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The COVID-19 pandemic catapulted dermatology services into a digital era, with the rapid introduction of teleconsultations. The UK National Health Service operational planning guidance recommends ≥ 25% of consultations are delivered remotely. There is a lack of data regarding the acceptability and effectiveness of paediatric dermatology teleconsultations. We surveyed UK healthcare professionals (HCPs) to explore their experiences of teleconsultations in paediatric dermatology, with a focus on follow-up consultations for paediatric eczema (PE), to inform a future clinical trial. There were 119 responses. Pre-pandemic, 37% provided some form of teleconsultation service, rising to 92% post-pandemic. In total, 41% (n = 49) now carry out > 25% of consultations remotely. We found 55% felt teleconsultations were less effective than face-to-face ones for PE follow-up. Eighty HCPs offered teleconsultations for PE. Among the HPCs who offered teleconsultations for PE, the most effective format for follow-up consultations was felt to be telephone with photographs (52/80, 65%). Our results demonstrate varying opinion on the effectiveness and optimal format of paediatric teleconsultations, supporting the need for further research. [ABSTRACT FROM AUTHOR]

The science of learning, bolstered by the foundational principles of adult learning, has evolved to allow for a more sophisticated understanding of how humans acquire knowledge. To optimize learning outcomes, cardiology educators should be familiar with these concepts and apply them routinely when teaching trainees. This paper presents an overview of the neurobiology of learning and adult learning principles and offers examples of ways in which this science can be applied in cardiology fellowships. Both fellows and educators benefit from the science of learning and its artistic application to education. [ABSTRACT FROM AUTHOR]

Providing teleconsultations for appropriate patients is a priority for outpatient service transformation, yet little evidence exists on their effectiveness and acceptability in paediatric eczema. We conducted a UK-wide online patient and parent survey to explore experiences of eczema teleconsultations. Further objectives included determining patient preferences and costs incurred with different appointments. Young people (13-16 years) and parents of children (0-16 years) with eczema, who had had a follow-up teleconsultation under secondary/tertiary care dermatology were eligible. Ethical approval was sought and a Jisc Online survey was advertised on social media for 12 weeks. Data was analysed descriptively in Microsoft Excel. There were 51 responses (31 parents, 20 adolescents) from across the UK. Most participants were receiving topical treatment, with 8 on systemic therapy. Of those who had experience of face-to-face appointments, 31/42 (73.8%) were 'satisfied or very satisfied', compared with 19/46 (41.3%) for telephone, 10/14 (71.4%) for video and 4/10 (40%) for online/mobile messaging. 49 (96.1%) participants reported they would feel 'happy or very happy' if their next appointment was face-to-face, compared with 14 (27.5%) for telephone, 14 (27.5%) for video and 6 (11.8%) for online/mobile messaging. 34 (66.7%) participants' first-choice consultation was face-to-face, followed by 8 (15.7%) preferring a combination of face-to-face and telephone. Many commented that face-to-face was better for assessing the skin. These results, along with a qualitative interview study currently underway, provide an insight into the experiences and preferences of young people and parents regarding eczema follow-up and will help inform a future trial. [ABSTRACT FROM AUTHOR]

Dear Editor, As dermatologists, being asked to look at a skin lesion is nothing unusual. As skin cancer rates rise, the organ transplant waiting list lengthens and the organ donation opt-out system takes effect, dermatologists may increasingly find themselves consulted about skin lesions in potential organ donors. Before organ donation can take place, donor characterization is needed to evaluate suitability for organ donation and to identify risk factors for transmission of disease to the recipient. [Extracted from the article]

