Prevention Advice Research Articles

Preventing chronic disease in overweight and obese patients with low health literacy using eHealth and teamwork in primary healthcare (HeLP-GP): a cluster randomised controlled trial

ObjectivesTo evaluate a multifaceted intervention on diet, physical activity and health literacy of overweight and obese patients attending primary care.DesignA pragmatic two-arm cluster randomised controlled trial.SettingUrban general practices in lower...

“I Have Only Checked after the Event”: Consumer Approaches to Safe Online Shopping

ABSTRACT Online shopping has now become very common, with consumers increasingly opting to purchase products on the World Wide Web instead of visiting traditional “bricks and mortar” stores, particularly during the COVID-19 pandemic. This has, however, also provided significant opportunities for offenders to abuse the inherent trust-based nature of online shopping, whereby consumers typically do not see the products physically prior to purchasing them. As such, this article sets out to examine the actions and behaviors that individuals take to prevent online shopping fraud and what, if any, discrepancy exists between prevention messaging and consumer behavior. To accomplish this, the study utilizes secondary survey data (n = 3478 respondents) obtained from a private-sector initiative called ScamAdviser. The results find that many respondents do not use appropriate behaviors to reduce their risk when shopping online and that furthermore there is reason to believe that consumers are not served well by the online safety advice that they are given. The paper argues that there is scope to increase guardianship through better prevention advice being communicated to online shoppers.

415. A WEBCAST FOR THE EDUCATION AND INFORMATION OF PATIENTS WITH BARRETT’S ESOPHAGUS AND BARRETT’S CANCER

Abstract To provide expert knowledge to patients becomes more and more important, especially during the Sars-CoV-2 pandemics, where self-helping groups could not meet and on-site information events could not take place. We discovered a need due to patients’ uninformedness about diagnostic procedures, treatment options and advice for disease prevention or special nutrition and medications after the diagnosis of Barrett’s esophagus and Barrett’s cancer. A webpage was created, including a video streaming platform (https://webcast.barrett-initiative.de/). The events were performed live with the opportunity to ask questions via the chat function. Vimeo was used for the live streaming. Three to four lecturers were invited and one moderator organized the sequence of talks and questions. Additionally, the webpage is contains an encyclopedia, to explain disease related terms in a patient-orientated language. The invitation was done based on our nation-wide patient network based on genes for barrett’s (g4b) study https://www.barrett-konsortium.de/. Patients used a desktop computer (65%), mobile phones (28%), and tablets (7%) to join the video sessions. The lecture series was started with a kick-off event in September 2021 to give a bright overview about reflux, Barrett’s esophagus und Barrett’s cancer. Four special topic events were conducted, dealing with tumor biology, cancer prevention, diagnostics needed for the correct staging and how the diagnostic will guide the therapy by explaining the expertise review board, discussing operability and prehabilitation. The series will be continued by the endoscopic and surgical treatment options. There were 1,100 views to the webpage. While during the kick-off 204 patients were online, approx. 71 to 171 patients saw the following events during the live sessions. Based on the questions by our patients and the continuous participation at our livestream events, we discovered an urgent need to provide a platform to patients, where they can find disease specific information in a patients-oriented language. Therefore, all lectures were deposited to a media archive where they are available to patients. We implemented our webcast project as a growing platform to cover aspects from the disease development, to diagnosis, treatment, and follow-up care.

Concordance of three point of care testing devices with clinical chemistry laboratory standard assays and patient-reported outcomes of blood sampling methods

