Dental management is critical prior to radiotherapy (RT) for head and neck cancer (HNC) but cumbersome and time intensive. This qualitative study investigates dentists’ evaluative processes to identify areas for improvement.

Semi-structured interviews were conducted with dentists involved in the care of HNC patients. The interviews were guided by the Consolidated Framework for Implementation Research and the Theoretical Domains Framework to identify factors influencing pre-RT dental management.

Five dentists were participated in the interviews. Key themes were identified through qualitative and quantitative evaluation and are as follows: Coordination among care providers, knowledge of the RT plan, visual depictions of dose distribution and understanding of the patient’s dental history.

This study demonstrates the complexity of pre-RT management and identifies key elements. Knowledge of the RT plan and improved interdisciplinary coordination represents opportunities for improvement. Visual dose prediction methods may expedite and improve pre-RT management.

The study sought to explore nutrition graduates’ employability and role of employability capitals in supporting nutrition science graduate outcomes.

In-depth semi-structured, audio-recorded interviews were conducted with nutrition graduates who had completed a nutrition science degree between 2015 and 2021. Interpretivism guided this study, which endeavoured to co-construct meaning with participants. Transcribed interviews were thematically analysed, whereby data were coded, themes identified and discussed by all authors. The data were further mapped against the graduate capital model (GCM) by deductively coding against the five graduate capitals (human, identity, social, psychological and cultural).

Ireland and Australia.

Forty-two nutrition graduates from across nine universities in Ireland and twenty-two from a single university programme in Australia.

All elements of the GCM were identified with human, social and identity capital most dominant and identified as significantly influential on employability. Presence or absence of these capitals could be clearly identified within each graduates’ experience. Formation of professional identity and connection to the profession was strongest amongst Irish graduates. However, more than half of the Australian cohort perceived barriers to professional identity formation, including lack of regulation, imposter syndrome, presence of non-qualified individuals and comparison to dietetics. Both psychological and cultural capitals were rarely spoken about.

The development of human, social and identity capital is observed among nutrition science graduates. Further investigation is required to enhance the process of identity development and ascertain potential remedies for obstacles. The absence of psychological and cultural capital, therefore, poses a significant issue for the resilience and comprehension of prospective graduates.

This work aimed to demonstrate that a website, www.epidemic-em.org, encompassing “static” resources, and videos, as well as other tools, can be used to strengthen public health emergency management capacity during epidemic response.

Existing resources were updated and developed for self-directed Emergency Operations Centers’ capacity strengthening, in order to encompass current best practices, and to emphasize how public health emergency management concepts can support epidemic response activities. These materials formed the core of the website, launched in June 2020, to which country case studies were added. In 2021, a pilot virtual training program was designed using recorded video lectures and interviews with global experts in addition to the website material, which was delivered to South African responders.

The website has been accessed in more than 135 countries, demonstrating widespread reach and interest in online and freely accessible materials to support public health emergency operations. Over 30 people participated in the pilot virtual training, and the evaluation showed improvement in knowledge, confidence in using emergency management concepts for epidemic response, and positive feedback on the virtual modality.

Online tools can expand access to materials and resources for public health emergency management capacity strengthening. Virtual modalities can further serve as a powerful complement, and perhaps replacement, for traditional in-person technical assistance, despite some limitations.

We conducted a population-based study using Ontario health administrative data to describe trends in healthcare utilization and mortality in adults with epilepsy during the first pandemic year (March 2020–March 2021) compared to historical data (2016–2019). We also investigated if changes in outpatient visits and diagnostic testing during the first pandemic year were associated with increased risk for hospitalizations, emergency department (ED) visits, or death.

Projected monthly visit rates (per 100,000 people) for outpatient visits, electroencephalography, magnetic resonance, computed tomography, all-cause ED visits, hospitalizations, and mortality were calculated based on historical data by fitting monthly time series autoregressive integrated moving-average models. Two-way interactions were calculated using Quasi-Poisson models.

In adults with epilepsy during the first quarter of the pandemic, we demonstrated a reduction in all-cause outpatient visits, diagnostic testing, ED visits and hospitalizations, and a temporary increase in mortality (observed rates of 355.8 vs projected 308.8, 95% CI: 276.3–345.1). By the end of the year, outpatient visits increased (85,535.4 vs 76,620.6, 95% CI: 71,546.9–82,059.4), and most of the diagnostic test rates returned to the projected. The increase in the rate of all-cause mortality during the pandemic, compared to pre-pandemic, was greater during months with the lower frequency of diagnostic tests than months with higher frequency (interaction p-values <.0001).

We described the impact of the pandemic on healthcare utilization and mortality in adults with epilepsy during the first year. We demonstrated that access to relevant diagnostic testing is likely important for this population while planning restrictions on non-urgent health services.

There is growing evidence that disasters may increase the risk of developing chronic diseases, including diabetes, dyslipidemia, chronic kidney disease, and cardiovascular disease. However, how much disaster exposure specifically affects chronic disease risk is unknown. This presentation introduces the study protocol for the Risk of hEalth ConditiOn AdVerse Events after disasteRs (RECOVER) Cohort Study, which addresses this gap.

