Bupropion is an antidepressant thought to have a reduced risk of inducing mood switching as compared to other antidepressants. Minimal information is available on the induction of mood shifts when used for smoking cessation. This case describes a 38-year-old female who experienced mania following initiation of bupropion for smoking cessation. After completion of a thorough literature search, this appears to be the first case report describing mania induced by bupropion that was refractory to medications and was resolved with electroconvulsive therapy. This case highlights the need for clinicians to perform thorough histories of patients to avoid missing psychiatric history prior to starting bupropion as well as monitor for changes in mood or behavior after initiation of therapy.

Background Early Childhood Education Centre (ECEC) staff are strongly recommended to receive several immunizations including influenza and pertussis. However, evidence regarding the uptake is either old or lacking across all Australian States/Territories. This study aimed to explore the attitudes and barriers around ECEC staff vaccination and the immunisation policy/practices employed at their workplaces. Methods An online cross-sectional survey was undertaken of staff members (administrators and childcare center staff) in early 2017. We compared the individual’s knowledge, attitude and practices as well as the centre’s policy and practice variables between the vaccinated and unvaccinated respondents. A logistic model was used to identify the factors associated with uptake of the different vaccines. Results A total of 575 ECEC staff completed the survey. Sixty percent reported being aware of the recommendations about staff immunisation. While participants did acknowledge that they could spread diseases if unvaccinated (86%), 30% could not recall receiving a dTpa in the last 10 years. Private centres were less likely to provide free or onsite vaccination compared to other categories of centres. Less than half reported receiving any encouragement to get the influenza vaccine and only 33% reported that their centre provides onsite influenza vaccination. Regarding the introduction of mandatory policies, 69% stated that they would support a policy. Conclusion Employers should consider supporting methods to maximize vaccination of their employees including providing free onsite vaccination. Participants were open to idea of mandatory vaccination; however, this needs to be explored further to determine how vaccine costs and access issues could be resolved.