Impact and cost-effectiveness of scaling up HCV testing and treatment strategies for achieving HCV elimination among people who inject drugs in England: a mathematical modelling study.

Background: England aims to reach the World Health Organization (WHO) elimination target of decreasing HCV incidence among people who inject drugs (PWID) to <2 per 100 person-years (/100pyrs) by 2030. We assessed what testing and treatment strategies will achieve this target and whether they are cost-effective.

Methods: A dynamic deterministic HCV transmission model among PWID was developed for four England regions, utilising data on the scale-up of HCV treatment among PWID in prisons, drug treatment centres (DTC, where opioid agonist therapy is provided), and any other setting (e.

Modeling the Potential Health, Health Economic, and Health Inequality Impact of a Large-Scale Rollout of the Drink Less App in England.

Objectives: Alcohol places a significant burden on the National Health Service (NHS); yet, uptake of cost-effective approaches remains low. Digital interventions may overcome some barriers to delivery. The Drink Less app has evidence of being effective at supporting heavier drinkers to reduce their alcohol intake.

Outcomes of Patients With Five or More Brain Metastases Treated With Stereotactic Radiosurgery From 2014 to 2019: A UK Series.

Aims: Treatment with stereotactic radiosurgery/radiotherapy (SRS/SRT) is standard practice in selected patients with small numbers of brain metastases (BMs). It is less accepted in those with ≥5 BMs, due to the lack of a prospective evidence base. While randomised trials are ongoing, we present the experience of a single UK cancer centre in using SRS/SRT for patients with 5 or more BMs without whole brain radiotherapy (WBRT).

Seroprevalence of Hepatitis C in Ethiopia: First National Study Based on the 2016 Ethiopian Demographic and Health Survey.

Hepatitis C virus (HCV) is hypothesised to be a public health problem in Ethiopia, and systematic review evidence suggested 1%-3% seroprevalence. We aimed to estimate the seroprevalence of HCV overall and across regions of Ethiopia. We estimated HCV seroprevalence using the 2016 Ethiopian Demographic and Health Survey (EDHS-2016).

Qualitative service evaluation of a multimodal pilot service for early detection of liver disease in high-risk groups: 'Alright My Liver?'.

Objective: Liver disease is a growing cause of premature death in the UK. The National Health Service in England (NHS England) has funded regional early detection programmes through Community Liver Health Check pilots. 'Alright My Liver?' is Bristol and Severn's pilot service offering early detection of liver disease through screening events serving populations at risk, including people with a history of drug or alcohol use, type 2 diabetes and obesity.

Clinical Outcomes and Relevance of Composite V12 Gy in Patients With Four or More Brain Metastases Treated With Single Fraction Stereotactic Radiosurgery.

Aims: Tissue V12Gy (total brain volume receiving 12Gy including target) can predict for late toxicity in single target benign disease treated with stereotactic radiosurgery (SRS). The value of this metric remains uncertain for multiple brain metastases. This retrospective cohort study reports the outcomes and evaluates the predictors of toxicity in patients with four or more brain metastases treated with single-fraction SRS.

Association of volatile substance, nitrous oxide and alkyl nitrate use with mental health in UK adolescents.

Background: 'Inhalants' have been associated with poorer mental health in adolescence, but little is known of associations with specific types of inhalants.

Aims: We aimed to investigate associations of using volatile substances, nitrous oxide and alkyl nitrates with mental health problems in adolescence.

Method: We conducted a cross-sectional analysis using data from 13- to 14-year-old adolescents across England and Wales collected between September 2019 and March 2020.

Does maternal education moderate the relationship between adolescent cannabis use and mental health in early adulthood?

Introduction: Socioeconomic disadvantage has been associated with cannabis use and poor mental health. It is therefore hypothesised that lower maternal education, a proxy for socioeconomic disadvantage, may increase the risk of cannabis-related mental health and substance use consequences.

Methods: A total of 5099 participants from the Avon Longitudinal Study of Parents and Children reported cannabis use via questionnaires at 16 or 18.

Making sense of drug use and dependence-A scoping review of mass media interventions intended to reduce stigma towards people who use drugs.

Background: People who use drugs face entrenched stigma, which fosters shame, restricts service access, and exacerbates inequalities. The use of mass media in anti-stigma interventions offers an opportunity to challenge stigmatising attitudes at scale. There are, however, inconsistencies in messaging approaches used in mass media anti-stigma interventions, and how authors conceptualise and measure 'stigma'.

The role of emotion in urban development decision-making: A qualitative exploration of the perspectives of decision-makers.

People's feelings about their neighbourhoods are important for health, but they may be undervalued in urban development decision-making. This study explores how decision-makers understand and respond to residents' emotions. Reflexive thematic analysis was conducted on a secondary dataset consisting of 123 interviews with influential professionals in urban development decision-making.

