Short Visit Research Articles

Development, Implementation, and Formative Evaluation of a Social Needs Screening Tool.

We aim to develop and formatively evaluate a brief social needs screening tool that adheres to Massachusetts Department of Public Health (MDPH) clinical service standards for sexual and reproductive health (SRH) agencies and is acceptable and feasible for use by staff during a clinical encounter. Through a multi-stage literature and expert review process, we developed an evidence-informed, two-page social needs screening tool, scoring form, and implementation guide. We piloted this tool at three SRH agencies in Massachusetts and recruited staff to provide quantitative and qualitative feedback through post-pilot test self-reported surveys and semi-structured interviews. Participants (n = 13) felt the social needs screening tool was easy to integrate into their clinical workflow and were comfortable using it with patients. All participants reported feeling comfortable administering the tool, scoring it, and referring patients to appropriate resources, if applicable. Most reported they would like to continue using the tool after the pilot implementation period, either with or without modifications. Our multi-stage tool development and formative evaluation process involving literature review, expert review, and pilot-testing in clinical settings enabled our team to create a brief, evidence-informed social needs screening tool that is acceptable to staff and feasible for use during a short clinic visit at SRH agencies in Massachusetts. Staff felt that there is value in using this tool, are comfortable using it, and are able to integrate it into their existing clinical workflows.

‘’It’s like I am always on a leash’’: A multi-stakeholder qualitative analysis of the time toxicity of cancer care.

209 Background: As the oncology community increasingly acknowledges the time burdens of cancer care, there is a critical need for foundational work to understand the sources, populations impacted, and consequences of time toxicity. We sought to evaluate these through qualitative interviews. Methods: We conducted semi-structured interviews with adults with advanced stage gastrointestinal cancer, informal care partners, and clinicians at an NCI-designated cancer center in MN, USA from Feb-Oct 2023. We explored aspects of cancer care that took up time and were perceived as burdensome, identified those most impacted, and the consequences. We recorded and transcribed interviews, and conducted inductive thematic analysis. Results: We interviewed 47 participants [16 patients (8 <60 years; 12 women), 15 care partners (10 <60 years; 9 women), and 16 clinicians (including advanced practice providers, nurses, physicians, schedulers, and social workers; 11 women)]. We identified 22 subthemes that we grouped into 5 themes (Table). Conclusions: This multi-stakeholder qualitative analysis provides a deeper understanding of time toxicity. These data will help the oncology community to map, measure, and ultimately address time toxicity. Theme Subthemes Illustrative quotes Source: Healthcare outside the home Travel, parking, and, waiting time, planned appointments, unplanned care, hospitalizations and facility-based care '’My wife and I made over 100 drives in two years, over an hour and a half in each direction.’’ (Patient) Source: Often invisible tasks performed at home Logistic and administrative tasks, learning about the disease and treatment, medical management, time spent managing symptoms and on recovery, home-based care ‘’A large burden was like the insurance paperwork.’’ (Care partner)‘’And that has happened before where I've just spent the whole day at home waiting for home care.’’ (Patient) Populations impacted: Care partners alongside patients Care partners are equally affected, taking over social responsibilities/ tasks of daily living ‘’Anything that takes time for me, is almost an equal burden on her. If not more sometimes.’’ (Patient) Consequences Care becomes all-consuming, short visits turn into ‘’all-day’’ affairs, missing important life events/work, emotional distress, demoralization, financial burdens ‘’ It’s like I am always on a leash. I really don't have any control.’’ (Patient)‘’Even for a 30-minute infusion, you'll be there, like half a day or a whole day.’’ (Patient) Positive interactions and hope for change Not all time spent is perceived as burdensome, clinicians are hopeful of decreasing time burdens, clinicians recognize their own time burdens as a barrier to addressing patients’ ‘’Patients having to walk through this incredibly long, circuitous way to check in, do labs as ritual—we are disdainful of a patient's time. We should demand change.’’ (Clinician)

