Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial.

Background: People with disadvantaged backgrounds are less likely to visit the dentist for planned care, even though they have disproportionately poorer oral health. They are correspondingly more likely to experience dental problems and use urgent dental care, general practices and Accident and Emergency departments, which not only makes meeting their needs expensive, but, since these services often rely on prescriptions rather than addressing the clinical cause, can contribute to antimicrobial resistance.

Methods: The RETURN intervention has been developed with substantial community co-production, to be delivered opportunistically in urgent dental care settings.

Admission Glucose Number (AGN): A Point of Admission Score Associated With Inpatient Glucose Variability, Hypoglycemia, and Mortality.

Aims: We investigated a point of admission metric of glycemia, the Admission Glucose Number (AGN), and its relationship with both high risk inpatient glucose patterns and mortality in hospital inpatients with type 2 diabetes (T2DM).

Methods: Inpatient capillary blood glucose (CBG) data for patients with T2DM in our health board were identified for a 5-year period and associated with most recent preadmission HbA1c. AGN was calculated as first CBG measured during admission (mmol/L), subtracted from most recent preadmission HbA1c (converted to estimated median glucose mmol/l) within 15 months preadmission.

A Slow-Digesting, Low-Glycemic Load Nutritional Beverage Improves Glucose Tolerance in Obese Pregnant Women Without Gestational Diabetes.

Background: Obesity is a risk factor for gestational diabetes (gestational diabetes). Low-glycemic index diets attenuate hyperglycemia. We designed a study to determine whether a slow-digesting, low-glycemic load (SD-LGL) beverage improves glucose tolerance in obese pregnant women without GDM.

Symptom-Guided Emergency Department Discharge Instructions for Children With Concussion.

Objectives: The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed.

Methods: A convenience sample of 114 children aged 7 to 17 years presenting to an urban pediatric emergency department with a complaint of concussion was assembled.

Oral Jewelry and Piercing: Risks to Health.

What appears to be a decorative fad, pursued by people of all ages, is, for the most part, an invasion of the body by poorly trained individuals. Simple-to-complex, the insertion of body jewelry is embarked upon on a whim with little concern for health, including the possibility of infection. Many of those who opt for piercings have outcomes that are unremarkable and relatively trouble free.

The effects of sleep restriction and altered sleep timing on energy intake and energy expenditure.

Experimental evidence suggests that sleep restriction increases energy intake (EI) and may alter energy expenditure (EE). However, it is unknown whether the timing of a sleep restriction period impacts EI and EE the following day. Hence, we examined the effects of sleep restriction with an advanced wake-time or delayed bedtime on next day EI and EE.

What it means to be a doctor. Sensitizing the dentist and the student to professionalism.

Professional demeanor and the inter-personal behavior of the dentist play a large part in building the trust patients measure as they gain confidence in their choice of practitioner. Most of the time, patients experience comfort through the competent, compassionate care of a genuinely respected provider. That important im- age is determined by the ethical and proper relationships every patient encounters.

Prediction of gestational diabetes in obese pregnant women from the UK Pregnancies Better Eating and Activity (UPBEAT) pilot trial.

Aim: To examine the prediction of gestational diabetes in obese women using routine clinical measures and measurement of biomarkers related to insulin resistance in the early second trimester.

Methods: A total of 117 obese pregnant women participating in a pilot trial of a complex intervention of dietary advice and physical activity were studied. Blood samples were obtained at recruitment (15⁺⁰-17⁺⁶ weeks' gestation) and demographic, clinical history and anthropometric measures recorded.

Professional responsibility and patient retention: alerts for the new dentist.

Getting to know your patients, well beyond recognition of their specific chief dental complaint, is most important in operating a successful and satisfying practice. In addition to the clinical findings and pertinent history alerts, a good understanding of the person being treated can go a long way toward cementing lasting and rewarding doctor-patient relationships. Almost all new patients to the practice are welcome.

Debatable evidence for the adverse drug reactions to local anaesthetics.

