BackgroundSalivary fistulas are a well-known sequel of parotidectomy, and successful treatment with botulinum toxin has been demonstrated in individual cases. Here, we report on 12 patients with fistulas treated following parotidectomy for various indications.Methods and resultsInjection of botulinum toxin type A into the residual gland tissue was the initial treatment. After early intervention (within 6 weeks after development of the fistula), only one fistula remained (9 of 10 fistulas treated early only with botulinum toxin). One patient with early intervention did not want to wait for the botulinum toxin treatment to take effect and demanded early surgical revision, which was successful. In one patient with a permanent fistula, botulinum toxin treatment began 420 days after the operation and was unsuccessful. No side effects were evident after the treatment.ConclusionIn summary, botulinum toxin injections into the parotid tissue remaining after surgery appear to be an effective treatment for salivary fistulas following parotidectomy.

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Abstract. To better understand factors shaping adaptive behavior and resilience is crucial in designing policy strategies to prepare households for future flooding. The central question of our paper is how frequent flood experience (FFE) impacts adaptive behavior and self-reported household resilience. The applied empirical methods are binary logistic and linear regression models using data from a panel dataset, including 2462 residents (Germany, state of Saxony). Four main conclusions from the investigations can be drawn. First, more flood experienced households are statistically significantly more likely to have taken precautionary measures in the past. Second, FFE has a statistically significant negative impact on self-reported resilience. Third, the impact of FFE on the capacity to recover and the capacity to resist is statistically significant non-linear. Fourth, putting together these results reveals the paradox of more flood-experienced households being better prepared but feeling less resilient at the same time. It can be concluded that more research is needed to obtain deeper insights into the drivers behind self-reported resilience and that this study can be seen as a piece of the puzzle, taking frequent flood experience as the primary entry point.

<p>Individual adaptation is essential for achieving community resilience as well as coping with residual risks that have not been addressed by current structural schemes for reducing flood risks. At the same time, it also implies that individuals should have the resources and capacity to protect themselves. So far, this has been interpreted in the social vulnerability concept as accounting only for income, wealth, or other materially relevant factors, showing how much vulnerable people are exposed to more risk. However, individual behavioural adaptability has hardly been included in the current vulnerability assessment.</p> <p>In light of this, this study proposes a novel way to expand and link social classes using well-established social vulnerability indicators (i.e. income, education, and job status) with socio-psychological and lifestyle elements theoretically and empirically known to influence individual protective behaviour. We conducted a bias-adjusted three-step Latent Class Analysis (LCA) with covariates (socio-psychological and lifestyle elements) and distal outcomes (adaptive behaviour). A household survey (n = 1,753) conducted between June and July 2020 in 11 cities in Saxony, Germany, was used.</p> <p>The preliminary result shows that socio-psychological and cultural factors that influence individual decision-making on proactive adaptive behaviour co-vary with social classes based on their resource endowment. It also revealed that the lower class tends to have less implementation of costly adaptation methods, for example, structural measures on housing, while less costly measures did not make a significant difference. As a result, we recommend that, in addition to the lack of material endowment, which can be associated with an increased risk of exposure, individual inaction of protective behaviour motivated by socio-psychological traits be considered for social vulnerability.</p>

<p>In natural hazards research, social resilience is becoming a topic of high scientific interest. Due to global climate change, most natural hazards are occurring more often and put individuals' mental and physical health, economic endowments, and the existence of their valued objects at risk. One way to decrease the impacts of these hazards is to increase individual's resilience. Consequently, the knowledge of the drivers behind it becomes more desirable as it is necessary to design strategies to prepare households for future hazards. The central question of the research project is if flood experience impacts adaptive behavior and self-perceived social resilience and, if so, in what ways. The applied empirical method is an ordered logistic regression model using data from a panel dataset (2020-2021), including 1750 residents (Germany, state of Saxony). Four main conclusions from the investigations can be drawn. First, more experienced individuals are statistically significantly more likely to have taken precautionary measures in the past. Second, flood experience has a statistically significant negative impact on self-perceived social resilience. Third, the impact of flood experience on the capacity to resist is not linear. Fourth, putting together these results reveals the paradox that more flood-experienced people are better prepared but feel less resilient at the same time. It can be concluded that more research is needed to obtain deeper insights into the drivers behind social resilience and that this study can be seen as a piece of the puzzle, taking flood experience as the primary target point. While this study contributes with more profound knowledge of what role experiences play in building social resilience, it connects theories from social and natural sciences. Consequently, it enriches the existing knowledge with more interdisciplinarity.</p>

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