(025) DEVELOPING AND TESTING AN ONLINE PRIMARY CARE TOOLKIT FOR COMMUNITY MANAGEMENT OF VULVODYNIA

Abstract Introduction Vulvodynia is a chronic vulvar pain condition that affects 8-10% of women and people with vulvas. Despite its prevalence, healthcare providers (HCPs) often lack awareness, knowledge, and confidence in managing vulvodynia. This knowledge gap can lead to diagnostic delays, misdiagnoses, and reflex referrals to specialists. Moreover, research shows that patients feel invalidated in healthcare settings and perceive that their HCPs’ lack of vulvodynia awareness negatively impacts their care. Thus, there is a need for educational resources about vulvodynia that can be applied in healthcare settings. Specifically, community-based primary care providers could greatly benefit from vulvodynia resources because they are often a point of entry into the healthcare system. Objective To develop and test a new, online toolkit tailored to supporting community-based primary care providers with the assessment, diagnosis, and management of vulvodynia. In this pilot study, we sought to evaluate the adoption, acceptability, and preliminary efficacy of the vulvodynia toolkit in a pilot sample of community-based family physicians. Methods A working group of HCPs (family physicians, gynecologists, physiotherapist, psychologists) and patient partners with vulvodynia expertise developed the toolkit. The toolkit was designed in an online, modular format that could be integrated into short healthcare visits. A sample of 19 family physicians completed online surveys before and after piloting the toolkit in their community practice for 6 months. Adoption was measured in the post-toolkit survey by assessing the frequency and timing of toolkit use during the pilot period. Acceptability was measured in the post-toolkit survey by assessing physicians’ satisfaction with the toolkit content and quality. Preliminary efficacy was assessed by comparing physicians’ self-reported level of confidence with diagnosing, treating, and supporting patients with vulvodynia before and after the pilot period. Results Adoption. During the pilot period, physicians used the toolkit in advance of patient appointments (52.6%), during patient appointments (5.3%), or used a combination of both timepoints (42.1%). Over the 6-month pilot period, physicians used the toolkit an average of 2.61 times (SD = 1.50) in advance of seeing patients and 1.63 times (SD = 2.19) during patient appointments. Acceptability. Most physicians reported that they were satisfied or very satisfied with the toolkit overall (79.0%) and that it contained the right amount of information (68.4%). On average, the physicians rated their likelihood of recommending the toolkit to a colleague as 8/10 (SD = 1.75). Preliminary efficacy. Using repeated-measures MANOVAs, we found significant pre-toolkit to post-toolkit increases in physician’s confidence for diagnosing vulvodynia, p = .003, ηp 2 = .59, treating vulvodynia, p < .001, ηp2 = .72, and supporting patients with vulvodynia, p < .001, ηp2 = .73. Conclusions In this pilot study, we developed and tested an online vulvodynia toolkit tailored to educating community-based primary care providers. The toolkit demonstrated high acceptability and preliminary efficacy amongst a pilot group of family physicians, with large effect sizes. The results of this study exemplify the value of tailored education for improving physicians’ confidence with managing vulvodynia in community practice and lay the foundation for upscaling this tool to a wider population of HCPs. Disclosure No.

Evaluation of metabolic changes in clinic attendees with therapeutic carbohydrate restriction

Background: Obesity and related metabolic health disorders are major clinical problems that have become increasingly prevalent worldwide.Aim: This before-after study examined the impact of therapeutic carbohydrate restriction (TCR) in managing metabolic health and promoting weight loss in a clinical setting using indirect calorimetry (IC).Setting: Data were collected from medical records obtained from a specialised allied health clinic focusing on metabolic health.Methods: The study analysed retrospective data from 202 overweight or obese participants (77% female, mean age 47.3) who received TCR as part of a behavioural modification programme involving multiple visits where their lifestyle, body composition and respiratory quotient (RQ), a key indicator of fat oxidation were recorded.Results: The study found that TCR improved fat oxidation in 84% of participants at short term visit (around 2 weeks), with an average weight loss of 1.8 kg. At medium term visit (around 12 weeks), 82% of participants maintained an increase in fat oxidation rate, with an average weight loss of 3.9 kg. In addition, among those with recorded body composition and waist circumference, 71% of weight lost was from fat, with an average reduction of 4.9 cm in waist measurements.Conclusion: This real-world study suggests that personalised TCR guided by IC can be an effective strategy for improving metabolic flexibility to help manage excess weight and related co-morbidities in a free-living population. Further research is needed to examine the long-term effects of TCR using this approach.Contribution: The utilisation of IC allows for the examination of individual shifts and improvements in metabolism among patients undergoing TCR.

