Practice-based Research Research Articles

Randomized controlled trial of an audit and feedback cycle to improve adherence to Choosing Wisely Canada recommendations.

Context: Choosing Wisely Canada (CWC) aims to engage healthcare providers to reduce unnecessary care. Reducing overuse of antimicrobials and antipsychotics in patients with dementia in primary care settings remains an ongoing challenge. Audit and Feedback (A&F) interventions can facilitate practice change but can be improved by understanding factors affecting the likelihood of uptake of the feedback. Objective: To assess the impact of A&F interventions to reduce unnecessary prescribing of antibiotics and antipsychotics use and evaluate whether practice changes remain stable over time. Design: Clustered randomized controlled trial. Dataset: The Manitoba Primary Care Research Network (MaPCReN), a practice-based network that includes a repository containing de-identified EMR data from over 288,000 Manitobans. Population: Primary care providers participating in MaPCReN were randomized to three A&F groups: 1) Information on the relevant CWC recommendations; 2) practice specific data along with general information regarding the CWC recommendations 3) No CWC information. Outcome Measures: Statistics demonstrating changes in target prescriptions. Multivariate regression assessed characteristics of providers with improved prescribing. Results: 182 primary care providers were evaluated, 86.3% decreased the number of target prescriptions. More providers decreased prescribing in group1 (88.9%) or group2 (94.0%) compared to the control group 3 (76.7%) (p-value 0.02). There was no statistically significant difference between practice specific feedback and generic CWC information. An average of 46 antibiotic medications per provider were prescribed for viral indications in 2014/2015. This dropped to 15 in 2016/17 and was 18 in 2018/19. An average of 3 antipsychotic medications were prescribed for patients with dementia in 2014/2015. This dropped 7% in 2016/17 and remained stable in 2018/19. There were no statistically significant provider characteristics when considering all providers with improved prescribing, but male, rural and fee for service providers were more likely to decrease prescribing greater than the mean. Conclusion: Both practice specific and generic A&F information sent directly to primary care providers by a trusted source reduced potentially unnecessary prescriptions. This supports ongoing engagement with primary care providers in practice-based research networks to improve care and promote sustained practice changes.

WebXR Asset Management in Developing Virtual Reality Learning Media

Extended Reality (XR) is the technology that allows blending virtual and physical worlds using augmented reality (AR) and Virtual Reality (VR) to create a fully immersive experience. While WebXR is a web based XR environment built on a JavaScript framework that enables interactivity of AR and VR devices within the web browser. Contemporarily, educators are demanded to explore the variety of new media in practicing interactive learning, specifically in an academic environment. Arguably, VR has recently been identified as one of the most popular gamification mediums. It can create an environment that is both physically and digitally engaging. This paper reviews, simplifies as well as recommends a better component management system in the VR production pipeline using practice-based research methodology.

Applying QI-focused SPIDER approach to safer deprescribing for geriatric patients: Results of the Toronto Feasibility Study.

Context: More than 25% of Canadian seniors are prescribed 10+ different medications each year. There is a direct association between more medications and persistent high care needs/costs for seniors. Effective and appropriate deprescribing for seniors in primary care is needed. Objective: To present results of a feasibility study of the Structured Process Informed by Data, Evidence and Research (SPIDER) project aiming at improving safer deprescribing for complex older patients in community-based primary care. Study Design: Single-arm mixed methods study in Toronto, Ontario. Evaluation included participant interviews, focus groups, field notes and quantitative EMR data. Setting: Primary care practices affiliated with the University of Toronto Practice-Based Research Network (UTOPIAN). Population Studied: Patients aged 65+ years taking 10+ different medications. Intervention: 1) QI-focused Learning Collaboratives (LCs); 2) practice coaching; and 3) EMR data for audit & feedback. Outcome Measures: feasibility across eight dimensions: acceptability, demand, implementation, adaptation, integration, practicality, and efficacy. Results: Demand: 33 physicians and 24 allied health professionals from ten UTOPIAN practices and one community health centre participated in the Toronto LC. Implementation: the LC included a full day initial workshop, two short webinars, and a half-day summative congress over nine months. Practices had a monthly call with their QI coach and quarterly data reports. Adaptation, integration, practicality: teams developed various deprescribing tools and processes that were integratable to local context and existing practices. Acceptability: Teams perceived access to coaching as a valuable element of the approach. The initial review and validation of patients identified in the data reports were deemed time-consuming, particularly for under-resourced practices with a large cohort of target patient population. Access to pharmacist services and in-house QI and data support was considered two critical enablers to the sustainability of the approach. Efficacy: reductions in PIP prevalence and prevalence of patients with at least one PIP were 3.6% (p=.4) and 1.4% (p=.5), respectively. Conclusions: The SPIDER approach appears to be feasible. Access to coaching support and pharmacist services may enhance sustainability.