Background: Cardiovascular disease (CVD) is a leading cause of death among adults. Over 35% of women worldwide report lifetime exposure to sexual violence. While psychosocial factors broadly have been linked to CVD risk, it is unclear if a history of sexual violence is associated with increased risk for CVD. This study employed quantitative meta-analysis to investigate the association between sexual violence and CVD risk.Methods: PubMed and PsycINFO databases were searched through March 1, 2021. Included articles had a measure of sexual violence and at least one cardiovascular outcome (i.e., clinical CVD, subclinical CVD, select CVD risk factors) in women and men aged 18 years or older. Data were expressed as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI) extracted from fully-adjusted models. OR and HR effects were pooled separately, given the inability to statistically harmonize these effects and differences in interpretation, using random effects meta-analysis. Heterogeneity of effects was tested using Cochran's Q test.Results: Overall, 45 articles based on 830,579 adults (77.1% women) were included (113 individual effects expressed as OR and 9 individual effects expressed as HR). Results indicated that sexual violence was related to adult CVD risk (OR [95%CI] = 1.25 [1.11-1.40]; HR [95%CI] = 1.17 [1.05-1.31]). Results varied by outcome type and measurement, and timing of violence.Conclusions: Adults with a history of sexual violence demonstrate greater CVD risk relative to those without this history. The results highlight the importance of addressing sexual violence in CVD risk reduction efforts. [ABSTRACT FROM AUTHOR]

Study Objective: Single parenthood is associated with adverse health outcomes. How cardiovascular risk differs by parenthood status has had limited study. We hypothesized that single parents would have worse cardiovascular risk profiles compared to those in partnered-parent households., Design: We compared associations of parenthood status and the American Heart Association's Life Simple 7 (LS7), an established metric measuring modifiable components of cardiovascular health (smoking status, body mass index, physical activity, diet, cholesterol, glycohemoglobin, and blood pressure) in multivariable-adjusted models., Participants: We selected adults (age ≥ 25) from the National Health and Nutrition Examination Survey (NHANES) 2015-16 cycle. We defined single parenthood as reporting a child <18 years residing in the home and marital status other than married or living with partner., Main Outcome Measures: LS7, continuous (range 0-14) and categorized as poor (0-4), intermediate (5-9), or ideal (10-14)., Results: In total, 2180 NHANES participants identified as parents and 1782 (82%) had complete LS7 scores. Of these, 462 identified as single parents, of whom 356 (74.9%) were women. Single parents were more likely to smoke, have poor physical activity, and have high blood pressure ( p < 0.01) than partnered parents. Single parents had 1.3-fold greater likelihood of poor cardiovascular health compared with partnered parents, adjusting for age, sex, race/ethnicity, health insurance, healthcare access, poverty index, educational attainment and number of children (95% confidence interval [CI] 1.01-1.71)., Conclusions: We identified an association between single parenthood and adverse cardiovascular health. Our results demonstrate the importance of considering household composition in risk assessment and cardiovascular disease prevention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Dyspnea is a common chief complaint in the emergency department, with over 4 million visits annually in the US. Establishing the correct diagnosis can be challenging, because the subjective sensation of dyspnea can result from a wide array of underlying pathology, including pulmonary, cardiac, neurologic, psychiatric, toxic, and metabolic disorders. Further, the presence of dyspnea is linked with increased mortality in a variety of conditions, and misdiagnosis of the cause of dyspnea leads to poor patient-level outcomes. In combination with the history and physical, efficient, and focused use of laboratory studies, the various cardiopulmonary biomarkers can be useful in establishing the correct diagnosis and guiding treatment decisions in a timely manner. Use and interpretation of such tests must be guided by the clinical context, as well as an understanding of the current evidence supporting their use. This review discusses current standards and research regarding the use of established and emerging cardiopulmonary laboratory markers in the evaluation of acute dyspnea, focusing on recent evidence assessing the diagnostic and prognostic utility of various tests. These markers include brain natriuretic peptide (BNP) and N-terminal prohormone (NT-proBNP), mid-regional peptides proatrial NP and proadrenomedullin, cardiac troponins, D-dimer, soluble ST2, and galectin 3, and included is a discussion on the use of arterial and venous blood gases.