A glimpse into the diversity of Colombian Acanthaceae

SummaryA short visit to four Colombian herbaria in 2022 is highlighted as an example of modern-day herbarium plant hunting which resulted in the discovery of 14 new species: Aphelandra guacharorum J.R.I.Wood, A. montis-tusae J.R.I.Wood & Hoyos-Gómez, Justicia betancurii J.R.I.Wood, J. chloroleuca J.R.I.Wood, J. cristalina J.R.I.Wood & Hoyos-Gómez, J. daironcardenasii J.R.I.Wood & Hoyos-Gómez, J. ipanorensis J.R.I.Wood, J. lutescens J.R.I.Wood & Hoyos-Gómez, J. macuirensis J.R.I.Wood, J. perijaensis J.R.I.Wood, J. reniformis J.R.I.Wood, J. rheophytica J.R.I.Wood & Hoyos-Gómez J. santanderana J.R.I.Wood & Hoyos-Gómez and Ruellia rheophytica J.R.I.Wood & Hoyos-Gómez. These are described and illustrated with line drawings. Additionally, a full description and line drawings of two poorly known species, Justicia hochreutineri J.F.Macbr. and J. trianae (Leonard) J.R.I.Wood are provided. Notes are provided on 21 other species drawing attention to new records for Colombia, rediscoveries and taxonomic issues. Justicia hochreutineri J.F.Macbr., J. pilosa (Ruiz ex Nees) Lindau, J. zamorensis Wassh. and Stenostephanus lasiostachyus Nees are recorded for the first time for Colombia. Justicia pampolystachys Leonard is treated as a synonym of J. hyperdasya Leonard. Poikilacanthus moritzianus (Nees) Lindau is shown to be restricted to Venezuela. Adhatoda pilosa Ruiz ex Nees is lectotypified. Attention is drawn to the number of rheophytes in Colombian Acanthaceae and to the importance of the Río Claro and Río Samaná Norte area of Antioquia as a centre of plant diversity.

Breaking Barriers in Behavioral Change: The Potential of Artificial Intelligence-Driven Motivational Interviewing.

Patient outcomes in ophthalmology are greatly influenced by adherence and patient participation, which can be particularly challenging in diseases like glaucoma, where medication regimens can be complex. A well-studied and evidence-based intervention for behavioral change is motivational interviewing (MI), a collaborative and patient-centered counseling approach that has been shown to improve medication adherence in glaucoma patients. However, there are many barriers to clinicians being able to provide motivational interviewing in-office, including short visit durations within high-volume ophthalmology clinics and inadequate billing structures for counseling. Recently, Large Language Models (LLMs), a type of artificial intelligence, have advanced such that they can follow instructions and carry coherent conversations, offering novel solutions to a wide range of clinical problems. In this paper, we discuss the potential of LLMs to provide chatbot-driven MI to improve adherence in glaucoma patients and provide an example conversation as a proof of concept. We discuss the advantages of AI-driven MI, such as demonstrated effectiveness, scalability, and accessibility. We also explore the risks and limitations, including issues of safety and privacy, as well as the factual inaccuracies and hallucinations to which LLMs are susceptible. Domain-specific training may be needed to ensure the accuracy and completeness of information provided in subspecialty areas such as glaucoma. Despite the current limitations, AI-driven motivational interviewing has the potential to offer significant improvements in adherence and should be further explored to maximally leverage the potential of artificial intelligence for our patients.

Paediatricians’ perspectives in treating lower urinary tract symptoms: a qualitative exploratory needs assessment study

BackgroundPaediatric lower urinary tract symptoms (LUTS) are common experiences among school-aged children, with prevalence rates reaching as high as 20%. Paediatricians are often first-line stakeholders in providing treatment for these...