Tensions in transparent urban AI: designing a smart electric vehicle charge point

The increasing use of artificial intelligence (AI) by public actors has led to a push for more transparency. Previous research has conceptualized AI transparency as knowledge that empowers citizens and experts to make informed choices about the use and governance of AI. Conversely, in this paper, we critically examine if transparency-as-knowledge is an appropriate concept for a public realm where private interests intersect with democratic concerns. We conduct a practice-based design research study in which we prototype and evaluate a transparent smart electric vehicle charge point, and investigate experts’ and citizens’ understanding of AI transparency. We find that citizens experience transparency as burdensome; experts hope transparency ensures acceptance, while citizens are mostly indifferent to AI; and with absent means of control, citizens question transparency’s relevance. The tensions we identify suggest transparency cannot be reduced to a product feature, but should be seen as a mediator of debate between experts and citizens.

Increasing Engagement of Women Veterans in Health Research

BackgroundMeaningful engagement of patients in health research has the potential to increase research impact and foster patient trust in healthcare. For the past decade, the Veterans Health Administration (VA) has invested in increasing Veteran engagement in research.ObjectiveWe sought the perspectives of women Veterans, VA women’s health primary care providers (WH-PCPs), and administrators on barriers to and facilitators of health research engagement among women Veterans, the fastest growing subgroup of VA users.DesignSemi-structured qualitative telephone interviews were conducted from October 2016 to April 2018.ParticipantsWomen Veterans (N=31), WH-PCPs (N=22), and administrators (N=6) were enrolled across five VA Women’s Health Practice-Based Research Network sites.ApproachInterviews were audio-recorded and transcribed. Consensus-based coding was conducted by two expert analysts.Key ResultsAll participants endorsed the importance of increasing patient engagement in women’s health research. Women Veterans expressed altruistic motives as a personal determinant for research engagement, and interest in driving women’s health research forward as a stakeholder or research partner. Challenges to engagement included lack of awareness about opportunities, distrust of research, competing priorities, and confidentiality concerns. Suggestions to increase engagement include utilizing VA’s patient-facing portals of the electronic health record for outreach, facilitating “warm hand-offs” between researchers and clinic staff, developing an accessible research registry, and communicating the potential research impact for Veterans.ConclusionsParticipants expressed support for increasing women Veterans’ engagement in women’s health research and identified feasible ways to foster and implement engagement of women Veterans. Given the unique healthcare needs of women Veterans, engaging them in research could translate to improved care, especially for future generations. Knowledge about how to improve women Veterans’ research engagement can inform future VA policy and practice for more meaningful interventions and infrastructure.

The use of spiritually integrated psychotherapies in mental health treatment centers

ABSTRACT Practice-based evidence research was used to document the use of spiritual interventions in three mental health treatment settings among eight therapists and 128 clients. Materials included measures of client distress, along with measures of counselor’s therapeutic process use and orientations toward the delivery of spiritual interventions. Analyses revealed the most common theoretical approaches and spiritual interventions in our settings. Differences emerged in cross-site comparisons of therapeutic processes, as well as in spiritual intervention use with clients of different genders. This study contributes insight into what is being done in real-world settings to address spirituality into psychotherapeutic interventions.

