Intensive Olfactory Training in Post-COVID Patients: A Randomized Multicenter Clinical Trial

Introduction: Olfactory dysfunction (OD) is one of the most reported symptoms of COVID -19. Previous studies have identified olfactory training (OT) as an important treatment for postinfectious OD, but little is known about its effect after SARS-CoV-2 infection and how it can be optimized. Objective: To assess whether OT can be optimized if performed intensively, with more fragrances over a shorter period in patients with persistent OD after COVID -19. Also, to determine the presence of other variables related to OD and treatment response in this population. Method: This multicenter randomized clinical trial recruited 80 patients with persistent OD with previous COVID-19 for less than three months. The patients were divided into two groups, who received treatment with 4 and 8 essences over four weeks. Subjective assessments and the University of Pennsylvania Smell Identification Test (UPSIT) were performed before and after treatment. Results: A significant improvement in olfaction was measured subjectively and on UPSIT in both groups, but without significant differences between groups. In addition, the presence of olfactory fluctuation was associated with higher UPSIT scores. Conclusion: These data suggest that intensifying the training by increasing the number of essences for 4 weeks does not show superiority over the classical method. Moreover, a fluctuating olfactory ability seems to be related to a better score in the UPSIT

Primary Care and Youth Mental Health in Ireland: Qualitative Study in Deprived Urban Areas

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people\u27s unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that primary care is well placed to address mental and substance use disorders in young people especially in deprived urban areas. This study aims to describe healthcare professionals\u27 experience and attitudes towards screening and early intervention for mental and substance use disorders among young people (16-25 years) in primary care in deprived urban settings in Ireland. METHODS: The chosen method for this qualitative study was inductive thematic analysis which involved semi-structured interviews with 37 healthcare professionals from primary care, secondary care and community agencies at two deprived urban centres. RESULTS: We identified three themes in respect of interventions to increase screening and treatment: (1) Identification is optimised by a range of strategies, including raising awareness, training, more systematic and formalised assessment, and youth-friendly practices (e.g. communication skills, ensuring confidentiality); (2) Treatment is enhanced by closer inter-agency collaboration and training for all healthcare professionals working in primary care; (3) Ongoing engagement is enhanced by motivational work with young people, setting achievable treatment goals, supporting transition between child and adult mental health services and recognising primary care\u27s longitudinal nature as a key asset in promoting treatment engagement. CONCLUSIONS: Especially in deprived areas, primary care is central to early intervention for youth mental health. Identification, treatment and continuing engagement are likely to be enhanced by a range of strategies with young people, healthcare professionals and systems. Further research on youth mental health and primary care, including qualitative accounts of young people\u27s experience and developing complex interventions that promote early intervention are priorities

The Bifidobacterium dentium Bd1 Genome Sequence Reflects Its Genetic Adaptation to the Human Oral Cavity

Bifidobacteria, one of the relatively dominant components of the human intestinal microbiota, are considered one of the key groups of beneficial intestinal bacteria (probiotic bacteria). However, in addition to health-promoting taxa, the genus Bifidobacterium also includes Bifidobacterium dentium, an opportunistic cariogenic pathogen. The genetic basis for the ability of B. dentium to survive in the oral cavity and contribute to caries development is not understood. The genome of B. dentium Bd1, a strain isolated from dental caries, was sequenced to completion to uncover a single circular 2,636,368 base pair chromosome with 2,143 predicted open reading frames. Annotation of the genome sequence revealed multiple ways in which B. dentium has adapted to the oral environment through specialized nutrient acquisition, defences against antimicrobials, and gene products that increase fitness and competitiveness within the oral niche. B. dentium Bd1 was shown to metabolize a wide variety of carbohydrates, consistent with genome-based predictions, while colonization and persistence factors implicated in tissue adhesion, acid tolerance, and the metabolism of human saliva-derived compounds were also identified. Global transcriptome analysis demonstrated that many of the genes encoding these predicted traits are highly expressed under relevant physiological conditions. This is the first report to identify, through various genomic approaches, specific genetic adaptations of a Bifidobacterium taxon, Bifidobacterium dentium Bd1, to a lifestyle as a cariogenic microorganism in the oral cavity. In silico analysis and comparative genomic hybridization experiments clearly reveal a high level of genome conservation among various B. dentium strains. The data indicate that the genome of this opportunistic cariogen has evolved through a very limited number of horizontal gene acquisition events, highlighting the narrow boundaries that separate commensals from opportunistic pathogens

Re-evaluating the Quoit Brooch Style: Economic and Cultural Transformations in the 5th Century ad, with an Updated Catalogue of Known Quoit Brooch Style Artefacts

Quoit Brooch Style material, produced from the early 5th century onwards, has previously been considered mostly from a stylistic point of view, leaving much scope for further investigation. In addition, the known corpus of material has been much expanded through newly excavated and metal-detected finds. In this article, I bring together the known extant material for the first time, and document important evidence relating to contextual dating, gender associations, manufacture (including new compositional analysis of c 75 objects), repair, and reuse. The article questions previous interpretations of Quoit Brooch Style material relating to Germanic mercenaries and/or post-Romano-British political entities. It interprets the earliest material as part of wider trends elsewhere, in Britain and in Continental northwestern Europe, for the production of material imitating late Roman symbols of power. It presents new evidence for connectivity with Continental Europe via the western Channel route in the 5th century. A detailed investigation of individual artefacts shows that many Quoit Brooch Style objects were reused, sometimes being subjected to extensive repair and modification. This provides new insights into the 5th century metal economy, for instance, acute problems in the availability of new metal objects in southeastern Britain in the middle years of the 5th century. Compositional analysis contributes further to our understanding of metal supply in the 5th century and relationships with the post-Roman West. Insights are provided into wider cultural transformations in the 5th century and the gradual loss of value that occurred for Roman-style objects

Youth mental health in deprived urban areas: A Delphi study on the role of the GP in early intervention.

For table 1-4, box 1-2 & figure 1 relating to this article please see attached files.Background: GPs, as healthcare professionals with whom young people commonly interact, have a central role in early intervention for mental health problems. However, successfully fulfilling this role is a challenge, and this is especially in deprived urban areas. Aims: To inform a complex intervention to support GPs in this important role, we aim to identify the key areas in which general practice can help address youth mental health and strategies to enhance implementation. Methods: We conducted a modified Delphi study which involved establishing an expert panel involving key stakeholders / service providers at two deprived urban areas. The group reviewed emerging literature on the topic at a series of meetings and consensus was facilitated by iterative surveys. Results: We identified 20 individual roles in which GPs could help address youth mental health address youth mental health, across five domains: 1. Prevention, Health Promotion and Access, 2. Assessment and Identification, 3. Treatment Strategies, 4.Interaction with Other Agencies/Referral, and 5. Ongoing Support. With regard to strategies to enhance implementation, we identified a further 19 interventions, across five domains: 1.Training, 2. Consultation Improvements, 3. Service-Level Changes, 4. Collaboration, and 5.Healthcare-system Changes. Conclusions: GPs have a key role in addressing youth mental health and this study highlights the key domains of this role and the key components of a complex intervention to support this role