Bako National Park's Circumstances Amid the COVID-19 Pandemic: Perspectives on Biodiversity and Community Well-being

Bako National Park (BNP) is the oldest and smallest national park in Sarawak, Malaysia and its richness in biodiversity of flora and fauna here is indeed a major attraction for international and local tourists to watch proboscis monkeys. However, this COVID-19 pandemic instigates challenges to tourism development in the BNP because the number of tourists is very low compared to before pandemic season. This also has a huge impact on the local community and wildlife in this area. These new norms bring challenges and benefits to human and nature life. The following photos were taken during our five-day visit to BNP from 24th to 28th August 2020. The purpose of our short visit was to observe the circumstances of BNP in the midst of pandemic by emphasizing the aspects of biodiversity and the well-being of local communities. Thus, the photographs taken describe the situation in this area that elucidate the challenges and benefits to wildlife and community livelihood. Based on this study, it is clear that humans and biodiversity have complex and interdependent relationships with each other that need to emphasized by relevant stakeholders towards social sustainable development.

VIZITA LA CRAIOVA A REGELUI CAROL AL II-LEA ȘI A PRINCIPELUI NICOLAE CU OCAZIA UNOR EVENIMENTE LOCALE SOLEMNE (26 OCTOMBRIE 1933)

The autumn of 1933 marked a festive moment for the city of Craiova, a royal visit made by King Carol II and Prince Nicolae with the aim of celebrating a series of local events such as: the consecration of St. Dumitru's Church, the inauguration of the „Carol al II-lea” Stadium as well as the celebration of 100 years of existence of the „Carol I” High School. The local authorities treated the event carefully, the preparation for October 26, 1933 involved a great effort. The day turned out to be a real success. Although a short visit of only one day, it was full of solemn events. The moment of October 26, 1933 remained recorded as an important day for the history of Craiova.

What is the impact of successive COVID-19 lockdowns on population mental health? Findings from an Australian natural experiment using health service data.

ObjectiveThe causal effect of successive population-wide lockdowns in response to increased COVID-19 cases on mental health has yet to be examined using robust methods. A natural experiment design underpinned by objective data can improve our understanding surrounding the definitive impact of social distancing restrictions.MethodsThe study employed a natural experiment design underpinned by objective data. Health service cost for visits to general practitioners and psychologists and medication dispensing costs served as objective measures of mental health. Difference-in-difference (DID) estimators, which in this study quantify differences in spending changes between groups over time, were produced based on three comparisons: Victoria 2020 lockdown comparison, Victoria 2021 lockdown comparison, and New South Wales (NSW) 2021 lockdown comparison. Specifically, differences in public health service spending during lockdown periods and the same timeframe in 2019 for Victoria and NSW, and control groups (remaining states and territories), were compared.ResultsPositive estimator values indicate that public health service spending for Victoria and NSW increased more during lockdown periods compared to control states and territories. The Victorian lockdowns of 2020 and 2021, but not the NSW lockdown of 2021, resulted in increased public spending for general practitioner mental health consults (2020 DID estimator: $8498.96 [95% CI $4012.84, $12,373.57], 2021 DID estimator: $6630.06 [95% CI $41.27, $13,267.20], all monetary values in AUD$) and short visits to psychologists (2020 DID estimator: $628.82 [95% CI $466.25, $796.00], 2021 DID estimator: $230.11 [95% CI $47.52, $373.98]). The first Victorian lockdown in 2020 and the NSW lockdown in 2021 resulted in greater spending on short visits to clinical psychologists. Spending on long visits to psychologists and clinical psychologists and medication spending did not change.ConclusionsStrict lockdowns can have an adverse impact on population mental health. The impact is particularly evident in those who have a history of previous mental health concerns but does not necessitate extra use of medications, suggesting that psychological care can address the adverse impact of the lockdowns.

