Michelle Irving

Sax Institute | SAXINST

Indigenous people in Australia experience considerably more dental and medical ill-health than non-Indigenous people. Cultural competence of dental and medical teams is crucial in the delivery of services to address these health disparities. Traditionally, cultural training has been incorporated later in health education curricula, resulting in stu...

Introduction: Good oral health is important for good overall health. Studies have reported poorer oral health outcomes for people with cerebral palsy, but there has been no synthesis of the evidence surrounding this and, there are no clear oral health recommendations for people with cerebral palsy globally. This review synthesizes the existing kno...

Objectives This study was conducted to compare the use of intraoral photographs with the unaided visual dental examination as a means of dental caries detection in children. Methods Children aged 4‐ to 14‐year‐olds were visually examined at their schools. Following dental examinations, children had five photographs of their teeth taken using a sma...

Background Dental caries is the most common multifactorial oral disease; it affects 60% to 90% of the global population. Dental caries is highly preventable through prevention behaviors aimed at improving oral hygiene, adequate fluoride usage, and dietary intake. Mobile apps have the potential to support patients with dental caries; however, little...

Indigenous people in Australia experience a greater burden of dental and oral disease than non-Indigenous Australians. Cultural competence of the dental team is crucial in the delivery of oral health services in addressing these health disparities. Higher education institutions across Australia are required to incorporate Indigenous culture into th...

Abstract Background: Different skill-mix models have changed the face of the dental workforce. This study aimed to assess how this skill-mix translates into different practice models of care and the employer-dentists' perception of the dental team. Methods: Twenty-two oral health therapists (OHTs) and 12 employer-dentists from both the private an...

BACKGROUND Dental caries is the most common oral disease and affects 60-90% of the world’s population. It is highly preventable through effective self-management strategies addressing key risk factors; oral hygiene, fluoride usage and dietary intake. Mobile apps have the potential to support patients with dental caries but, little is known about th...

Reorientation of education for health professionals is necessary to support future health workforce in meeting population needs. Dental graduates must be competent to effectively communicate with patients, their families and other health professionals involved in their care, regardless of social or cultural background. Indigenous people in Australi...

Background Different skill-mix models have changed the face of the dental workforce. This study aimed to assess how this skill-mix translates into different practice models of care and the employer-dentists' perception of the dental team. Methods Twenty-two oral health therapists (OHTs) and 12 employer-dentists from both the private and public sect...

Background: Despite great improvement in child oral health, some children subgroups still suffer from higher levels of dental caries. Geographic and socioeconomic barriers and the lack of access to dental care services are among common reasons for poor oral health in children. Historically in Australia, oral health therapists or dental therapists...

Objective: This review aims to systematically map the literature reporting on oral health outcomes the health indicate is a measure experienced by people with cerebral palsy. Introduction: At present, there are no documented systematic reviews reporting on oral health outcomes for people of all ages with cerebral palsy. Subsequently, there are n...

Indigenous Australians experience poorer oral health than non-Indigenous Australians despite closing-the-gap initiatives. Cultural competence is an important skill in the delivery of oral health care. The need for academic institutions to incorporate Indigenous culture more widely into their curricula to improve educational outcomes for Indigenous...

Objective Completion rates in vocational education are typically poor for Aboriginal students (<30%). A scholarship program was designed for Australian Aboriginal students using five enablers of success previously identified for Aboriginal preregistration tertiary nursing students. The purpose of this study was to evaluate whether the five enablers...

Background Australian Aboriginal children experience high levels of dental caries (tooth decay) and are less likely to access preventive dental health services. High-strength fluoride varnish has been shown to reduce the incidence of dental caries and is commonly used in community-based preventive dental health service programs. In New South Wales,...

Background A community-led oral health service for Aboriginal people in Central Northern NSW identified the need for oral health promotion, as well as dental treatment; in three remote communities with limited access to dental services. A three-stage plan based on the Precede-Proceed model was used to develop a school-based preventive oral health p...

