The role of primary healthcare professionals in oral cancer prevention and detection

AIM: To investigate current knowledge, examination habits and preventive practices of primary healthcare professionals in Scotland, with respect to oral cancer, and to determine any relevant training needs. SETTING: Primary care. METHOD: Questionnaires were sent to a random sample of 357 general medical practitioners (GMPs) and 331 dental practitioners throughout Scotland. Additionally, focus group research and interviews were conducted amongst primary healthcare team members. RESULTS: Whilst 58% of dental respondents reported examining regularly for signs of oral cancer, GMPs examined patients' mouths usually in response to a complaint of soreness. The majority of GMPs (85%) and dentists (63%) indicated that they felt less than confident in detecting oral cancer, with over 70% of GMPs identifying lack of training as an important barrier. Many practitioners were unclear concerning the relative importance of the presence of potentially malignant lesions in the oral cavity. A high proportion of the GMPs indicated that they should have a major role to play in oral cancer detection (66%) but many felt strongly that this should be primarily the remit of the dental team. CONCLUSION: The study revealed a need for continuing education programmes for primary care practitioners in oral cancer-related activities. This should aim to improve diagnostic skills and seek to increase practitioners' participation in preventive activities

Maps, Memories and Manchester: The Cartographic Imagination of the Hidden Networks of the Hydraulic City

The largely unseen channelling, culverting and controlling of water into, through and out of cities is the focus of our cartographic interpretation. This paper draws on empirical material depicting hydraulic infrastructure underlying the growth of Manchester in mapped form. Focusing, in particular, on the 19th century burst of large-scale hydraulic engineering, which supplied vastly increased amounts of clean drinking water, controlled unruly rivers to eliminate flooding, and safely removed sewage, this paper explores the contribution of mapping to the making of a more sanitary city, and towards bold civic minded urban intervention. These extensive infrastructures planned and engineered during Victorian and Edwardian Manchester are now taken-for-granted but remain essential for urban life. The maps, plans and diagrams of hydraulic Manchester fixed particular forms of elite knowledge (around planning foresight, topographical precision, civil engineering and sanitary science) but also facilitated and freed flows of water throughout the city. The survival of these maps and plans in libraries, technical books and obscure reports allows the changing cultural work of water to be explored and evokes a range of socially specific memories of a hidden city. Our aetiology of hydraulic cartographics is conducted using ideas from science and technology studies, semiology, and critical cartography with the goal of revealing how they work as virtual witnesses to an 1 unseen city, dramatizing engineering prowess and envisioning complex and messy materiality into a logical, holistic and fluid network underpinning the urban machine. 1