Data Sources: Medline, Embase, Chinese National Knowledge Infrastructure VIP Database for Chinese Technical Periodicals (and Chinese Biomedical Literature Database.

Study Selection: Randomised controlled trials (RCTs), non-RCTs, case-control studies, case reports, case series and cross-sectional studies that focused on adverse drug reactions of local anaesthetics were considered.

Data Extraction And Synthesis: Data abstraction was conducted independently by two reviewers, and summary data and a meta-analysis presented.

Severe hypertriglyceridaemia in Type 2 diabetes mellitus: beneficial effect of continuous insulin infusion.

Background: Severe hypertriglyceridaemia is a recognized complication of Type 2 diabetes mellitus (T2DM); however, there is no consensus on acute management despite the significant risk of developing associated complications such as acute pancreatitis and hyperviscosity syndrome.

Aim: To identify the association between hyperglycaemia and severe hypertriglyceridaemia in patients with T2DM and assess the effect of continuous insulin infusion therapy on serum triglyceride (TG) concentrations and report any adverse events associated with this therapeutic approach.

Design: Retrospective review of case records.

One-third of doctors completing specialist training in diabetes fail to secure a substantive consultant post: young Diabetologists' Forum Survey 2010.

Reports have highlighted a shortage of consultant diabetologist posts in the UK. The number of doctors completing specialist training in diabetes has increased in recent years, but little is known about their employment after they receive their certificate of completion of training. An online survey was sent to all doctors who completed specialist diabetes training from January 2008 to September 2010.

Taking training into your own hands.

The Young Diabetologists' Forum (YDF) is a group designed and run by specialist trainees in endocrinology and diabetes that aims to provide high quality educational events. The YDF recognised that not all trainees in the specialty had equitable access to training opportunities and resolved to try and remedy the situation. This article describes the history and evolution of the YDF into an organisation representing over 400 trainees in endocrinology and diabetes, providing up to seven training events per year and with a budget of over pounds 200,000.

Analysis of Amblyomma surveillance data in the Caribbean: lessons for future control programmes.

Amblyomma variegatum, the Tropical Bont Tick (TBT), is the principal vector of heartwater and is associated with dermatophilosis, major causes of losses in animal production and mortality in Caribbean livestock. From 1995 to 2007, the Caribbean Amblyomma Programme (CAP) supported treatment and surveillance activities in 11 islands of the Eastern Caribbean with an initial objective of eradicating TBT. In addition to control activities, surveillance data were collected between 1997 and 2006 in a unique regional database.

The New York State postgraduate fifth-year dental residency as a new licensure path: concerns for public protection.

The recently enacted law creating an alternative pathway to dental licensure in New York state is benchmark legislation. Along with the positive effects of dental education that may ensue, the author has serious concerns that the strongly emotional and political debate occurring during the bill's consideration obscured important considerations for public safety and the erosion of standards for licensure in New York. In addition, this pathway has potential to negatively affect freedom of movement and licensure by credentials for practice in other jurisdictions.

A response from the American Association of Dental Examiners.

The American Association of Dental Examiners supports a testing environments that include supervision of patient care. Extensive steps are taken in licensure examinations to ensure content validity through standardization by practice surveys, standards of competency, common core content, dental school curricula, and the limitations of practical constraints. Examining agencies report consistent, high collaboration among examiners.

The separation of dentistry and family.

There are times when dentistry and family don't mix. When treating those who are closest to you, you should, at a minimum, observe the same rules you do when treating other, unrelated patients. The wiser course, however, may be to let someone else take care of your loved ones.

Direct posterior Class II composites.

The achievement of successful class II posterior composite restorations depends on very careful technique and the use of materials that allow for reduced wear, prevention of sensitivity, proper anatomic form, accurate and stable color matching, marginal integrity, and surface polish. The intricacies of material science with the burgeoning array of newer, better restoratives are discussed in the context of technique excellence and attention to detail. Today, posterior composite restorations can serve as a reliable functioning part of dentistry's restorative armamentarium.