Operative treatment is indicated for most toothache/dental abscesses, yet antibiotics instead of procedures are often prescribed. This ethnographic study aimed to identify clinician and patient factors influencing urgent dental care for adults during actual appointments; and to identify elements sensitive to context. Appointments were observed in out-of-hours and general dental practices. Follow-up interviews took place with dentists, dental nurses, and patients. Dentist and patient factors were identified through thematic analysis of observation records and appointment/interview transcripts. Dentist factors were based on a published list of factors influencing antibiotic prescribing for adults with acute conditions across primary health care and presented within the Capability-Opportunity-Motivation-Behaviour model. Contextually sensitive elements were revealed by comparing the factors between settings. In total, thirty-one dentist factors and nineteen patient factors were identified. Beliefs about antibiotics, goals for the appointment and access to dental services were important for both dentists and patients. Dentist factors included beliefs about the lifetime impact of urgent dental procedures on patients. Patient factors included their communication and negotiation skills. Contextual elements included dentists’ concerns about inflicting pain on regular patients in general dental practice; and patients’ difficulties accessing care to complete temporary treatment provided out of hours. This improved understanding of factors influencing shared decisions about treatments presents significant opportunity for new, evidence-based, contextually sensitive antibiotic stewardship interventions.

There is general agreement in the literature that international students are more likely to plagiarise compared to their native speaker peers and, in many instances, plagiarism is unintentional. In this article we describe the effectiveness of an academic writing development programme embedded into a Biological Sciences Taught Masters course designed to reduce unintentional plagiarism amongst international students in the cohort. We compared plagiarism rates in the years before and after the implementation of the writing intervention. In addition, we analysed data from a high response rate questionnaire (87.8%: class of 90 students) designed to evaluate students' perceptions of the usefulness of the writing development programme and to elicit information about their prior educational experiences which might relate to plagiarism. Our combined quantitative and qualitative data show that an early pedagogical response reduced plagiarism levels amongst international students. However, the UK and international students in the same cohort reported markedly different responses to the writing programme. We therefore suggest that, if international students are provided with an initial opportunity to practise academic writing and receive feedback, they are more likely to be successful when writing coursework assignments later on. However, any initial writing development programme should be adapted to accommodate the differing needs of the UK and international students within the cohort.

Research shows that when students arrive at university they are often not prepared for independent learning. New students enter a period of transition during their first year, which is often characterised by emotional destabilisation, as they move towards becoming more self-regulating in their new learning environment. In this small-scale qualitative study, data from an in-depth pair interview were triangulated with data from a questionnaire, to explore participants' experiences of self-regulated learning in the first year of a Dental Surgery course. Five threshold concepts relating to learning in transition emerged from the analysis of the data. These concepts were as follows: learning how to learn using a range of self-chosen sources instead of a single textbook, learning how to organise incoming information without guidance, distinguishing between main ideas and detail during revision, coping with a heavy workload, and knowing what to expect from examinations and coursework. Strong emotions (feeling confused, overwhelmed and scared) were associated with negotiating these threshold concepts. However, the study illustrates how the participants adopted new cognitive and metacognitive strategies to become more self-regulating over time. The findings of the study suggest that lecturers, tutors, study advisers and peers all have an important role to play in explicitly guiding first-year students as they grapple with troublesome threshold concepts relating to self-regulated learning. Furthermore, structural changes to the content-heavy, lecture-based curricula often associated with first-year Medical and Dental courses would help ease students' transition to independent learning, which may make an impact on student attainment.

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Students are rarely explicitly taught how to develop their writing within a subject discipline, as there is usually a focus on teaching content. However, academic writing, and in particular Academic Reflective Writing (ARW), is very challenging for most students. In this study, a series of three embedded writing development interventions were trailed with successive cohorts of postgraduate Nursing students writing a summative 4000 word piece of ARW. The interventions included the use of example texts to make task requirements more explicit, formative peer feedback on draft texts and facilitating increased dialogue between staff and students regarding expectations of this task. Overall the interventions represented a shift towards assessment for learning. Quantitative results showed a decrease in the number of students investigated for plagiarism, a rise in pass rates and mean grades, and an increased uptake of academic supervision over the three cohorts. In addition, complementary findings from a self-selected focus group interview indicated that respondents perceived the writing development activities to be very useful. In particular, the formative peer and tutor review of written drafts, was valued. However, a limitation of this pragmatic mixed method study was that the three cohorts were non-equivalent. Despite this, it is argued that, as ARW is so complex, disciplinary academics should embed explicit guidance and scaffolding in their teaching in order to enhance written reflection and learning. Failure to do so may lead ARW to become an exclusive educational practice leading to unintentional plagiarism and poor written reflection on practice.ÂÂ

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The editorial team greatly appreciates the reviewers who have dedicated their considerable time and expertise to the journal's rigorous editorial process over the past 12 months, regardless of whether the papers are finally published or not. In 2019, a total of 317 papers were published in the journal, with a median time to first decision of 22 days and a median time from submission to publication of 55 days. The editors would like to express their sincere gratitude to the following reviewers for their generous contribution in 2019:Abbas, Azhar