BACKGROUND: Acute myocardial infarction places additional demands on an already compromised myocardium. Relaxing music can induce a relaxation response, thereby reversing the deleterious effects of the stress response. OBJECTIVES: To compare the effects of relaxing music; quiet, uninterrupted rest; and "treatment as usual" on anxiety levels and physiological indicators of cardiac autonomic function. METHODS: A 3-group repeated measures experimental design was used. Forty-five patients, 15 per group, with acute myocardial infarction were assigned randomly to 20 minutes of (1) music in a quiet, restful environment (experimental group); (2) quiet, restful environment without music (attention); or (3) treatment as usual (control). Anxiety levels and physiological indicators were measured. RESULTS: Immediately after the intervention, reductions in heart rate, respiratory rate, and myocardial oxygen demand were significantly greater in the experimental group than in the control group. The reductions in heart rate and respiratory rate remained significantly greater 1 hour later. Changes in heart rate, respiratory rate, and myocardial oxygen demand in the attention group did not differ significantly from changes in the other 2 groups. The 3 groups did not differ with respect to systolic blood pressure. Increases in high-frequency heart rate variability were significantly greater in the experimental and attention groups than in the control group immediately after the intervention. State anxiety was reduced in the experimental group only; the reduction was significant immediately and 1 hour after the intervention. CONCLUSIONS: Patients recovering from acute myocardial infarction may benefit from music therapy in a quiet, restful environment.

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Background Fear of contracting coronavirus disease 2019 may be the latest addition to the barriers to clinic attendance. This study aimed to examine the impact of coronavirus disease 2019 and other variables on non-attendance rate at an out-patient clinic. Methods Clinic attendance at the Department of Otolaryngology and Head and Neck Surgery, Waikato Hospital, New Zealand, was assessed. For each appointment, the impact of coronavirus disease 2019 and other variables on non-attendance rate were analysed. Results In total, 1963 appointments were scheduled, with 194 non-attendances (9.9 per cent). Patients who had their appointments confirmed beforehand were 10.0 times more likely to attend their appointment. Sex, socioeconomic status, ethnicity and age were found to impact non-attendance rate. Conclusion In New Zealand, coronavirus disease 2019 does not appear to be a barrier to out-patient clinic appointment attendance. The patient's age, sex, ethnicity, socioeconomic status and prior appointment confirmation were found to influence clinic attendance.

Few protocols have been published for the dental management of patients with head and neck cancer to prevent complications from head and neck radiation therapy. Radiation therapy not only affects the tumor cells targeted, but also the dentition, bone, salivary gland, and oral soft tissue structures. A comprehensive dental evaluation prior to head and neck radiation therapy can help prevent many complications. The following clinical guidelines were established by a workgroup of oral health providers within the Department of Veterans Affairs. This workgroup focused on developing a set of recommendations regarding dental care prior to the initiation of head and neck radiation therapy based on the best clinical evidence and expert consensus. A systematic algorithm was developed for the evaluation including pre‐exam data gathering, examination, education, and treatment, followed by maintenance and postradiation dental follow‐up. This document is evidence‐based, patient‐centered, consistent with accepted practices of care and safety, and in accordance with applicable statutes and regulations.

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