Background. Dental trainees (dental students, graduate students, and postdoctoral residents) are at increased risk of experiencing poor mental health, which can lead to intentions to leave their program, especially during the COVID-19 pandemic.Methods. The authors invited 355 dental trainees at the University of Washington School of Dentistry to complete an 83-item questionnaire in August and September 2020. The outcome analyzed was intention to leave their programs. There were 4 self-reported predictors: anxiety, burnout, depression, and COVID-19 impact on overall mental health. The authors ran multiple variable logistic regression models to evaluate relationships between each predictor and outcome (a ¼ .05) and reported odds ratios (ORs) and 95% CIs.Results. The survey response rate was 35.5%. Overall, 12.7% of participants reported any intention to leave. In total, 22.2% and 16.7% of participants endorsed clinically significant anxiety or depression symptomatology, respectively; 28.6% reported 1 or more burnout symptoms; and 69.0% reported that COVID-19 affected their overall mental health.

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With cannabis medicines now obtaining legal status in many international jurisdictions (generally on the authorisation of a medical professional), a rapid increase in consumer demand for access to cannabis as a therapeutic option in the treatment and management of a range of indications is being noted. Despite this accessibility, knowledge on optimal use is lacking. Further drug development and clinical trials at regulatory standards are necessary both if a better understanding of the efficacy of cannabis medicines, optimal product formulation and indication-specific dosing is needed and to ensure the broader quality and safety of cannabis medicines in the clinical setting.To enable this, clinical, academic and public calls for the undertaking of rigorous clinical trials to establish an evidence base for the therapeutic use of cannabis medicines have been made internationally. While this commitment to undertake human studies with cannabis medicines is welcomed, it has highlighted unique challenges, notably in the review stages of ethics and governance. This often results in lengthy delays to approval by Human Research Ethics Committees (herein ‘HREC’, Australia’s nomenclature for Institutional Review Boards) and trial commencement. A principal concern in these cases is that in contrast to clinical trials using other more conventional pharmaceutical products, trials of cannabis medicines in humans often involve the use of an investigational product prior to some (or any) of the preclinical and pharmaceutical safety issues being established. This paucity of data around product safety, potential drug interactions, continuity of supply, shelf life and product storage results in apprehension by HRECs and governance bodies to endorse trials using cannabis medicines.This manuscript draws from the experiences of Australian researchers and staff involved in clinical trials of cannabis medicines to describe some of the common difficulties that may be faced in the HREC approval process. It also presents practical advice aimed to assist researchers, HRECs and governance officers navigate this complex terrain. While the authors’ experiences are situated within the Australian setting, many of the barriers described are applicable within the international context and thus, the solutions that have been proposed are typically adaptive for use within other jurisdictions.

Background The nitrogen isotope ratio (NIR) is a promising index of traditional food intake for an Alaska Native (Yup'ik) population, which can be measured in blood and hair. However, the NIR has not been calibrated to high-quality measures of Yup'ik traditional food intake. Objectives Our primary objective was to examine associations between intakes of Yup'ik traditional food groups, including fish, marine mammals, birds, land mammals, berries, greens, and total traditional foods, and the NIR. In an exploratory analysis, we also examined whether NIR analyzed sequentially along hair could reflect dietary seasonality. Methods We recruited 68 participants from 2 Yup'ik communities in the Yukon Kuskokwim region of Southwest Alaska (49% female, aged 14–79 y). Participants completed 4 unscheduled 24-h food recalls over the period peak of RBC and hair synthesis preceding a specimen collection visit. The NIR was measured in RBCs ( n = 68), a proximal hair section (n = 58), and sequential segments of hair from individuals in the upper 2 quartiles of traditional food intake having hair >6 cm in length, plus 2 low subsistence participants for reference (n = 18). Diet–biomarker associations were assessed using Pearson's correlation and linear regression. Results Intakes of fish, marine mammals, berries, and greens were significantly associated with the NIR. The strongest dietary association was with total traditional food intake (R2 = 0.62), which indicated that each 1‰ increase in the RBC NIR corresponded to 8% of energy from traditional foods. Hair NIR appeared to fluctuate seasonally in some individuals, peaking in the summertime. Conclusions Findings support the use of the RBC and hair NIR to assess total traditional food intake in a Yup'ik population. Analyses of sequential hair NIR provided evidence of seasonality in traditional food intake, although seasonal variations were modest relative to interindividual variation.

Objectives Reflection spectroscopy serves as a biomarker of vegetable and fruit intake by measuring skin carotenoids, however it's validity in populations who consume high levels of salmon (another source of carotenoids) is unknown. Our objective was to validate reflection spectroscopy as a biomarker for vegetable and fruit intake among Yup'ik Alaska Native people in a remote community who consume a subsistence diet rich in salmon. Methods We assessed the convergent validity of a portable reflection spectroscopy device (The Veggie Meter), two 24-hour recalls using NDSR 2018, and the nitrogen stable isotope ratio of hair (a validated biomarker of fish intake) collected from adults (>18 years) in a remote Alaska community. Results The study population (n = 84) was primarily Yup'ik Alaska Native (84%), evenly distributed by sex (45.2% male), and had a mean age of 47.5 years. The mean skin carotenoid score was 222.23 ± 105.81. The median number of fruit servings reported was 0.33 (range = 0 to 4.0), while median servings of vegetables was 1.55 (range = 0 to 11.44). Men had significantly higher skin carotenoid scores than women (202 vs 248; P = .001). Participants who consumed 3 or more servings of vegetables and fruit had a significantly greater Veggie Meter score than participants who consumed less than 3 servings (255 vs 202 respectively; P = .059). The relationship did not change when controlling for fish intake in a general linear model. Conclusions Consistent with previous findings, vegetable and fruit intake is very low among Yup'ik people. Findings suggest that the Veggie Meter distinguishes between participants who consume high and low levels of vegetables and fruit. Participants consumed lower levels of fish than estimated in previous studies in southwestern Alaska. At this level of fish intake, fish does not appear to confound the relationship between the Veggie Meter and vegetable and fruit intake. Funding Sources Research reported here was supported by UAF BLaST, funded by the National Institute Of General Medical Sciences of the National Institutes of Health.