BackgroundPoint of care testing (POCT) devices have been developed to facilitate immediate results with the potential to aid screening for new disease and enable patients to self-monitor their disease. Non-communicable diseases (NCDs) are the major cause of mortality globally and are increasing in prevalence as the population ages. Allied health care professionals (AHPs) are skilled in undertaking risk assessment and delivering preventative advice, providing opportunities to access large proportions of the population who may not visit their doctor, within non-traditional community settings. There is evidence of high levels of support from public, patients and health professionals for engaging AHPs in risk-targeted early case detection of certain NCDs. Thus, POCT devices offer a potential alternative to traditional venous blood collection, as novel care pathways for increasing early case detection and access to preventative care. The objectives of this study were to: (i) determine the concordance of the specific POCT devices with laboratory-based standard assays employed within clinical biochemistry laboratories. (ii) compare the sampling experience of both methods via patient-reported experiences.MethodsA prospective, two-centre study was undertaken involving 158 participants who provided informed consent. Venous blood was collected for traditional assays of HbA1c, creatinine/ estimated Glomerular-Filtration-Rate (eGFR) and vitamin-D. Capillary blood was collected by finger prick test and also assayed for the same biochemical indices (Nova StatSensor (creatinine/eGFR); Siemens DCA-Vantage (HbA1C); CityAssays (vitamin-D)). All users were provided with device training. Participants reported any discomfort experienced by each simultaneously applied method (randomised in order) via a 100 mm Visual-Analogue-Scale.ResultsResults for each POCT device and the laboratory standard were analysed by Bland-Altman plots to determine assay concordance. POCT devices demonstrated good concordance with laboratory testing, with at least 95% of all samples being within two standard deviations, for each of the devices tested. The majority of participants reported less discomfort with POCT than venepuncture, with the average reported discomfort being 17/100 mm less for POCT compared to venous blood sample collection on the visual analogue scale.ConclusionsThe POCT devices demonstrated acceptable concordance with laboratory-based assays, and patients reported lower levels of discomfort compared to traditional means of blood collection. This study demonstrates the potential of using these devices as acceptable methods for opportunistic testing of “at-risk” individuals within non-traditional community care settings.

Infection control in cystic fibrosis: evolving perspectives and challenges.

This article reviews the impact of some of the most recent changes in clinical care management in cystic fibrosis on infection prevention practice and advice for people with cystic fibrosis. People with cystic fibrosis (CF) consistently highlight infection control as one of their major concerns. Infection prevention guidance and practice has facilitated successful decreases in rates of many transmissible CF pathogens. The coronavirus disease 2019 pandemic highlighted the clinical significance of respiratory viral infections and has accelerated the implementation of remote monitoring and telemedicine consultations as standard practice in CF. The continued improvement in health of the CF population is being further augmented by the introduction of new therapies, in particular cystic fibrosis transmembrane conductance regulator modulators. Infection prevention will remain pertinent to CF care, but these recent changes in clinical practice will have ongoing implications for infection prevention guidance in CF. Recent changes in CF clinical care have implications that will lead to further evolution of infection control practice and advice.

O57 - eLearning significantly improves midwives’ knowledge of the congenital cytomegalovirus prevention guidelines

Congenital cytomegalovirus (CMV) infection is a preventable cause of neurodevelopmental disability. Australian guidelines recommend pregnant women are informed about CMV hygiene precautions to reduce their risk of infection however less than 10% of maternity health professionals routinely provide such prevention advice. We developed and evaluated the effectiveness of an eLearning course for midwives to improve knowledge and confidence about CMV. Participants undertaking the online course through the Australian College of Midwives Learning Management System between March and November 2020 were invited to complete a course evaluation questionnaire; prior to commencing the course (T1), immediately following completion (T2) and three months after completion (T3). A linear mixed model with random intercept was used to evaluate change in participant scores over time, while accounting for within-subject correlation. A p-value of <0.05 was considered statistically significant. 363 midwives (87%), midwifery students (8%) and other nurses (5%) participated. At T1 80% indicated they had not received education about CMV. Total adjusted mean scores for questionnaires completed between T1 (n=363) and T2 (n=238) increased significantly (from 17.2 to 22.8, p<0.001). Limited data at T3 (n=27) indicated that whilst scores were lower than at T2 (-1.7, p<0.001), they remained significantly higher than at T1 (+3.6, p <0.001). Participant’s awareness of CMV information resources improved from 10% at T1 to 97% by T2 and 100% at T3. Confidence in providing CMV advice increased from 6% at T1 to 95% at T2 (p<0.001). 99% of participants indicated they would recommend the course to their colleagues. Participants who completed the eLearning course had significantly improved knowledge and confidence in providing advice about CMV. Programs targeting other maternity health professional groups should be considered, to further support the implementation of the congenital CMV prevention guidelines.