Icon metaphor design based on ideographic Chinese character-creation

Icons, as core morphemes of interface design, have relatively standardised visual style definitions. However, little is known about the related metaphorical design method from the academic and industrial standpoints. We conducted comparisons based on Chinese character-creation and examined radical (root) forms and rules based on mainstream metaphorical designs, with a focus on the Airstar Bank icon. We adopted a practice-based design research method to continue to explore and evaluate the icon metaphor design method. We found similar approaches in icon metaphor design and ideographic Chinese character-creation. We further explored three icon metaphor design methods based on the ideographic design methods used for Chinese characters, including the single-body, variant, and compound-body modelling methods. An analysis of the Airstar Bank icon exemplifies an efficient, standardised icon morpheme, based on Chinese character-creation, which provides practical insight into systematic icon metaphor design.

Analysis of Dual Combination Therapies Used in Treatment of Hypertension in a Multinational Cohort

More than 1 billion adults have hypertension globally, of whom 70% cannot achieve their hypertension control goal with monotherapy alone. Data are lacking on clinical use patterns of dual combination therapies prescribed to patients who escalate from monotherapy. To investigate the most common dual combinations prescribed for treatment escalation in different countries and how treatment use varies by age, sex, and history of cardiovascular disease. This cohort study used data from 11 electronic health record databases that cover 118 million patients across 8 countries and regions between January 2000 and December 2019. Included participants were adult patients (ages ≥18 years) who newly initiated antihypertensive dual combination therapy after escalating from monotherapy. There were 2 databases included for 3 countries: the Iqvia Longitudinal Patient Database (LPD) Australia and Electronic Practice-based Research Network 2019 linked data set from South Western Sydney Local Health District (ePBRN SWSLHD) from Australia, Ajou University School of Medicine (AUSOM) and Kyung Hee University Hospital (KHMC) databases from South Korea, and Khoo Teck Puat Hospital (KTPH) and National University Hospital (NUH) databases from Singapore. Data were analyzed from June 2020 through August 2021. Treatment with dual combinations of the 4 most commonly used antihypertensive drug classes (angiotensin-converting enzyme inhibitor [ACEI] or angiotensin receptor blocker [ARB]; calcium channel blocker [CCB]; β-blocker; and thiazide or thiazide-like diuretic). The proportion of patients receiving each dual combination regimen, overall and by country and demographic subgroup. Among 970 335 patients with hypertension who newly initiated dual combination therapy included in the final analysis, there were 11 494 patients from Australia (including 9291 patients in Australia LPD and 2203 patients in ePBRN SWSLHD), 6980 patients from South Korea (including 6029 patients in Ajou University and 951 patients in KHMC), 2096 patients from Singapore (including 842 patients in KTPH and 1254 patients in NUH), 7008 patients from China, 8544 patients from Taiwan, 103 994 patients from France, 76 082 patients from Italy, and 754 137 patients from the US. The mean (SD) age ranged from 57.6 (14.8) years in China to 67.7 (15.9) years in the Singapore KTPH database, and the proportion of patients by sex ranged from 24 358 (36.9%) women in Italy to 408 964 (54.3%) women in the US. Among 12 dual combinations of antihypertensive drug classes commonly used, there were significant variations in use across country and patient subgroup. For example starting an ACEI or ARB monotherapy followed by a CCB (ie, ACEI or ARB + CCB) was the most commonly prescribed combination in Australia (698 patients in ePBRN SWSLHD [31.7%] and 3842 patients in Australia LPD [41.4%]) and Singapore (216 patients in KTPH [25.7%] and 439 patients in NUH [35.0%]), while in South Korea, CCB + ACEI or ARB (191 patients in KHMC [20.1%] and 1487 patients in Ajou University [24.7%]), CCB + β-blocker (814 patients in Ajou University [13.5%] and 217 patients in KHMC [22.8%]), and ACEI or ARB + CCB (147 patients in KHMC [15.5%] and 1216 patients in Ajou University [20.2%]) were the 3 most commonly prescribed combinations. The distribution of 12 dual combination therapies were significantly different by age and sex in almost all databases. For example, use of ACEI or ARB + CCB varied from 873 of 3737 patients ages 18 to 64 years (23.4%) to 343 of 2292 patients ages 65 years or older (15.0%) in South Korea's Ajou University database (P for database distribution by age < .001), while use of ACEI or ARB + CCB varied from 2121 of 4718 (44.8%) men to 1721 of 4549 (37.7%) women in Australian LPD (P for drug combination distributions by sex < .001). In this study, large variation in the transition between monotherapy and dual combination therapy for hypertension was observed across countries and by demographic group. These findings suggest that future research may be needed to investigate what dual combinations are associated with best outcomes for which patients.