Wizyta delegata Przełożonego Generalnego Towarzystwa Salezjańskiego dla Inspektorii Polskich ks. Stanisława Rokity SDB na Wileńszczyźnie w 1973 r. Edycja źródłowa

Following the end of second World War, 48 percent area of the Second Polish Republic was incorporated into the Union of Soviet Socialist Republic. A significant number of Polish citizens remained in the annexed areas and along with them their pastors. As for members of the Society of St. Francis de Sales (Salesians), ten remained in the areas incorporated into the USSR, who helped organize the religious life of the faithful under very difficult circumstances. They maintained contact with the religious congregation in Poland, mostly it was limited to correspondence and short visits on the occasion of family visits to Poland. The source presents notes from the stay in the USSR of Fr. Stanisław Rokita SDB, who in 1973 was the first Salesian superior to visit his congregation remaining in the East.

Consuming patients’ days: Time spent on ambulatory visits by persons with cancer.

324 Background: Health care-related time burdens faced by persons with cancer can be substantial. In qualitative work, patients report that ‘’seemingly short clinic visits (e.g., a supposed 10-minute blood draw) often turn into all-day affairs.” We sought to estimate the total time spent (home-to-home) by patients with cancer on ambulatory services at an urban cancer center. Methods: We conducted a retrospective study of all patients with cancer scheduled for any ambulatory care (e.g., laboratory testing, imaging, procedures, infusions, clinician visits) at a Midwestern academic cancer center during a randomly selected week (Monday-Friday) in January 2023. We extracted sociodemographics, clinical characteristics, and services received from the electronic medical record. The primary exposure was the ambulatory care type or combination received by a patient on a day (e.g., clinician visit only, labs and infusion, etc.). Using data from the Real-Time Location System (RTLS) badge that patients wear from clinic entry to exit (standard of care to optimize clinic workflow), we tracked time spent in each patient location (e.g., exam room) and in the clinic overall. We estimated round-trip travel times using home and clinic zip codes and SAS/Google Maps. We calculated median parking time by directly observing 20 random patients between the clinic and their vehicles (e.g., parking ramp or valet). We calculated and summarized clinic and total (clinic + travel + parking) times for different ambulatory care types. Results: We analyzed 468 encounters by 436 unique patients (median age, 64 years, 52% women, 82% white race, 19% breast cancer). Median (IQR) clinic time per encounter was 118 (76-200) minutes. The median (IQR) round-trip driving distance and travel time was 33 (21-53) miles and 50 (36-68) minutes. The median parking time was 8 (6-10) minutes. The median (IQR) total time was 189 (136-277) minutes. Table 1 presents the times by type(s) of ambulatory services. Conclusions: In this single-center retrospective study, pursuing ambulatory cancer care on a given day required patients (and their accompanying care partners) to commit several hours to their care. These findings highlight the need to decrease care time demands on patients to mitigate time toxicity. Accounting for opportunity time costs and the coordination of other daily activities around ambulatory care, these results support our previously proposed practical measure of the time burdens of cancer care—that any day with in-person healthcare contact may represent a ‘’lost day.”[Table: see text]

A comparison of the practice patterns of emergency department teams that include physicians, nurse practitioners, or physician assistants

BackgroundPhysicians see most emergency department (ED) patients, but, recently, nurse practitioners (NPs) and physician assistants (PAs) have provided an increasing amount of ED care. PurposeCompare NP and PA teams’ practice patterns to physician teams in EDs. MethodsUsing 12 years of data from the National Hospital Ambulatory Medical Care Survey (2009–2020), we used multivariate regression analysis to separately examine the associations between the ED practice patterns (i.e., number of diagnostic services, number of procedures, waiting time, boarding time, length of visit, and hospital admission) of patients seen by NP or PA teams compared with physician teams. DiscussionPatient visits to NP and PA teams received fewer diagnostic services and procedures, had shorter visits, and were less likely to be hospitalized. ConclusionIf the additional diagnostic services, procedures, and hospital admission provided by physician teams were unnecessary for the patients studied, NP and PA team care could be more efficient.

