Optimising GPs' communication of advice to facilitate patients' self-care and prompt follow-up when the diagnosis is uncertain: a realist review of 'safety-netting' in primary care.

Background: Safety-netting has become best practice when dealing with diagnostic uncertainty in primary care. Its use, however, is highly varied and a lack of evidence-based guidance on its communication could be harming its effectiveness and putting patient safety at risk.

Objective: To use a realist review method to produce a programme theory of safety-netting, that is, advice and support provided to patients when diagnosis or prognosis is uncertain, in primary care.

Whole grain cereals for the primary or secondary prevention of cardiovascular disease.

Background: There is evidence from observational studies that whole grains can have a beneficial effect on risk for cardiovascular disease (CVD). Earlier versions of this review found mainly short-term intervention studies. There are now longer-term randomised controlled trials (RCTs) available.

Human LPLUNC1 is a secreted product of goblet cells and minor glands of the respiratory and upper aerodigestive tracts.

Long PLUNC1 (LPLUNC1, C20orf114) is a member of a family of poorly described proteins (PLUNCS) expressed in the upper respiratory tract and oral cavity, which may function in host defence. Although it is one of the most highly expressed genes in the upper airways and has been identified in sputum and nasal secretions by proteomic studies, localisation of LPLUNC1 protein has not yet been described. We developed affinity purified antibodies and localised the protein in tissues of the human respiratory tract, oro- and nasopharynx.

Characterisation and expression of SPLUNC2, the human orthologue of rodent parotid secretory protein.

We recently described the Palate Lung Nasal Clone (PLUNC) family of proteins as an extended group of proteins expressed in the upper airways, nose and mouth. Little is known about these proteins, but they are secreted into the airway and nasal lining fluids and saliva where, due to their structural similarity with lipopolysaccharide-binding protein and bactericidal/permeability-increasing protein, they may play a role in the innate immune defence. We now describe the generation and characterisation of novel affinity-purified antibodies to SPLUNC2, and use them to determine the expression of this, the major salivary gland PLUNC.

Caries experience and dental attendance of Somali children living in a British city.

Aim: To facilitate the planning of future dental services, this study sought baseline data, relating to caries experience and dental attendance, for Somali children resident in Sheffield, UK.

Methods: A convenience sample of 4 to 14 year old Somali children was drawn from pupils attending Somali religious education classes, youth groups and selected schools in Sheffield. During 1998 and 1999, 238 Somali children were subjected to a dental examination and a structured interview.

The oral health of a group of prison inmates.

The oral health of prison inmates in England has come under increased scrutiny with the arrival of joint responsibility between the Home Office and the NHS for prison healthcare. This brief study indicates very high levels of oral disease amongst a group of prisoners attending for treatment in an English prison. Further study of the oral health of prisoners seems timely, as does the exploration of effective oral health promotion for this group of people.

The working patterns and retirement plans of general dental practitioners in a Midlands Health Authority.

Introduction: With the problems of access to NHS primary dental care services in the last few years attention has focused on manpower considerations for dentistry.

Materials And Method: This paper presents the results of a simple survey of general dental practitioners in South Staffordshire.

Results: The response rate was 88%.

Dental health of 12-year-old children living in similar rural communities in France and England.

A survey was conducted of the dental health of 12-year-old children attending state schools in the towns of Segré (France) and Shaftesbury (England). The results showed that the Segré children had DMFT and DMFS scores double that of the Shaftesbury children. More Segré children had calculus and more were undergoing orthodontic treatment.

The use of the index of orthodontic treatment need (IOTN) as a public health tool: a pilot study.

Many attempts have been made in the past to develop indices of malocclusion. The index of orthodontic treatment need was developed in the United Kingdom to assess both dental health and aesthetics, primarily for clinical purposes. This study was designed to assess the use of the index of orthodontic treatment need in dental public health.

Differences in dental caries in 5-year-old children within and between adjacent districts on the south coast of England.

Examination of the differences in caries patterns in 5-year-old children between adjacent English South Coast districts prompted a more specific study using larger samples in more discrete localities. Although the overall caries levels varied significantly between the two districts, no significant differences were found between two defined areas of social deprivation. The children in one area were predominantly of Indian or Pakistani background and in the other mainly white Caucasian and it is suggested that differences in caries experience are related to indicators of social deprivation, rather than ethnicity.

The development of a toothbrushing programme at a school for children with moderate and severe learning difficulties.

A toothbrushing programme was established in a school for children aged 3 to 19 years with moderate and severe learning difficulties. Toothbrushes were provided and the importance of using the school staff to help and encourage the children to brush their teeth on a daily basis was emphasized. The early improvement in oral cleanliness was maintained after a period of fourteen months.

Studies of temperature balance after open-heart surgery.

An analysis of postoperative records over a two-year period has shown that a mean rise in central body temperature greater than 2 degrees occurs in patients within 12 hours of return from the operating room following open-heart surgery. In some patients the central body temperature may rise to greater than 41 degrees C. despite an adequately warm peripheral temperature, and this is associated with a high mortality rate.

Heat loss during thoracotomy. A preliminary report.

Our aim in this report is, first, to explain why we think it is important to measure body temperatures during operation and, secondly, to describe a simple way to lessen heat loss during thoracotomy.