Providing psychological consultation within children’s social care: a mixed-methods service evaluation

ABSTRACT It’s widely acknowledged that Social Work requires a more psychological approach when working with families. However, social care settings are under increased financial constraints and creative solutions are necessary. The provision of psychological consultations may be one way to meet this identified need; however, practice-based research is in its infancy. Using a mixed-methods approach, this service evaluation aimed to evaluate the provision of psychological consultations across community Social Care, and Residential Edge of Care teams. Quantitative analysis revealed that psychological consultations significantly improved consultees’ knowledge, confidence, motivation, and understanding – factors associated with best practice. Thematic analysis of the consultees’ qualitative feedback resulted in four key themes pertaining to areas of benefit: ‘enriching assessments’, ‘developing formulations’, ‘improving interventions’, and ‘supporting reflective professional practice’. Three key themes emerged in relation to what staff viewed as areas for improvement; that is: ‘changes to the process of consultation’, ‘changes to the content of consultation’, and ‘no improvement necessary’. These findings further evidence the beneficial impact of psychological consultations when provided across a range of Children’s Social Care settings. Psychology consultations therefore offer a promising means of promoting psychologically informed Social Care practice, contributing to best practice standards within the context of financial constraints.

Museum-based research: a typological exploration

ABSTRACT The term ‘research’ has multiple meanings in the museum context, ranging from a self-reflective practice integrated into any daily task to a highly specialised scientific activity. At the same time, conventional academic standards and scholarly publications are prioritised over practice-based research methods and museological forms of dissemination. This leads to an inherent hierarchy and a culture of exclusion when it comes to research practice within museums. In this article, I argue how the conceptual confusion around research creates major obstacles to this key function in museums, perhaps even more so than administrative challenges such as the lack of time and funding. To offer some clarification to a chaotic field, I present a five-fold typology of research models typically hosted by museums. Rather than presenting a fixed definition of how to do research in museums, the aim is to encourage a non-hierarchical and pluralistic approach to museum-based research.

A Comparative Study to Evaluate the Effectiveness of Silver Diamine Fluoride at Different Time Durations of Application in Treating Carious Primary Teeth: A Randomized Trial.

Background and objectivesIdeally every child must have access to preventive and restorative care of greater quality. However, in rural areas, resources and dental care services are limited. Silver diamine fluoride (SDF) has been identified as an efficient topical cariostatic and preventive medicament for managing ECC in children who cannot be treated conventionally. Since SDF is an emerging alternative for caries prevention and arrest, AAPD recommends more practice-based research to evaluate its efficacy. The aim of this study was to evaluate the effectiveness of silver diamine fluoride at different time durations of application in treatment of carious primary teeth in children with least access to dental care.MethodologyThis was a prospective, randomized, field trial that included patients with primary tooth. Primary tooth presenting carious lesion in ICDAS 3-6 category were randomly assigned to one of the three groups.ResultsAt 3-week mean rank of lesions arrested in Group 1 and Group 2 were 73.3 and 72.29, whereas it was 86.9 in case of Group 3. At 6 months it was 79.15, 77.29, and 75.96 in Group 1, 2, and 3, respectively (p > 0.05).ConclusionSDF is effective in controlling caries progression in both cavitated and non-cavitated lesion with minimal time duration of application (30 seconds). This approach may be of great utility as an alternative to other expensive preventive and therapeutic methods in communities with limited resources. Nonetheless obtaining caregiver consent is mandatory.How to cite this articleThakur S, Sojan M, Singhal P, et al. A Comparative Study to Evaluate the Effectiveness of Silver Diamine Fluoride at Different Time Durations of Application in Treating Carious Primary Teeth: A Randomized Trial. Int J Clin Pediatr Dent 2022;15(S-2):S147-S150.

Community pharmacists' attitudes toward practice-based research and their perceived utilization of scientific evidence.