Clinical Aspects of Breast Cancer

Breast cancer is considered one of the major healthcare problems and one of the top biomedical research priorities among all biomedical research. Breast cancer is a common but extremely complex disease. The incidence of breast cancer becoming more aggressive is increasing, with around one million and seven hundred thousand new cases that get worse yearly, and this incidence is expected to increase significantly in the next 5–10 years. These rates are suggestive of the slow progress of this disease. Worldwide, Breast cancer is the most common cancer affecting women. The mortality rates for women who are already diagnosed with breast cancer have improved, but even then, the median survival in the metastatic stage is low, around 24 months. For the treatment, chemotherapy is the gold-standard approach for most cancer types and the modest improvement in both survival rates and toxicity reduction. Every newly diagnosed breast cancer should be presented at a multidisciplinary conference to ensure optimal management by all specialties involved. A careful history of a woman’s risk and symptoms and a thorough physical examination are important in the evaluation of breast problems and appropriately timed imaging and diagnostic studies are also important. Early detection of breast cancer at a stage when it is potentially curable and there is the possibility of saving a breast should be the goal of all health care professionals. Also, careful consideration should be given to the unique nature of each tumor and patient. This article aims to provide a brief introduction and the clinical picture of the disease, Etiology, Pathophysiology, Epidemiology, Nutrition, Prevention, and good practice management advice. Keywords: Breast Cancer, BRCA1 gene, BRCA2 gene, Type one Diabetes mullites. Type Two Diabetes Mellites.

Team approach to fall reduction in paediatric ward of national referral hospital, Thimphu, Bhutan: a quality improvement initiative

Falls are common and preventable adverse events that occur in a hospital setting. Falls can cause pain, damage, increase cost and mistrust in the health system. Inpatient fall is a...

Epidemiological Characteristics and the Dynamic Transmission Model of Dengue Fever in Zhanjiang City, Guangdong Province in 2018.

Background: With the progress of urbanization, the mobility of people has gradually increased, which has led to the further spread of dengue fever. This study evaluated the transmissibility of dengue fever within districts and between different districts in Zhanjiang City to provide corresponding advice for cross-regional prevention and control. Methods: A mathematical model of transmission dynamics was developed to explore the transmissibility of the disease and to compare that between different regions. Results: A total of 467 DF cases (6.38 per 100,000 people) were reported in Zhanjiang City in 2018. In the model, without any intervention, the number of simulated cases in this epidemic reached about 950. The dengue fever transmissions between districts varied within and between regions. When the spread of dengue fever from Chikan Districts to other districts was cut off, the number of cases in other districts dropped significantly or even to zero. When the density of mosquitoes in Xiashan District was controlled, the dengue fever epidemic in Xiashan District was found to be significantly alleviated. Conclusions: When there is a dengue outbreak, timely measures can effectively control it from developing into an epidemic. Different prevention and control measures in different districts could efficiently reduce the risk of disease transmission.

USing rolE-substitutioN In care homes to improve ORal health (SENIOR): a study protocol

BackgroundDental service provision in the care home sector is poor, with little emphasis on prevention. Emerging evidence suggests that the use of Dental Care Professionals (dental therapists and dental nurses) as an alternative to dentists has the potential to improve preventive advice, the provision of care and access to services within care homes. However, robust empirical evidence from definitive trials on how to successfully implement and sustain these interventions within care homes is currently lacking. The aim of the study is to determine whether Dental Care Professionals could reduce plaque levels of dentate older adults (65 + years) residing in care homes.MethodsThis protocol describes a two-arm cluster-randomised controlled trial that will be undertaken in care homes across Wales, Northern Ireland and England. In the intervention arm, the dental therapists will visit the care homes every 6 months to assess and then treat eligible residents, where necessary. All treatment will be conducted within their Scope of Practice. Dental nurses will visit the care homes every month for the first 3 months and then three-monthly afterwards to promulgate advice to improve the day-to-day prevention offered to residents by carers. The control arm will be ‘treatment as usual’.Eligible care homes (n = 40) will be randomised based on a 1:1 ratio (20 intervention and 20 control), with an average of seven residents recruited in each home resulting in an estimated sample of 280. Assessments will be undertaken at baseline, 6 months and 12 months and will include a dental examination and quality of life questionnaires. Care home staff will collect weekly information on the residents’ oral health (e.g. episodes of pain and unscheduled care). The primary outcome will be a binary classification of the mean reduction in Silness-Löe Plaque Index at 6 months. A parallel process evaluation will be undertaken to explore the intervention’s acceptability and how it could be embedded in standard practice (described in a separate paper), whilst a cost-effectiveness analysis will examine the potential long-term costs and benefits of the intervention.DiscussionThis trial will provide evidence on how to successfully implement and sustain a Dental Care Professional-led intervention within care homes to promote access and prevention.Trial registrationISRCTN16332897. Registered on 3 December 2021.

Randomized clinical trial of nitazoxanide or sofosbuvir/daclatasvir for the prevention of SARS-CoV-2 infection.