Introduction Indigenous Australians continue to experience significant oral health disparities, despite numerous closing‐the‐gap initiatives. Higher education institutions and accrediting bodies recognise the need to incorporate Indigenous culture more widely into dentistry curricula to address these inequalities. This study aimed to define and exp...

Introduction: As part of an oral health service for Aboriginal people in central northern New South Wales (NSW), Australia, oral health promotion was identified as a priority by the local Aboriginal community. The objective of this study was to collaborate with local Aboriginal communities to determine (1) the oral health needs of Aboriginal child...

Background: Indigenous Australians have more than double the rate of poor oral health than their non-Indigenous counterparts. Cultural competence of dental and oral health practitioners is fundamental to health care and quality of life in addressing health disparities in minority cultural groups in Australia. Higher education curricula reviews hav...

Indigenous and other minority populations worldwide experience higher rates of disease including poor oral health than other populations. Cultural competence of practitioners is increasingly being recognized as fundamental to health care and quality of life in addressing these disparities. The aims of this study were to conduct a systematic review...

Indigenous and other minority populations worldwide experience higher rates of disease including poor oral health than other populations. Cultural competence of practitioners is increasingly being recognized as fundamental to health care and quality of life in addressing these disparities. The aims of this study were to conduct a systematic review...

Objectives This systematic review examines the evidence on the effectiveness of programmes that aim to improve the oral health of Indigenous populations worldwide, as well as presents a qualitative analysis to explore the design and implementation of these initiatives. Methods MEDLINE and EMBASE were searched. Studies were included if they describ...

Background Access to dental care is important for overall health, but can remain problematic for those in rural or isolated locations. It can be difficult to encourage clinicians to choose or continue a rural health career. Teledentistry is showing some promise as a strategy to support rural, isolated and new health care workers. This study aims to...

Background: Aboriginal people, and particularly those in rural areas, continue to suffer very high levels of dental disease despite significant reductions in the wider Australian population in the past 30 years. Until recently, there has been a shortage of oral health clinicians and the majority have provided care in major cities. The NSW Governme...

Objectives: Dental issues are more prevalent for Aboriginal Australians, especially those living in rural/remote locations, but distribution of clinicians is favoured towards metropolitan areas and are not always culturally competent. This study aimed to document the experiences of dental clinicians who relocated to rural/remote communities to pro...

Objective: An oral health service was implemented, using a unique community development approach, for Northern NSW Australian Aboriginal communities in 2013-14. This study examined the views of children (and parents) who accessed the service, including: the extent of reported dental problems, oral health knowledge, attitudes and behaviour, accessi...

Background Obesity is a risk factor for cardiovascular disease and death in people without chronic kidney disease (CKD), but the effect of obesity in people with CKD is uncertain. Methods Medline and Embase (from inception to January 2015) were searched for cohort studies measuring obesity by body mass index (BMI), waist:hip ratio (WHR) and/or wai...

A sustainable model of oral health care for disadvantaged Aboriginal people living in rural and remote communities in New South Wales was developed using collective impact methodology. Collective impact is a structured process which draws together organizations to develop a shared agenda and design solutions which are jointly resourced, measured an...

Objectives To describe the beliefs and attitudes to organ donation in the Arabic-speaking community. Design Arabic-speaking participants were purposively recruited to participate in 6 focus groups. Transcripts were analysed thematically. Participants 53 participants, aged 19–77 years, and originating from 8 countries, participated in 1 of 6 focus g...

Background: Despite broad public support for organ donation, there is a chronic shortage of deceased donor organs. We sought to identify community preferences for features of organ donation policies. Methods: A discrete choice study was conducted using an online panel of Australian community respondents older than 18 years. Respondents were pres...

Background: Widespread in-principle community support for organ donation does not necessarily translate to individuals becoming organ donors after death. Previous studies have identified factors that influence individuals' decisions to become organ donors, which may be effectively targeted by interventions. We aimed to describe and evaluate the ef...

Demand for organs for transplant exceeds supply. There is an ongoing debate about the relative weighting that should be given to different allocation criteria. Little is known about the relative weight the community places on various allocation criteria. This study aims to determine community preferences for organ allocation. Community respondents...