BackgroundEnhancing the contribution of practicing pharmacists into scientific evidence via practice-based research (PBR) is crucial in maintaining high-quality clinical practice and healthcare delivery. Involving community pharmacists in PBR can potentially can also help break barriers to the utilization of the current best evidence in everyday pharmacy practice. The impact of pharmacists’ attitude towards PBR on their utilization of current best evidence in pharmacy practice is understudied.ObjectivesThe aim of the study was to investigate the impact of community pharmacists’ attitudes toward PBR on their utilization of current best evidence, barriers for conducting PBR in clinical practice were also investigated.MethodsIn this cross-sectional study, 169 community pharmacists working across Jordan filled a questionnaire to assess their attitudes towards PBR, barriers to PBR, and their utilization of the current best evidence in clinical practice.ResultsPharmacists in this study showed a positive attitude toward PBR (attitude mean score >3.5). A positive attitude towards PBR was associated with high utilization of the best current scientific evidence. We also investigated several barriers to PBR and their association with utilization those included; the lack of perceived benefits, lack of institutional support, and lack of self-engagements of community pharmacists to PBR. The lack of perceived benefit was found to be negatively associated with pharmacists’ utilization of the current best scientific evidence.ConclusionIn this study, pharmacists’ utilization of current best evidence was found to be significantly impacted by their attitude toward PBR. The current study findings highlight the importance of supporting, promoting, and facilitating PBR among community pharmacists which can potentially enhance their utilization of the current best evidence in their everyday pharmacy practice.

A pilot study exploring the effectiveness of a whole-school intervention targeting receptive vocabulary in the early years: Findings from a mixed method study involving students as part of a practice-based research placement

Studies that have examined whole-school interventions that target conceptual knowledge reveal characteristics that are important in the delivery of a deep processing approach to word learning. These consist of explicit instruction, play, and multi-sensory experiences that are situated within and repeated across varied contexts. Word Aware (WA) is an example of a vocabulary intervention that incorporates such features. This study examined the effectiveness of the Early Years version of the WA programme in supporting the development of vocabulary knowledge in a sample of 92 children comparing them to a control group of 31 children who received usual teaching. Student speech and language therapists supported the testing and delivery of a 10-week intervention as part of their clinical placement and were interviewed along with the teachers on their perceptions of the intervention and their experiences collaborating with staff to support the whole school delivery of the programme. Informal and standardised assessment scores of receptive vocabulary showed no significant difference in the overall improvement between both groups despite finding significant improvement within each group on words targeted for intervention. Qualitative thematic analysis revealed positive observations of child engagement with aspects of the programme that aimed to promote a deep processing of word meaning. Students reported an increased sense of confidence in their ability to collaborate with teaching staff and in their willingness to engage in research as part of their clinical practice. The ceiling effects reported in the outcome measures of both the intervention and control group suggest that the WA programme may be better suited to a sample of younger-aged children. The study provides original insight into the student experience of working in a whole-class environment whilst conducting practice-based research as part of clinical placement. The methodological limitations of this study are discussed along with suggestions for future research.

One-year clinical results of restorations using a novel self-adhesive resin-based bulk-fill restorative

This prospective study assessed the dual-curing self-adhesive bulk-fill restorative Surefil one. The restorations were placed and reviewed by dental practitioners who are members of a practice-based research network in the United States. Seven practitioners filled 60 cavities (20 class I, 19 class II and 21 class V) in 41 patients with Surefil one without adhesive, according to the manufacturer’s instructions. The restorations were evaluated using modified USPHS criteria at baseline, 3 months, and 1 year. Patients were also contacted to report postoperative hypersensitivity one to four weeks after placement. The only patient that showed moderate hypersensitivity after 1 year had previously reported symptoms that were unlikely associated to the class I molar restoration. One class II restoration in a fractured maxillary molar was partially lost. The remaining restorations were found to be in clinically acceptable condition resulting in an annual failure rate of 2%. Color match showed the lowest number of acceptable scores (88%) revealing significant changes over time (P = 0.0002). No significant differences were found for the other criteria (P > 0.05). The novel self-adhesive bulk-fill restorative showed clinically acceptable results in stress-bearing class I and II as well as non-retentive class V cavities at 1-year recall.