BackgroundThe COVER trial evaluated whether nitazoxanide or sofosbuvir/daclatasvir could lower the risk of SARS-CoV-2 infection. Nitazoxanide was selected given its favourable pharmacokinetics and in vitro antiviral effects against SARS-CoV-2. Sofosbuvir/daclatasvir had shown favourable results in early clinical trials.MethodsIn this clinical trial in Johannesburg, South Africa, healthcare workers and others at high risk of infection were randomized to 24 weeks of either nitazoxanide or sofosbuvir/daclatasvir as prevention, or standard prevention advice only. Participants were evaluated every 4 weeks for COVID-19 symptoms and had antibody and PCR testing. The primary endpoint was positive SARS-CoV-2 PCR and/or serology ≥7 days after randomization, regardless of symptoms. A Poisson regression model was used to estimate the incidence rate ratios of confirmed SARS-CoV-2 between each experimental arm and control.ResultsBetween December 2020 and January 2022, 828 participants were enrolled. COVID-19 infections were confirmed in 100 participants on nitazoxanide (2234 per 1000 person-years; 95% CI 1837–2718), 87 on sofosbuvir/daclatasvir (2125 per 1000 person-years; 95% CI 1722–2622) and 111 in the control arm (1849 per 1000 person-years; 95% CI 1535–2227). There were no significant differences in the primary endpoint between the treatment arms, and the results met the criteria for futility. In the safety analysis, the frequency of grade 3 or 4 adverse events was low and similar across arms.ConclusionsIn this randomized trial, nitazoxanide and sofosbuvir/daclatasvir had no significant preventative effect on infection with SARS-CoV-2 among healthcare workers and others at high risk of infection.

Covid-19 a brief Overview

In December 2019, pneumonia brought on by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection first appeared in Wuhan City, Hubei Province, China. The World Health Organization (WHO) will formally refer to the illness brought on by SARS-CoV-2 infection as coronavirus disease by February 11, 2020. (COVID-19). Fever, a dry cough, and exhaustion are the most common clinical symptoms of COVID-19, and pulmonary involvement is often evident. Being extremely infectious, SARS-CoV-2 may infect the majority of people in the general population. Currently, the major sources of the illness, which is spread by respiratory droplets and direct contact, are infected individuals and wild animal hosts. Since the outbreak, the Chinese government and scientific community have moved quickly to uncover the underlying cause, disclose the viral DNA sequence, and implement control measures. While past studies have concentrated on epidemiology, clinical characteristics, diagnosis, treatment, as well as the development of drugs and vaccines, current research has uncovered crucial parts of SARS-CoV-2 biology and disease pathogenesis. This review tries to establish agreement among experts by summarising the most recent study results. Along with current advice for prevention, containment, and essential treatment of this pandemic, we will also discuss existing initiatives and experience from China that may provide light on how to curb the outbreak and further our knowledge of this newly emergent infectious illness.

An Interpretive Descriptive Approach to Understanding Osteoporosis Management from the Perspective of People at Risk of Fracturing.

PurposeAdherence to both non-pharmacological and pharmacological fracture prevention interventions is often low in people with osteoporosis. Understanding how patients acquire information about osteoporosis management is important for understanding both the initial decision-making and ongoing adherence. This study explored the narrative of people living with osteoporosis and their personal experience getting information about their osteoporosis management.MethodsAn interpretive descriptive method was used for this qualitative study. In-depth interviews were conducted with 13 Canadian participants (age range 51–90) who knew that they had osteoporosis or osteopenia. Participants were asked to participate in one-on-one interviews to address the type of health professionals providing osteoporosis management advice focusing specifically on advice received about exercise, nutrition, and falls prevention. Interviews were transcribed verbatim and coded sentence-by-sentence.ResultsPeople with osteoporosis rely on physicians for advice related to pharmacological treatment needs, and other health professionals for non-pharmacological needs such as exercise advice, nutrition advice, and falls prevention advice. People value non-professionals, such as family members and close friends, who may or may not have osteoporosis, to discuss or corroborate health professional advice, or to validate their belief system.ConclusionTraining patients to more effectively engage in conversations with their healthcare providers may be a strategy to improve the quality of communication and its translation into adherence to best practices in managing osteoporosis.

Dietary patterns derived by reduced rank regression and non-communicable disease risk.

