The role of the Royal Air Force Deployed Readiness Preparation Team in the UK
Abstract: Royal Air Force (RAF) Waddington and Cranwell are both based in Lincolnshire and have Defence Primary Health Care Dental Centres on Station to provide dental care to service personnel. The facility at RAF Waddington was temporarily closed for refurbishment early 2020 and this saw the amalgamation of the two Dental Centres. This, alongside COVID, significantly impacted on the ability to deliver dental care to a combined patient group. Military dental teams are routinely deployed overseas to provide care for patients; however, the Deployed Readiness Preparation Team (DRPT) had not previously been activated in the UK in support of RAF Dental Centres. This UK-based deployment was to be innovative and able to demonstrate the wider utility of the military dental teams and portable equipment, to expand the facility at RAF Cranwell.The aim of this paper is to highlight the key principles and utility of deployable Defence dentistry by discussing the establishment and use of portable dental equipment to facilitate the increased clinical output of a dental centre. Through energetic and focused leadership, training and assurance, dentistry can be delivered with an occupational focus to provide a responsive and deployable care capability in a UK setting.
Abstract: Novel and automated means of opioid use and relapse risk detection are needed. Unstructured electronic medical record data, including written progress notes, can be mined for clinically relevant information, including the presence of substance use and relapse-critical markers of risk and recovery from opioid use disorder (OUD). In this study, we used natural language processing (NLP) to automate the extraction of opioid relapses, and the timing of these occurrences, from veteran patients' electronic medical record. We then demonstrated the utility of our NLP tool via analysis of pre-/post-COVID-19 opioid relapse trends among veterans with OUD. For this demonstration, we analyzed data from 107,606 veterans OUD enrolled in Veterans Health Administration, comparing a pandemic-exposed cohort (n = 53,803; January 2019-March 2021) to a matched prepandemic cohort (n = 53,803; October 2017-December 2019). The recall of our NLP tool was 75% and our precision was 94%, demonstrating moderate sensitivity and excellent specificity. Using the NLP tool, we found that the odds of opioid relapse postpandemic onset were proportionally higher compared to prepandemic trends, despite patients having fewer mental health encounters from which to derive instances of relapse postpandemic onset. In this research application of the tool, and as hypothesized, we found that opioid relapse risk was elevated postpandemic. The application of NLP Methods: to identify and monitor relapse risk holds promise for future surveillance, risk prevention, and clinical outcome research.