The Public Health 12 framework: interpreting the \u2018Meadows 12 places to act in a system\u2019 for use in public health

BackgroundSystems science approaches have demonstrated effectiveness in identifying underlying drivers of complex problems and facilitating the emergence of potential interventions that are locally tailored, feasible, sustainable and evidence informed. Despite the potential usefulness of system dynamics simulation modelling and other systems science modelling techniques in guiding implementation, time and cost constraints have limited its ability to provide strong guidance on how to implement complex interventions in communities. Guidance is required to ensure systems interventions lead to impactful systems solutions, implemented utilising strategies from the intersecting fields of systems science and implementation science. To provide cost-effective guidance on how and where to implement in systems, we offer a translation of the ‘Meadows 12 places to act in a system’ (Meadows 12) into language useful for public health.MethodsThis translation of Meadows 12 was informed by our experience in working with 31 communities across two complex large scale randomised control trials and one large whole of community case study. These research projects utilised systems science and implementation science to co-create childhood obesity prevention interventions. The team undertaking this translation comprised research academics, implementation specialists and practitioners, practice-based researchers and a systems dynamicist. Our translation of each of the Meadows 12 levels to act in the system maintains the fidelity and nuance of the 12 distinct levels. We provide examples of each level of the Public Health 12 framework (PH12) drawn from 31 communities. All research was conducted in Victoria, Australia between 2016 and 2020.ResultsPH12 provides a framework to guide both research and practice in real world contexts to implement targeted system level interventions. PH12 can be used with existing implementation science theory to identify relevant strategies for implementation of these interventions to impact the system at each of the leverage points.ConclusionTo date little guidance for public health practitioners and researchers exists regarding how to implement systems change in community-led public health interventions. PH12 enables operationalisation Meadows 12 systems theory into public health interventions. PH12 can help research and practice determine where leverage can be applied in the system to optimise public health systems level interventions and identify gaps in existing efforts.Trial registrationWHO STOPS: ANZCTR: 12616000980437. RESPOND: ANZCTR: 12618001986268p.

Middle school matters: examining the effects of a schoolwide professional development model to improve reading comprehension.

Many middle school students perform below grade-level standards in reading (National Center for Education Statistics, Washington, 2019), and recent observation studies demonstrate middle school teachers’ limited use of reading comprehension practices within content area instruction (e.g., science and social studies; as reported by Greenleaf (in: Hinchman (ed) Adolescent literacies: A handbook of practice-based research, Guilford Press, 2017)). In this experimental pilot study, we aimed to boost middle schoolers’ reading comprehension outcomes by providing schoolwide professional development (PD) on integrating reading comprehension practices within content instruction for English language arts, social studies, and science teachers. Six schools were matched into pairs and randomized to the schoolwide PD or a business-as-usual (BAU) condition. Content area teachers in schools assigned to the PD condition received distributed PD resources to support implementation, and coaching in one reading comprehension practice in the fall (i.e., get the gist) and one in the spring (i.e., asking and answering questions). Contrary to traditional PD, this PD was implemented across three content areas, was narrow in scope but long in duration (one practice per semester), focused on practices that could feasibly be integrated into content area instruction, and included ongoing coaching in content area teams. Students in schools assigned to the PD condition significantly outperformed those in the BaU condition on a measure of main idea generation (ES = 0.29) but not on measures of asking and answering questions (ES = 0.11) and general reading comprehension (ES = − 0.09). Findings suggest promise for implementing schoolwide approaches embedded within content area instruction to improve reading comprehension performance for middle school students.

Pluriverse Skins DIY Bio-Production. For a Post-Anthropocentric Coexistence

By developing practice-based research, through critical and speculative design methodologies, we propose a definition of “skin” not as a univocal boundary of subjective bodies (animal, plants, or other creatures), but as a pluriverse membrane of connection across and between species. Deeply inspired by holistic and posthuman philosophical approaches (such as Braidotti, Pannikar, Escobar, Coccia), the ongoing research feeds such a definition of “pluriverse skins” by experiments on bio-media and the relative speculative scenarios. We present three aspects of the study: a) preliminary reflection about how design is affected and transformed by ecological notions; b) design experiments in bio-media to create skins that can unfold as the carrier of new forms of ecological awareness; c) discussion about the aesthetic of bioskins and implication for the notion of a new post-anthropocentrism at large. Pluriverse Skins offers an alternative look into biomaterials, by the means of practical and speculative investigation: in the paper we discuss how such an approach could contribute to reshaping the meaning of bio production, within the emerging post-anthropocentric paradigm.

