational safety and health intervention in small businesses. This model was evaluated with several intermediary organizations. Four case studies which describe efforts to reach small businesses with occupational safety and health assistance include the following: trenching safety training for construction, basic compliance and hazard recognition for general industry, expanded safety and health training for restaurants, and fall prevention and respirator training for boat repair contractors. Successful efforts included participation by the initiator among the intermediaries' planning activities, alignment of small business needs with intermediary offerings, continued monitoring of intermediary activities by the initiator, and strong leadership for occupational safety and health among intermediaries. Common challenges were a lack of resources among intermediaries, lack of opportunities for in-person meetings between intermediaries and the initiator, and balancing the exchanges in the initiator-intermediary-small business relationships. The model offers some encouragement that initiator organizations can contribute to sustainable OSH assistance for small firms, but they must depend on intermediaries who have compatible interests in smaller businesses and they must work to understand the small business social system.

A model for occupational safety and health intervention diffusion to small businesses

BACKGROUND

Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations.

METHODS

This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations ("initiators") must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model.

RESULTS

The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming.

CONCLUSIONS

The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed. Am. J. Ind. Med. 56:1442-1451, 2013. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.