A protocol for a systematic review of clinical guidelines and published systematic reviews on the early detection of oral cancer

Background: The predicted increase in incidence of oral cavity cancer (OCC) coupled with high mortality and poor prognosis – particularly when diagnosed at a late/advanced stage – highlights the need for prevention and early detection/screening to reverse these trends. Dental healthcare professionals in primary care settings have a pivotal role in this effort. Aim: The aim of this protocol is to detail the process for assessing the evidence for the best practice and methods of early detection/screening for OCC in primary care dental settings by undertaking a systematic review of global clinical guidelines and published systematic reviews. Method: Searches for clinical guidelines and systematic reviews will be conducted in the following databases: Cochrane library, Medical Literature Analysis and Retrieval System Online (Ovid), Excerpta Medical dataBASE, PubMed, Turning Research into Practice, SCOPUS and Web of Science Core Collection. Our search will extend to include Google Scholar and international professional organizations/associations websites. In addition, we will handsearch the bibliographies and undertake citation searches of the selected papers. Quality appraisal will be undertaken using the Appraisal of Guidelines for Research and Evaluation version II instrument for the clinical guidelines and both A MeaSurement Tool to Assess Systematic Reviews and Risk of Bias in Systematic Reviews tools for the systematic reviews. A narrative synthesis approach will be used to assess the evidence of extracted data, primarily taking account of quality appraisal and recency of publication. Discussion: The synthesis of evidence will determine best practice for OCC early detection/screening by primary care dental healthcare professionals and will evaluate the relationship between clinical guidelines and the evidence base available from systematic reviews in this area

Oncolog, Volume 37, Issue 03, July-September 1992

Retinoic acid/interferon combination shows promising response rates Cross-matching test helps find donors for patients in dire need of platelets Silicone gel-filled implants: Women should have the option to choosehttps://openworks.mdanderson.org/oncolog/1039/thumbnail.jp

Medical versus Spiritual Orientations: Differential Patient Views toward Recovery

Background: Relapse among patients in substance abuse treatment has generated interest in identifying attitudinal factors that sustain recovery. Objective: To assess the relationship of attitudes toward approaches to motivation for treatment and Twelve Step beliefs. Methods: Dually diagnosed patients (N = 100) completed a survey assessing treatment attitudes, motivation, and Twelve Step beliefs. Results: Endorsement of medical services was positively correlated with motivation but unrelated to Twelve Step beliefs. Endorsement of religious services was unrelated to motivation but was associated with Twelve Step beliefs. Conclusions: Patients may have differing perceptions regarding routes to recovery based on preferences for professional services or spiritual resources

The effectiveness of Dental Health Support Workers at linking families with primary care dental practices: a population-wide data linkage cohort study

Background: Link workers (lay health workers, health support workers) based in the community provide additional support to individuals and families to facilitate engagement with primary care and other services and resources. This additional support aims to tackle the wider socio-economic determinants of health that lead to inequalities. To date, there is no clear evidence of the effectiveness of these programmes. This study evaluates the effectiveness of Dental Health Support Workers (DHSW) at linking targeted families with young children to primary care dental practices. The DHSW role is one component of Childsmile, the national oral health improvement programme in Scotland. Methods: A quasi-experimental approach captured the natural variation in the rollout of the DHSW intervention across Scotland in a cohort of children born between 2010 and 2013. Survival analysis explored “time to attendance” at primary care dental practice. Cox’s regression models compared attendance rates and time until first attendance between those families who received support from the DHSW and those who did not. Results: The cohort consisted of 35236 children. Thirty-three percent of the cohort (n = 11495) were considered to require additional support from a DHSW. Of these, 44% (5087) received that support. These families were more likely to attend a dental practice (Hazard Ratio [95% Confidence Interval] =1.87 [1.8 to 1.9]) and, on average, did so 9 months earlier (median time until first attendance: 8.8 months versus 17.8 months), compared to families not receiving additional support. Conclusions: Link workers (DHSW) within the Childsmile programme are effective at linking targeted children to primary care dental services and, most notably, at a younger age for prevention. This is the first study of its kind to evaluate the effectiveness of link-worker programmes using a robust quasi-experimental design on three, population-wide, linked datasets. These results will inform future health programmes which aim to improve health and reduce inequalities by reaching and supporting families from more disadvantaged backgrounds

Assessment and prevention of behavioural and social risk factors associated with oral cancer: protocol for a systematic review of clinical guidelines and systematic reviews to inform primary care dental professionals