Factors that affect dentists’ use of antibiotic prophylaxis: Findings from The National Dental Practice-Based Research Network questionnaire

BackgroundLittle is known about factors that influence dentists’ decision making concerning antibiotic prophylaxis (AP) prescribing. The objective of this study was to determine factors that influence dentists’ AP prescribing habits in patients at risk of developing infective endocarditis and prosthetic joint infections. MethodsA questionnaire was administered to 3,584 dentist members of The National Dental Practice-Based Research Network. In addition to descriptive statistics, ordinal regression models were used to determine the factors most likely to impact dentists’ decisions to prescribe AP. ResultsOverall, 2,169 (61%) dentists in The National Dental Practice-Based Resesarch Network responded. Responders’ decisions to prescribe antibiotics were influenced primarily by official guidelines, scientific literature, and physician or medical specialist opinion. Regarding potential risks, the greatest level of concern was for the development of infective endocarditis or prosthetic joint infections. Although litigation was deemed problematic, more than 90% of responders indicated a strong concern for the best course of action for the patient’s health. Dentists also indicated a high level of concern about the potential for generating antibiotic-resistant bacteria with AP use and increased risk of adverse drug reactions. ConclusionsDentists’ AP decision making seems most influenced by official guidelines, scientific literature, and advice from a physician or medical specialist. Practical ImplicationsThese results suggest that one of the most effective means for promoting concordance of dentists clinical practice with the scientific basis for AP is to emphasize the importance and clarity of American Heart Association and American Dental Association recommendations and antimicrobial stewardship regarding prevention of infective endocarditis and prosthetic joint infections.

Shirin Amaare: Bellisma-Urge Gele Headdress

The paper is of qualitative paradigm centred on practice-based research design. It highlights the creative process of a headdress style exhibit fashioned for a Millennial Muslim bride’s walima (celebration/reception) using indigenous African resources. The main materials used are “Epele” fabric from Northern Ghana and classic Gele fabrics used in Southern Nigeria. Non-routine design is adopted to impact the outcome. The results are thematically analysed to reflect the use of culture trends, fashion innovation, creativity and production in meeting the needs of the contemporary Ghanaian Millennial Muslim bride. The beautiful headdress accessories wrapped in local African fabrics (from Northern Ghana and Nigeria) are gorgeous with a focus on style, materials and method. The attractive Bellisma-Urge head wraps created give the Millennial Muslim Bride that dazzling look perfect for holding the attention of the groom and every guest; making her the real ‘centre’ of attraction deservedly.

Academic-industry partnership advancing cannabis science: A Complementary Care Practice-Based Research Network

ObjectivesData collected during routine care holds the potential to support hypothesis generation, study feasibility, and provide insight regarding how to address problems under real world conditions. Currently there are no practice-based research networks in Florida that focus on complementary care in general or medical marijuana specifically. Through an academic-industry partnership, we sought to develop a practice-based research network focused on cannabis science and create a de-identified database for analyses that support hypothesis generation, study feasibility estimation, and a network that also facilitates recruitment into future research studies. DesignThe Complementary Care Practice-Based Research Network (CC-PBRN) is a centralized repository, which contains electronic health records (EHR) from a private medical cannabis health system in the state of Florida. ResultsThis paper provides cross-sectional descriptive analyses of the CC-PBRN’s 43,802 currently active patients. There are 24 clinics in the network with nine in North Florida, 11 in Central Florida, and 4 in South Florida. ConclusionThis network serves as a statewide resource for patient-reported outcomes (PRO) research in medical marijuana. The network currently has numerous outpatient practices with thousands of patients that are a potential source of research participants for both observational studies as well as traditional clinical trials. The outpatient clinical practices can also serve as units of analysis for pragmatic trials comparing different care protocols and organizational structure.