The primary aim of RECOVER is to determine the extent to which disaster exposure specifically increases the risk of developing chronic disease (Aim 1). The secondary aims of the study are to determine if the nature, duration and severity of disaster exposure are risk factors for disease (Aim 2), to map mediators of post-disaster chronic disease risk (Aim 3), and to identify potential biomarkers of post-disaster chronic disease risk (Aim 4). RECOVER will recruit over 6000 adults (1:1 disaster exposed vs unexposed) in Australia to a nationally representative cohort for longitudinal follow-up. Detailed data will be obtained annually on disaster exposure, demographic, social and health factors. The primary health outcome (Aim 1) of chronic disease will be defined as new, incident diabetes, cardiovascular or respiratory disease, and will be ascertained through data linkage with the Pharmaceutical Benefits Scheme. A biomarker sub-stream will include ~1,000 participants who provide a hair and saliva sample for cortisol and epigenetic analysis.

N/A

There is an urgent need for detailed individual-level data to analyze the nature of the association between disaster exposure and chronic disease. In 2020 alone, 16.8 million Australians were exposed to disasters. The frequency and severity of disasters are only expected to grow due to climate change. As the first prospective cohort study to longitudinally track individual-level disaster exposure and chronic disease outcomes, RECOVER will fill a critical evidence gap.

To identify cognitive phenotypes in late-life depression (LLD) and describe relationships with sociodemographic and clinical characteristics.

Observational cohort study

Baseline data from participants recruited via clinical referrals and community advertisements who enrolled in two separate studies.

Non-demented adults with LLD (n = 120; mean age = 66.73 ± 5.35 years) and non-depressed elders (n = 56; mean age = 67.95 ± 6.34 years).

All completed a neuropsychological battery, and individual cognitive test scores were standardized across the entire sample without correcting for demographics. Five empirically derived cognitive domain composites were created, and cluster analytic approaches (hierarchical, k-means) were independently conducted to classify cognitive patterns in the depressed cohort only. Baseline sociodemographic and clinical characteristics were then compared across groups.

A three-cluster solution best reflected the data, including “High Normal” (n = 47), “Reduced Normal” (n = 35), and “Low Executive Function” (n = 37) groups. The “High Normal” group was younger, more educated, predominantly Caucasian, and had fewer vascular risk factors and higher Mini-Mental Status Examination compared to “Low Executive Function” group. No differences were observed on other sociodemographic or clinical characteristics. Exploration of the “High Normal” group found two subgroups that only differed in attention/working memory performance and length of the current depressive episode.

Three cognitive phenotypes in LLD were identified that slightly differed in sociodemographic and disease-specific variables, but not in the quality of specific symptoms reported. Future work on these cognitive phenotypes will examine relationships to treatment response, vulnerability to cognitive decline, and neuroimaging markers to help disentangle the heterogeneity seen in this patient population

This study evaluates the personal and professional experiences of physician mothers during the coronavirus disease 2019 (COVID-19) pandemic and the impact of the pandemic on the lives of physician mothers.

Using social media to reach a broad range of physicians, a convenience sample of physician mothers completed an on-line survey posted between April 27 and May 11. Members were encouraged to repost on social media and share with personal contacts resulting in a passive snowball sampling effect.

A total of 2709 physician mothers from 48 states, Puerto Rico, and 19 countries representing more than 25 medical specialties completed the survey. Most were between 30 and 39 y of age, 67% self-identified as white, 17% as Asian, 4% as African American. Most had been working for 11-16 y. A total of 91% had a spouse/partner of the opposite sex. Over half were practicing in an area they identified as high COVID-19 density, while 50% had personally cared for a person with COVID-19. Physician mothers were most concerned about exposing their children to COVID-19 and about the morale and safety of their staff.

This is one of the first studies to explore the personal and professional challenges facing physician mothers during a pandemic. Physician mothers were most concerned about exposing their families to COVID-19. Mothers continued to work and at times increased their work, despite having domestic, childcare, and schooling responsibilities.

Residual symptoms and cognitive impairment are among important sources of disability in patients with bipolar disorder. Methylene blue could improve such symptoms because of its potential neuroprotective effects.

We conducted a double-blind crossover study of a low dose (15 mg, ‘placebo’) and an active dose (195 mg) of methylene blue in patients with bipolar disorder treated with lamotrigine.

Thirty-seven participants were enrolled in a 6-month trial (trial registration: NCT00214877). The outcome measures included severity of depression, mania and anxiety, and cognitive functioning.

The active dose of methylene blue significantly improved symptoms of depression both on the Montgomery–Åsberg Depression Rating Scale and Hamilton Rating Scale for Depression (P = 0.02 and 0.05 in last-observation-carried-forward analysis). It also reduced the symptoms of anxiety measured by the Hamilton Rating Scale for Anxiety (P = 0.02). The symptoms of mania remained low and stable throughout the study. The effects of methylene blue on cognitive symptoms were not significant. The medication was well tolerated with transient and mild side-effects.

Methylene blue used as an adjunctive medication improved residual symptoms of depression and anxiety in patients with bipolar disorder.