Heritage language use in the country of residence matters for language maintenance, but short visits to the homeland can boost heritage language outcomes

This study examined how heritage children's experiences with the heritage language (HL) in the country of residence (e.g., children's generation, their HL use and richness) and the country of origin (e.g., visits to and from the homeland) may change as a function of the migration generation heritage children belong to, and how this may in turn differentially influence HL outcomes. Fifty-eight Greek-English-speaking bilingual children of Greek heritage residing in Western Canada and New York City participated in the study. They belonged to three different generations of migration: a group of second-generation heritage speakers, which were children of first-generation parents; a group of mixed-generation heritage children of first- and second-generation parents; and of third-generation heritage children with second-generation parents. They were tested on a picture-naming task targeting HL vocabulary and on an elicitation task targeting syntax- and discourse-conditioned subject placement. Children's performance on both tasks was predicted by their generation status, with the third generation having significantly lower accuracy than the second and the mixed generations. HL use significantly predicted language outcomes across generations. However, visits to and from the country of origin also mattered. This study shows that HL use in the country of residence is important for HL development, but that it changes as a function of the child's generation. At the same time, the finding that the most vulnerable domains (vocabulary and discourse-conditioned subject placement) benefited from visits to the country of origin highlights the importance of both diversity of and exposure to a variety spoken by more speakers and in different contexts for HL maintenance.

BIRD ENTANGLEMENT AND MORTALITY BY FRUITS OF THE ZAPALLO CASPI TREE PISONIA ZAPALLO IN THE DRY CHACO, ARGENTINA

Abstract ∙ Bird entanglement by plants may be globally widespread, but it is not a frequently studied phenomenon, and records in different regions of the world are still scarce. During a short visit to the El Impenetrable National Park, Chaco province, Argentina, in October–November 2022, we recorded 15 incidental cases of birds entangled or trapped by fruits of the tree Pisonia zapallo. Our report involves 12 bird species from eight families, with a wide range of body sizes and masses. To our knowledge, this is the first documented report on this phenomenon in continental South America.

Who belongs where? Geographies of (inter)religion and urban segregation in Surabaya, Indonesia

This study addresses urban segregation along religious identities in Indonesia's second-largest city, Surabaya, and explores the disruptive potential of short interreligious visits to places of worship. It contributes to the existing academic literature in at least three ways, namely (1) by expanding discussions about geographies of religion into discussions about geographies of (inter)religion; (2) by connecting interreligious education initiatives with urban democratic politics (i.e., urban subjectivity and citizenship), and (3) by demonstrating the powerful role of body spatiality in disrupting religious urban geographies. Based on organised visits to various religious sites and subsequent qualitative interviews, we found that the unusual visibility of religiously diverse visitors contributed to the normalisation of multi-religious diversity, and participants' positive experiences at places of worship contributed to the development of empathy and solidarity with the religious Other. In discussing the implications of the study, we suggest that deliberate efforts of interreligious place-making on the part of political and religious leaders can counter urban religious segregation and contribute to social cohesion.

World Famous Scientist Lotfi A. Zadeh Azerbaijan "Era"

One of modern science's most important tasks is to research and examine the era, perspective and philosophical views of the genius scientist Lotfi A. Zadeh, who served science for 70 years and raised it "from earth to the universe" in the context of the historical philosophy. This article describes the "era" of Lotfi A. Zadeh, which started in Azerbaijan and ended with his eternity in Azerbaijan. This article is the part monograph of the Author of the article "Lotfi A. Zadeh. Of course, the main part of Lotfi A. Zadeh's "era" passed far away from Azerbaijan - to the United States. After a long break, in 1965, when he came to Russia for a conference, he made a short visit to Azerbaijan. The genius scientist's first and last live visit to Azerbaijan took place in 2008, which the Author of the article called this visit "21st century. The peak of Lotfi A. Zadeh Azerbaijan and Azerbaijanis "era". And the last - a genius scientist - returned to his native land once and for all when he died in 2017 at 96. This entire period is evaluated in the context of the philosophy of history in the article.