Background: Tobacco and alcohol are recognised as the major risk factors for both oral cavity (mouth) and oropharyngeal (throat) cancers, with increasing acceptance of the role of human papillomavirus (HPV) in the aetiology of oropharyngeal cancers. In addition, there is a significant increased risk for oral cancer among lower socioeconomic groups, males and older age groups. There is a growing evidence for the potential role of primary care professionals in smoking cessation and reducing alcohol-related harm. However, there are uncertainties about the best approaches/strategies to assess risk factors associated with oral cancer, effective components of preventive interventions for behaviour change and implementation strategies in primary care dental settings. Thus, in order to contribute to the prevention of oral cancer effectively, dental professionals need to assess patients on the major risk factors (tobacco, alcohol and HPV/sexual behaviours) and deliver appropriate prevention, taking into account the patient’s sociodemographic context. Aim: The study aims to synthesise evidence on the best practice for undertaking an assessment of major behavioural risk factors associated with oral cancer and delivering effective behaviour change preventive interventions (e.g. advice, counselling, patient recall, signposting/referral to preventive services) by dental professionals in primary care dental settings. Method: The study involves a systematic review and evidence appraisal. We will search for clinical guidelines and systematic reviews from the following databases: Cochrane Library, Ovid MEDLINE, EMBASE, Web of Science, PsychINFO, PubMed, TRIP and Google Scholar. We will also search websites of professional organisations/agencies and bibliographies/reference lists of selected papers. Quality will be assessed with the AGREE II (Appraisal of Guidelines for Research & Evaluation II) instrument for included clinical guidelines and the AMSTAR (A Measurement Tool to Assess Systematic Reviews) and ROBIS instruments for included systematic reviews. The best practice evidence will be assessed via a narrative synthesis of extracted data, considering publication quality. Discussion: This systematic review will synthesise evidence on the best practice for oral cancer risk factor assessment and prevention and evaluate the relationship between available clinical guidelines and the review evidence base. This collation of evidence will be useful for making recommendations for future intervention, research and guideline development

Analyzing the effects of lactose on calcium absorption in premature infants using HR-ICP-Mass Spectrometry

Abstract only availableWith advances in neonatal care, premature infants are surviving at increasing rates. During the third trimester of pregnancy, the bone mineral content of infants rapidly increases. It is therefore becoming essential to accurately mimic the womb environment to maintain growth and sustain the health of premature infants as if they were in utero. Regulating calcium absorption in premature infants is crucial primarily for bone formation, as 99% of the calcium in the human body is found in the bones and the teeth. The effect of lactose containing formulas on calcium absorption in premature infants has not been well established. Concerns have been noted in the scientific community regarding lactose intolerance especially in premature infants, as lactase, the enzyme responsible for lactose digestion, is most readily detectible during the third trimester of pregnancy. In this study, in conjunction with Dr. Laura Hillman of the University of Missouri Hospital, each infant was fed lactose and maltose formulas during different weeks using a dual tracer method in which two calcium isotopes were administered, 44Ca orally and 46Ca intravenously. Urine samples were collected after 24 hours. Analysis related natural abundances of calcium isotopes to the measured values in the urine. Polyatomic ion interferences were differentiated from the calcium peaks by analyzing the samples at a resolution of 4000. Mathematical corrections for interferences caused by titanium and doubly charged strontium were determined by measuring the specific isotopes 47Ti and 87Sr++ and using known natural abundances of the interfering isotopes to correct each calcium count rate. Mathematical calculations relate the enriched isotope ratio measurements of 44Ca and 46Ca to calcium absorption. Analysis regarding the effect of lactose on calcium absorption is ongoing. Our data precision on the ICP-MS was acceptable with percent relative standard deviations (%RSD) for external precision over the course of a week at 1.4, 2.2, 0.71, and 1.4 for isotope ratios 42Ca: 43Ca, 42Ca: 44Ca, 42Ca: 46Ca, and 42Ca: 48Ca respectively. Daily internal precision (%RSD) values were .37, 1.3, .69, and 1.5. The precision shows the viability of utilizing HR-ICP-MS analysis for calcium isotope ratios.NSF-REU/NIH Program in Radiochemistr

Search for exotic baryons in double radiative capture on pionic hydrogen

We report a search for low-lying exotic baryons via double radiative capture on pionic hydrogen. The data were collected at the TRIUMF cyclotron using the RMC spectrometer by detecting gamma-ray pairs from pion stops in liquid hydrogen. No evidence was found to support an earlier claim for exotic baryons of masses 1004 and 1044 MeV/$c^2$. We obtain upper limits on the branching ratios for double radiative capture via these exotic states of $< 3 \times 10^{-6}$ and $< 4 \times 10^{-6}$ respectively.Comment: 13 pages, 4 figure

Heliconical smectic phases formed by achiral molecules

M.S. acknowledges the support of the US National Science Foundation I2CAM International Materials Institute Award, Grant DMR-1411344 and NSF grant DMR-1307674. D.P., E.G. acknowledges the support of the National Science Centre (Poland) under the grant no. 2016/22/A/ST5/00319. R.W. gratefully acknowledges the Carnegie Trust for the Universities of Scotland for the award of a PhD studentship. The beamline 11.0.1.2 at the Advanced Light Source at the Lawrence Berkeley National Laboratory is supported by the Director of the Office of Science, Office of Basic Energy Sciences, of the U.S. Department of Energy under Contract No. DE-AC02- 05CH11231. Addendum: Heliconical smectic phases formed by achiral molecules Published: 17 July 2018, https://doi.org/10.1038/s41467-018-05334-x "We would like to make our readers aware of the related publications by S.P. Sreenilayam et al. (Nat. Commun. 7, 11369 (2016) and Phys. Rev. Mat. 1, 035604 (2017)), which report the spontaneous helix formation in a polar smectic liquid crystal phase made of achiral bent-core mesogens."Peer reviewedPublisher PD