Engagement in rapid public health research among young people from underserved communities: maximising opportunities and overcoming barriers.

Background: Inclusion in public health research of young people from low-income households and those from minority ethnic groups remains low. It is recognised that there is a need to change the way in which research is conducted so that it becomes more inclusive. The aim of this work was to identify novel and innovative ways to maximise recruitment and inclusion of diverse participants when doing co-production within very short time frames for emergency responses.

Prevalence of problematic pharmaceutical opioid use in patients with chronic non-cancer pain: A systematic review and meta-analysis.

Background And Aims: Chronic non-cancer pain (CNCP) is one of the most common causes of disability globally. Opioid prescribing to treat CNCP remains widespread, despite limited evidence of long-term clinical benefit and evidence of harm such as problematic pharmaceutical opioid use (POU) and overdose. The study aimed to measure the prevalence of POU in CNCP patients treated with opioid analgesics.

Testing and Treatment Interventions in Community Settings Key to Controlling a Recent Human Immunodeficiency Virus Outbreak Among People Who Inject Drugs in Glasgow: A Modeling Study.

Background: A human immunodeficiency virus (HIV) outbreak was identified among people who inject drugs (PWID) in Glasgow in 2015, with >150 diagnoses by the end of 2019. The outbreak response involved scaling up HIV testing and improving HIV treatment initiation and retention.

Methods: We parameterized and calibrated a dynamic, deterministic model of HIV transmission among PWID in Glasgow to epidemiological data.

Evaluating the Acceptability of the Drink Less App and the National Health Service Alcohol Advice Web Page: Qualitative Interview Process Evaluation.

Background: The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy.

Objective: In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in the United Kingdom participating in a randomized controlled trial evaluating the effectiveness of the Drink Less app.

Methods: A subsample of 26 increasing- and higher-risk drinkers (Alcohol Use Disorders Identification Test score≥8) assigned to the intervention group (Drink Less; n=14, 54%; female: n=10, 71%; age: 22-72 years; White: n=9, 64%) or usual digital care group (NHS alcohol advice web page; n=12, 46%; female: n=5, 42%; age: 23-68 years: White: n=9, 75%) took part in semistructured interviews.

Pilot postal birth cohort hepatitis C virus screening in UK primary care: HepCAPP study.

Background: Birth cohort screening has been implemented in some countries to identify the potentially 'missed population' of people with undiagnosed chronic hepatitis C virus (HCV) who may not be found through targeted approaches.

Aim: To determine uptake of HCV antibody testing using an oral swab screening method, the overall yield, whether those testing positive had risk markers in their primary care record, and the cost per case detected.

Design And Setting: This was a pilot screening study set in general practices in the Southwest of England, Yorkshire and Humber, and South London.

Primary care-based interventions for secondary prevention of opioid dependence in patients with chronic non-cancer pain taking pharmaceutical opioids: a systematic review.

Background: Globally, almost one-third of adults with chronic non-cancer pain (CNCP) are prescribed opioids. Prevention of opioid dependence among these patients is a public health priority.

Aim: To synthesise the evidence on the effectiveness of primary care-based interventions for secondary prevention of opioid dependence in patients with CNCP who are taking pharmaceutical opioids.

Do engagement and behavioural mechanisms underpin the effectiveness of the Drink Less app?

This is a process evaluation of a large UK-based randomised controlled trial (RCT) (n = 5602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants' engagement ('self-reported adherence') and behavioural characteristics were mechanisms of action underpinning the effectiveness of Drink Less. Self-reported adherence with both digital tools was over 70% (Drink Less: 78.

Evaluating the effect of direct-acting antiviral agent treatment scale-up on Hepatitis C virus prevalence among people who inject drugs in UK.

Background: There is limited empirical work assessing the effectiveness of treatment as prevention (TasP) in reducing HCV prevalence among people who inject drugs (PWID). Here, we used survey data from the UK during 2010-2020, to evaluate the impact of direct-acting antiviral agent (DAA) treatment scale-up, which started in 2015, on HCV prevalence among PWID.

Methods: We fitted a logistic regression to time/location specific data on prevalence from the Needle Exchange Surveillance Initiative in Scotland and Unlinked Anonymous Monitoring programme in England.

Utilization of qPCR to Determine Duration and Environmental Drivers Contributing to the Persistence of Human DNA in Soil.

Little is known about the underlying mechanisms that contribute to the persistence and degradation of DNA within soil. The goals of this study are to determine the duration of mitochondrial DNA (mtDNA) and nuclear DNA (nuDNA) persistence in soils enriched by surface-level human decomposition and to better understand the contribution of environmental factors. The surface-level decomposition of three human cadavers was documented over 11 weeks.