Most current nutrition policies and dietary recommendations still reflect decades of research addressing the mechanism of action or health risks of individual nutrients. Yet, most high-income countries including the UK are far from reaching the dietary intakes which are recommended for good health. Food-based dietary patterns (DPs) can help target specific combinations of foods that are associated with disease risk, recognising the coexistence of multiple nutrients within foods and their potential synergistic effects. Reduced rank regression (RRR) has emerged as a useful exploratory approach which uses a priori knowledge of the pathway from diet to disease to help identify DPs which are associated with disease risk in a particular population. Here we reviewed the literature with a focus on longitudinal cohort studies using RRR to derive DPs and reporting associations with non-communicable disease risk. We also illustrated the application of the RRR approach using data from the UK Biobank study, where we derived DPs that explained high variability in a set of nutrient response variables. The main DP was characterised by high intakes of chocolate and confectionery, butter and low-fibre bread, and low intakes of fresh fruit and vegetables and showed particularly strong associations with CVD, type 2 diabetes and all-cause mortality, which is consistent with previous studies that derived 'Western' or unhealthy DPs. These recent studies conducted in the UK Biobank population together with evidence from previous cohort studies contribute to the emerging evidence base to underpin food-based dietary advice for non-communicable disease prevention.

The Effect of MI Varnish™ on Caries Increment and Dietary Habits among 6- and 12-Year-Old Children in Riga, Latvia: A 3-Year Randomized Controlled Trial.

Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-year-old children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia.

Cost-effectiveness of targeted genomic risk provision to prevent skin cancer: Results of a randomized trial.

10536 Background: Many melanomas and keratinocyte cancers (KC) are preventable by reducing sun exposure and improving sun protection behaviors. Recent evidence indicates a melanoma prevention program involving personalized genomic risk information provision can reduce self-reported sunburns at 12 months in Australian adults with no history of melanoma. This was alongside genetic counselling and educational materials on skin cancer prevention and early detection. However, the economic impact of this approach was unclear. This study aimed to determine the cost-effectiveness of the program to prevent melanoma and KC. Methods: A decision-analytic Markov model was developed to simulate the lifetime cost-effectiveness of personalized genomic risk provision compared with standard prevention advice alone, from a health system perspective. We used data from the Melanoma Genomics Managing Your Risk Study Randomized Control Trial. Traditional risk was measured by a validated melanoma risk prediction model involving hair color, nevus density, history of non-melanoma skin cancer, family history of melanoma, level of sunbed sessions. Quality-adjusted life years (QALY) gained was the primary outcome measure used to estimate an incremental cost-effectiveness ratio (ICER). Both deterministic and probabilistic sensitivity analyses (PSA) were undertaken. Results: The cost of the genomic testing and risk counselling program was AUD$189 (USD$132) per participant. Genomic risk provision targeting high-traditional risk individuals was the most cost-effective lifetime strategy with an ICER of AUD$23,033 (USD$16,059) per QALY gained and an 80% probability of being cost-effective at a willingness-to-pay threshold of AUD$50,000, compared with standard preventive advice (Table). When genomic risk provision was extended to low-traditional risk groups the ICER was $43,746 (USD30,500) per QALY gained with a 45% probability of being cost-effective. Conclusions: Genomic risk provision targeted to individuals at high-traditional risk of melanoma is a cost-effective strategy for the prevention of melanoma and KCs. Long-term sustainability of the program’s effect should be examined in future research. Clinical trial information: ACTRN12617000691347. [Table: see text]

Promoting farm advisor engagement and action toward the improvement of dairy cattle lameness

Lameness represents a significant management challenge in the dairy industry worldwide. In addition to farmers, many advisors are involved in lameness management, including veterinarians, hoof trimmers, and nutritionists. These advisors support farmers through lameness prevention practices, treatments, and advice, but little is known about how advisors view others' roles and the extent to which they work together. This study used qualitative participatory methods to facilitate the formation of lameness advisory groups among 13 advisors (4 veterinarians, 5 hoof trimmers, and 4 nutritionists), with the aims of promoting advisors' engagement with one another and documenting their perceptions of the benefits and challenges of the research activities through semi-structured interviews and thematic analysis. Participants shared predominantly positive views toward the project and voiced appreciation about the quality of discussions and the opportunity to connect and build relationships with other advisors. Participants reported improved communication with others via sharing reports and farm information, as well as increased confidence in reaching out to other advisors. Reported challenges included time constraints and discomfort in leading the lameness advisory group meetings. Difficulties were also found in bringing issues to farmers' attention when they might not align with the farmers' goals or priorities, as well as participants' questioning other advisors' knowledge and intentions. This study describes a promising avenue of facilitating advisor engagement, although more work is needed to determine whether such engagement translates to a reduction of lameness on farms.

Occupational and speech therapists' perceptions of their role in dental care for children with autism spectrum disorder: A qualitative exploration.