Advantages of visiting your home country: how brief reimmersion in their native country impacts migrants’ native language access

AbstractThe study explores how native language (L1) lexical access is affected by immersion in a second-language (L2) environment, and by short-term reimmersion in the L1 environment. We compared the L1 picture-naming performance of Polish–English bilinguals living in the UK (migrants) against that of bilinguals living in Poland (controls). Each group was tested twice: the migrants while in the UK (L2 immersion) and after visiting Poland (L1 reimmersion); the controls twice in their L1 environment. Contrary to our expectations, there was no main effect of group, thus suggesting that L2 immersion per se does not impact L1 lexical access. Nevertheless, migrants benefitted from L1 reimmersion by showing faster naming latencies for high-frequency words after a short visit to their home country, probably due to more opportunities to encounter these words. Overall, the study shows that the cognitive system is sensitive to the language environment by quickly adapting the activation level of lexical items.

Management of Attention-Deficit Hyperactivity Disorder Children for Dental Procedures.

Background A common psychiatric problem called attention-deficit hyperactivity disorder (ADHD) is characterized by impulsivity with resultant behavior issues and a very short attention span. The purpose of this study was to evaluate and compare the management of dental procedures in children with and without ADHD employing various behavior modification techniques. Materials and methods The study consisted of 121 children divided into two groups with 60 children diagnosed with ADHD and 60 children without ADHD between 7 and 15 years of age. Each of the three sessions, which were spaced a week apart, included a dental examination, oral prophylaxis, and a minor restorative procedure. The pulse rate (PR) and oxygen saturation (SpO2) were measured during each of these sessions. The study was conducted to evaluate the Tell-Show-Do (TSD) method, audiovisual distraction, and pharmacological management of children with and without ADHD during the dental procedure. IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States) was used to statistically analyze the findings. The mean values of the parameters from the three sessions were analyzed and compared using the Z-test. Result The children with ADHD included 39 (65%) boys and 21 (35%) girls, and the children without ADHD consisted of 27 (44.26%) boys and 33 (54.09%) girls. The mean values of the PR during sessions two and three were found to be statistically highly significant between the children with and without ADHD for TSD and audiovisual aids. In both groups, the mean SpO2 values for all the sessions were found to be statistically highly significant for the techniques evaluated (p<0.01). The change in the mean PR score for the ADHD children revealed a declining trend from sessions one through three for all the techniques evaluated (p<0.05), demonstrating a statistically significant effectiveness of the various techniques between the two groups and thereby revealing a decreased level of anxiety. Between sessions one and three, all of the three techniques showed a decreasing trend of SpO2 scores, with the exception of the pharmacological management of ADHD children (p<0.01) indicating that the uncontrollable ADHD children feel less anxious than in the other two approaches. Conclusion The findings of the study demonstrated that behavior management techniques were found to be effective at reducing anxiety in ADHD children than in children without ADHD. Our study further suggests that scheduling dental appointments into a series of short visits could enhance the effectiveness of the therapy and better cooperation of the children.

Lifting the cloche: Jeroen Bakkers interviews Didier Stainier.

Didier Stainier is Director of the Department of Developmental Genetics at the Max Planck Institute for Heart and Lung Research in Bad Nauheim, Germany. He became acquainted with the zebrafish model as a PhD student in Walter Gilbert's lab at Harvard, which motivated him to champion the use of this powerful model organism to study heart development as a postdoctoral fellow with Mark Fishman at Massachusetts General Hospital. Although his scientific focus has expanded significantly since then, zebrafish modelling and heart development and regeneration remain key topics in his research. The developmental biology and zebrafish modelling communities have embraced him as an inspiring mentor and advocate for basic research. Jeroen Bakkers is a group leader at the Hubrecht Institute for Developmental Biology and Stem Cell Research and Professor of Molecular Cardiogenetics at the University Medical Center Utrecht, The Netherlands. Jeroen did hid PhD with Herman Spaink at Leiden University, The Netherlands. A short visit to Massachusetts Institute of Technology during his doctoral training introduced him to the zebrafish model, which he applied to his PhD project. Zebrafish development remained the focus of his career, including during his postdoctoral training in the lab of Matthias Hammerschmidt at the Max Planck Institute of Immunology and Epigenetics in Freiburg and in his own lab at the Hubrecht Institute, where his group uses this powerful model organism to investigate cardiac development, disease and regeneration. Jeroen and Didier met up at a recent conference to talk about their shared interest in cardiac regeneration, a zebrafish mutant with a curious name and Didier's commitment to mentorship.