Background Indigenous populations around the world have consistently been shown to bear a greater burden of disease, death and disability than their non-Indigenous counterparts. Despite this, little is known about what constitutes cost-effective interventions in these groups. The objective of this paper was to assess the global cost-effectiveness l...

A major barrier to meeting the needs for organ transplantation is family refusal to give consent. This study aimed to describe the perspectives of donor families on deceased donation. We conducted a systematic review and thematic synthesis of qualitative studies. Electronic databases were searched to September 2012. From 34 studies involving 1035 p...

IntroductionRates of transplantation from deceased donors remain low, despite high rates of expressed support. We aimed to better understand this mismatch through determining community attitudes regarding willingness to register as organ donors. Methods Participants were recruited from the general public in four Australian states. Using nominal gro...

Background: Solid organ transplantation is the treatment of choice for those with organ failure, but suitable organs are a limited community resource. Little is known about community preferences for the allocation of those organs. We aimed to determine community preferences for organ allocation and reasons for their choices. Methods: Participant...

Background Iron supplementation can be administered either intravenously or orally in patients with chronic kidney disease (CKD) and iron deficiency anaemia, but practice varies widely. The aim of this study was to estimate the health care costs and benefits of parenteral iron compared with oral iron in haemodialysis patients receiving erythropoies...

Ongoing debate about how to maximize the benefit of scarce organs while maintaining equity of access to transplantation exists. This study aims to synthesize healthcare provider perspectives on wait-listing and organ allocation. MEDLINE, Embase, and PsycINFO were searched till February 21, 2011. Quantitative data were extracted, and a qualitative s...

Deceased donor kidneys are a scarce health resource, yet patient preferences for organ allocation are largely unknown. The aim of this study was to determine patient preferences for how kidneys should be allocated for transplantation. Patients on dialysis and kidney transplant recipients were purposively selected from two centres in Australia to pa...

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Despite broad community support for organ donation, there is a chronic shortage of donor organs for transplantation. This study elicited community attitudes on deceased organ donation and the current Australian organ donation system. Thirteen focus groups with 114 participants aged between 18 and 75 years. Qualitative analysis using a grounded theo...

Transplantation is the treatment of choice for organ failure, but a worldwide shortage of suitable organs exists. We conducted a systematic review of qualitative studies that explored community attitudes towards living and deceased solid organ donation to inform strategies to improve organ donation rates. Medline, Embase, PsycINFO and EconLIT were...

Deceased donor kidneys are a scarce resource and there is debate about how to maximize the benefit from each donated kidney while ensuring equity of access to transplants. Allocation of kidneys to waitlisted patients is determined by a computer algorithm, but the decision to waitlist patients or accept the kidneys offered is largely at the discreti...

Transplantation is the treatment of choice for people with severe organ failure. However, demand substantially exceeds supply of suitable organs; consequently many people wait months, or years to receive an organ. Reasons for the chronic shortage of deceased organ donations are unclear; there appears to be no lack of 'in principle' public support f...

A consistent gap exists between evidence-based guideline recommendations and clinical practice across all medical disciplines, including nephrology. This study aims to explore nephrologists' perspectives on guidelines and elicit their perspectives on the effects of guidelines on clinical decisions. Semistructured face-to-face interviews were undert...

Renal nurses in Australia and New Zealand are critical to the care of patients with chronic kidney disease (CKD), especially those on dialysis. We aimed to obtain the opinions of renal nurses in Australia and New Zealand on the Caring for Australasians with Renal Impairment (CARI) Guidelines. A self-administered survey was distributed to all member...

Evidence-based clinical practice guidelines have been a major development in nephrology internationally, but it is uncertain how the nephrology community regards these guidelines. This study aimed to determine the views of nephrologists on the content and effects of their local guidelines (Caring for Australasians with Renal Impairment [CARI]). In...

To evaluate the outcomes of and barriers to implementing standard guidelines (Caring for Australasians with renal impairment [CARI]), using iron management in patients having dialysis as an example. On-site review of iron management processes at six Australian dialysis units varying in size and locality. Patients' iron indices and haemoglobin level...