Children with autism spectrum disorder (ASD) have challenges in home oral care, accessing a dentist and accepting dental treatment. Occupational therapists (OTs) and speech therapists (STs) are likely to be involved earlier in managing communication, behavioural and sensory processing issues. To determine perceived issues, barriers and potential solutions to dental care for children with ASD in Singapore from the perspective of OTs and STs. Semi-structured interviews and a focus group discussion involving OTs and STs who treat children with ASD were conducted. Audio recordings were transcribed and coded into themes using the NVivo 12 software. Emergent themes indicated that: (i) OTs and STs have important roles in recognition of issues with toothbrushing, oral pathology and harmful oral habits; (ii) OTs and STs were able to identify reasons for difficulties in oral home care for children with ASD and offer helpful strategies; and (iii) OTs and STs can play a role in pre-dental visit preparations but lack a clear dental referral pathway. OTs and STs exclusively assist in the early identification and referrals of children with ASD to the dentist. Interprofessional collaboration with dentists should be further explored to aid in the provision of preventive dental advice.

A Proposed WoT System for Diagnosing the Infection of Coronavirus (Covid-19)

Coronavirus is one of the viruses that have broadly affected humans and the health system in general. The problem is that there is no treatment for the virus yet, and the virus spreads very quickly through coughing or touching. Therefore, patients infected with this virus must be isolated in their homes or designated care places. Therefore, the research aims to find appropriate methods to diagnose people with the virus remotely to avoid "mixing and trying to determine the virus's focus spread by presenting a new framework for e-health to identify Coronavirus patients. Since the web of things (WoT) is helpful in many areas of medical applications, it will be used as a technique to build a complete system for diagnosing those infected with the virus. Such an approach will provide advice for prevention and isolation. It is very important to check that you have the virus or if you only have a fever, to distance yourself from others who have been affected by Covid-19 when you go to the hospital. Therefore, you can check your health status remotely without going to the hospital. It will present a comprehensive WoT system for COVID-19 Virus Detection (CVD), which provides the most important needs of the infected people. Some of these vital needs are finding an easy way to detect infection by virus, contacting specialized doctors to provide consultations, contacting pharmacies to deliver treatment to the home, contacting Laboratories, mapping the spread of the virus over the world, and educating the citizen at home. In addition, it assists in articles related to the virus that will help the researchers and patients reach the newest details about the pandemic. In designing this system, a group of web design languages was used under the principle of the web of things, such as (HTML, HTML5, CSS, CSS3, JavaScript, Bootstrap) in addition to interactive graphic interfaces.

Mind the 'GAPP': a pre-graduation assessment of preparedness for practice amid a pandemic.

Introduction 'Preparedness for practice' refers to a multifaceted concept, encompassing not only clinical skills, but also broader, non-clinical skills, such as communication and professionalism. Previous graduates have reported feeling less prepared for complex procedures, such as molar endodontics and surgical extractions. Dental students typically utilise their final year to refine their clinical skills, however, the COVID-19 pandemic has meant that newly qualified dentists will have had around six months where they have not performed clinical dentistry before beginning dental foundation training (DFT).Aims This study aimed to explore final year students' self-reported preparedness for practice, identify areas of relative weakness that may influence future training needs and to highlight any perceived impact of the pandemic on final year experience and potential impact on DFT.Materials and methods The current Graduate Assessment of Preparedness for Practice (GAPP) questionnaire was adapted for our specific research aims and piloted and the PreGAPP questionnaire distributed via the social media channels of dental school student societies. Analysis was carried out using IBM Statistical Package for the Social Sciences software using descriptive statistics and the Mann-Whitney U test for two unrelated variables.Results Responses were received from final year students across all 16 UK dental schools. Students reported increased preparedness across domains in which they had the most experience; for example, providing preventative advice and administering local anaesthesia. Male students reported feeling significantly more prepared than female students, mature students significantly more than younger students, and students on four-year courses significantly more than traditional five-year courses. The COVID-19 pandemic was expected to have a major-to-severe impact on undergraduate experience and future DFT prospects.Conclusion Dental graduates in the COVID-19 era may have significantly different training needs to those before them. Complex clinical procedures remain the areas where students feel they are least prepared for practice. The importance of a clinical passport to highlight current experience level to trainers, alongside the creation of a personal development plan at the beginning of DFT, will ensure that targeted and personalised training can be implemented where required.Supplementary InformationZusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41415-022-4154-5 für autorisierte Leser zusätzliche Dateien abrufbar.