Objective: This study aimed to assess and comparatively analyse two menus from a Young Offenders Institution (YOI). One menu from 2019, and one from 2022, with the objective of identifying any improvements in meeting dietary guidelines. Design: Cross-sectional and comparative analysis. Setting: United Kingdom, a YOI in Northern England. Participants: YOI Menus. Results: Analysis of 30 dietary components identified that 25 exceeded the dietary guidelines (P < 0.05) for the 2022 menu, with five failing to meet the guidelines (P < 0.05). When compared to the 2019 menu, the 2022 menu showed improvements in saturated fat, sodium, and vitamin D. Despite the improvement, vitamin D levels remained below dietary guidelines (P < 0.01). Salt and energy content were reduced in the 2022 menu (P < 0.05); however, they were still above the dietary guidelines (P < 0.01). Free sugars were significantly above dietary guidelines for both menus, with no significant change between the 2019 and 2022 menu (P = 0.12). Conclusion: The 2022 menu has demonstrated progress in alignment with meeting dietary guidelines, particularly in reducing calories, fat, saturated fat, salt, sodium, and chloride, as well as increasing vitamin D. Despite improvements, calories, free sugars, salt, saturated fat, sodium, and chloride are still exceeding dietary guidelines, posing as potential health risks.

Agitation is experienced by over 90% of individuals with Alzheimer’s disease (AD) which increases morbidity and mortality and contribute to caregiver burden. There are no FDA-approved treatments for severe agitation in people with advanced dementia. Behavioral interventions are first-line management strategies but are not effective in the most severely agitated patients. Off-label use of psychotropic medications have limited efficacy and risk for adverse effects. New management strategies for severe agitation in AD refractory to psychopharmacologic and behavioral interventions are timely and warranted. Preliminary studies provide evidence for the safety and efficacy of acute electroconvulsive therapy (ECT) in reducing agitation in this population.

The ECT-AD study is a multi-site NIH-funded randomized single-blind randomized controlled trial to investigate the safety and efficacy of ECT in severe and treatment refractory agitation and aggression in AD. In a vulnerable population with advanced dementia and lack of capacity to provide informed consent, there are ethical and consent issues that need to be considered. In this presentation, we will describe the human research subject aspects of working with this population, the process of informed consent and variation of state laws, and efforts to ensure participant safety and minimize undue influence or coercion.

Recent manmade and natural disasters highlight weaknesses in the public health systems designed to protect populations from harm and minimize disruption of the social and built environments. Emergency planning and response efforts have, as a result, focused largely on ensuring populations' physical well-being during and after a disaster. Many public health authorities, including the World Health Organization, have recognized the importance of addressing both mental and physical health concerns in emergency plans. Individuals with mental disorders represent a notable proportion of the overall population, and anticipating their needs is critical to comprehensive emergency planning and response efforts. Because people with serious mental disorders historically have been stigmatized, and many individuals with mental disorders may be unable to care for themselves, ethical guidance may be of assistance to those engaged in emergency planning and response. This article considers several broad categories of ethical issues that arise during emergencies for people with serious mental disorders and offers recommendations for ways in which emergency planners and other stakeholders can begin to address these ethical challenges.

(Disaster Med Public Health Preparedness. 2012;6:72–78)

Objective: Older persons have levels of frailty and disability that place them at far greater risk of harm in disasters than younger adults, making it crucial for all agency planners, public health workers, and health care providers to be aware of age-appropriate considerations of preparedness and response. This research evaluated the knowledge and utilization intentions of participants of a geriatric emergency preparedness and response (GEPR) continuing education program that was designed to provide this training.

Methods: A qualitative training evaluation was conducted using course evaluation questionnaires from GEPR workshops offered in 2009 in 7 nationwide cities through a partnership of the University of Texas Center for Biosecurity and Public Health Preparedness with the Texas Consortium Geriatric Education Center at Baylor College of Medicine, Houston.

Results: Evaluations were completed by 292 participants. Respondents were able to name specific information learned, give examples of applications of the material, and devise plans for further action. Participants believed that their ability to do their jobs had increased, and they provided insightful suggestions instructive to both trainers and to leaders of health care organizations.

Conclusions: The results of the evaluation suggest that GEPR workshops are effective in increasing the knowledge of participants and their intentions to use it. There is both a need and a demand for this training. Developers and trainers should provide participants with sufficient time for absorbing the information, consider tailoring the training to the local context, and provide opportunity for practical application, particularly planning exercises.

(Disaster Med Public Health Preparedness. 2012;6:385-392)