Subclinical thyroid dysfunction symptoms in older adults: cross-sectional study in UK primary care.

Background: Subclinical thyroid dysfunction - abnormal serum thyrotrophin (thyroid-stimulating hormone; TSH) concentrations with normal free thyroxine (FT4) is common in older people. It remains unclear whether individuals with subclinical serum status experience an increased symptom profile.

Aim: To compare the prevalence of those symptoms typically associated with overt thyroid dysfunction in older individuals with a subclinical and euthyroid serum profile.

The burden of common chronic disease on health-related quality of life in an elderly community-dwelling population in the UK.

Background: Given the high prevalence of chronic conditions and multimorbidity in the elderly, there is a need to determine which chronic conditions have the greatest impact on health-related quality of life (HRQL) and identify where additional intervention may be required.

Objective: To explore the impact of a range of common chronic conditions on HRQL in a community-based population aged 65 years or more in the UK.

Methods: Secondary analysis of data derived from a large (n = 5849) cross-sectional study.

Exploring the use and effects of deliberate self-harm websites: an Internet-based study.

Background: In the United Kingdom, rates of deliberate self-harm (DSH) are rising. Alongside this, there has been an increase in the number of websites available with DSH content, and the Internet is known as a valuable resource for those who feel isolated by their condition(s). However, there is little and contradictory evidence available on the effects of using such websites.

Sunbed use, attitudes, and knowledge after the under-18s ban: a school-based survey of adolescents aged 15 to 17 years in Sandwell, United Kingdom.

Background: Sunbed use in childhood increases risk of melanoma. The under-18s sunbed ban was introduced in England, April 2011. Impact on use has not been investigated since.

A randomised controlled trial of a probiotic 'functional food' in the management of irritable bowel syndrome.

Background: Irritable Bowel Syndrome (IBS) is a common condition characterised by pain, distension and altered bowel habit. Evidence suggests functional foods containing probiotics improve gastrointestinal transit, however, data are limited by short follow-up periods and evaluation in selected populations.

Methods: A multi-centre, randomized, double blind, controlled trial to evaluate the effect of a probiotic vs non-probiotic dairy product on symptoms in IBS with a constipation element (IBS-Constipation or IBS-Mixed profile).

Why are GPs treating subclinical hypothyroidism? Case note review and GP survey.

Background: Subclinical hypothyroidism (SCHo) is a common biochemical diagnosis in older age. Evidence of impact is inconclusive and guidelines are inconsistent. With increasing numbers of thyroid function tests (TFTs) performed, GPs frequently have to make management decisions regarding this diagnosis.

The relationship between serum TSH and free T4 in older people.

The frequency distribution of serum thyroid stimulating hormone (TSH) shows a skewed pattern that may change with age. The set point of the hypothalamic-pituitary-thyroid axis for an individual is thought to be genetically determined and has been described as a log-linear relationship of serum TSH to free thyroxine (T4); however, the validity of this hypothesis has yet to be established in older people. The aim of the study was to describe the relationship between serum TSH and free T4 in older people and define factors influencing this relationship.

Inappropriate 999 calls: an online pilot survey.

Background: Abuse of ambulance services is high, and there is concern among healthcare professionals that misuse of ambulances places stress on services, which may jeopardise patient care. This study aims to determine the proportion of people who correctly identify appropriate situations to call for an ambulance, and determine the characteristics of those most likely to call inappropriately.

Methods: An online questionnaire presented 12 common scenarios that may require medical attention and required participants to identify when they would request an ambulance.

Medical students' attitudes to psychiatric illness in primary care.

Context: Previous research has shown that general practitioners (GPs) hold negative attitudes towards patients with schizophrenia, which do not simply reflect the nature or chronic aspects of the illness. This study aimed to describe the attitudes and predicted behaviour of medical students towards patients with mental illness in a primary care setting and to investigate whether these were affected by the students' level of training.

Methods: A sample of 1239 students from the University of Birmingham Medical School were each given one of four case vignettes, all of which were identical except that the patient involved was described as having a previous diagnosis of, respectively, schizophrenia, depression, diabetes or no illness.

Effects of exposure to mental illness in role-play on undergraduate student attitudes.

Background: Education is integral to reducing stigma toward the mentally ill. Medical educators have a key role in delivering education that reduces that stigma. Undergraduate psychiatric training and specific education programs are both effective in reducing stigma.

Evaluation of the Birmingham IBS symptom questionnaire.

Background: Irritable Bowel Syndrome (IBS) is a chronic/common condition that causes a significant effect on the individual (reduced quality of life), society (time lost off work) and health services. Comparison of studies evaluating the management of IBS has been hindered by the lack of a widely adopted validated symptom score. The aim of this study was to develop and validate a disease specific score to measure the symptoms of patients with IBS.

Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction?

Background: Widespread use of automated sensitive assays for thyroid hormones and thyroid-stimulating hormone (TSH) has increased identification of mild thyroid dysfunction, especially in elderly patients. The clinical significance of this dysfunction, however, remains uncertain, and associations with cognitive impairment, depression, and anxiety are unconfirmed.

Objective: To determine the association between mild thyroid dysfunction and cognition, depression, and anxiety in elderly persons.

Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey.

Context: Population-based screening has been advocated for subclinical thyroid dysfunction in the elderly because the disorder is perceived to be common, and health benefits may be accrued by detection and treatment.

Objective: The objective of the study was to determine the prevalence of subclinical thyroid dysfunction and unidentified overt thyroid dysfunction in an elderly population.

Design, Setting, And Participants: A cross-sectional survey of a community sample of participants aged 65 yr and older registered with 20 family practices in the United Kingdom.