Patient satisfaction with prescription opioid education in primary care.

Objectives: This study explores patients' satisfaction with opioid education, identifies areas for improvement, and assesses differences between those more or less satisfied with their opioid education.

Methods: A cross-sectional survey of adults with prescription opioid experience. Respondents reported opioid details, demographics, and pain coping.

Implementation of a CBT-based dental anxiety management pathway for patients with learning disabilities.

Dental anxiety is a common phenomenon in the general population and may be more prevalent in people with learning disabilities. There is growing interest in the use of cognitive behaviour therapy (CBT) approaches, including within dental anxiety management. However, relatively little is known regarding the application of CBT approaches in dental anxiety management for patients with learning disabilities.

Identification and support of autistic individuals within the UK Criminal Justice System: a practical approach based upon professional consensus with input from lived experience.

Background: Autism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual's journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes.

Patients' perspectives about the role of primary healthcare providers in long-term opioid therapy: a qualitative study in Dutch primary care.

Background: Over the past decade, long-term use of prescription opioids for chronic non-cancer pain has risen globally despite the associated risks. Most opioid users receive their first prescription in primary care.

Aim: To investigate the perspective of patients who are long-term opioid users in primary care regarding the role of healthcare providers (HCPs) in their prolonged opioid use.

Patients' perspectives on tapering programmes for prescription opioid use disorder: a qualitative study.

Objectives: Approximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients' experiences with tapering programmes for prescription OUD could help improve such programmes.

Patients' Perspectives on the Development of Prescription Opioid Use Disorder in Patients with Chronic Non-Cancer Pain.

Introduction: In the past decade, prescription opioid use increased exponentially and concomitantly opioid use disorders (OUD) are becoming more common. Several risk factors for developing OUD have been identified, but little is known regarding the patients' perspective on developing a prescription OUD.

Methods: We recruited 25 adults undergoing treatment for prescription OUD.

Daily testing for contacts of individuals with SARS-CoV-2 infection and attendance and SARS-CoV-2 transmission in English secondary schools and colleges: an open-label, cluster-randomised trial.

Background: School-based COVID-19 contacts in England have been asked to self-isolate at home, missing key educational opportunities. We trialled daily testing of contacts as an alternative to assess whether this resulted in similar control of transmission, while allowing more school attendance.

Methods: We did an open-label, cluster-randomised, controlled trial in secondary schools and further education colleges in England.

Implementation of a computer-guided consultation in the assessment of suspected obstructive sleep apnoea syndrome.

Background: We describe implementation of a clinical decision support system, a computer-guided consultation (CGC), in the assessment of subjects referred with suspected obstructive sleep apnoea syndrome (OSAS).

Methods: Two cohorts of patients were assessed. The first 100 cases had data collected with the CGC by a specialist sleep physician (stage1).

The Association Between Tobacco Outlet Density and Smoking Among Young People: A Systematic Methodological Review.

Aim: Evidence on the association between tobacco outlet density and proximity and smoking behavior among youth is inconsistent, which may be due to methodological problems in some studies. We assessed the association of outlet density or proximity with smoking behavior among young people while taking into account the methodological quality of studies.

Methods: MEDLINE, EMBASE, and Google Scholar were systematically searched for studies on the relationship between outlet density or proximity and smoking behavior among 12- to 25-year-olds, published between 1997 and 2017.

Low-dose oral theophylline combined with inhaled corticosteroids for people with chronic obstructive pulmonary disease and high risk of exacerbations: a RCT.

Background: Despite widespread use of therapies such as inhaled corticosteroids (ICSs), people with chronic obstructive pulmonary disease (COPD) continue to suffer, have reduced life expectancy and utilise considerable NHS resources. Laboratory investigations have demonstrated that at low plasma concentrations (1-5 mg/l) theophylline markedly enhances the anti-inflammatory effects of corticosteroids in COPD.

Objective: To determine the clinical effectiveness and cost-effectiveness of adding low-dose theophylline to a drug regimen containing ICSs in people with COPD at high risk of exacerbation.

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial.

Importance: Chronic obstructive pulmonary disease (COPD) is a major global health issue and theophylline is used extensively. Preclinical investigations have demonstrated that low plasma concentrations (1-5 mg/L) of theophylline enhance antiinflammatory effects of corticosteroids in COPD.

Objective: To investigate the effectiveness of adding low-dose theophylline to inhaled corticosteroids in COPD.

The role of self-control and cognitive functioning in educational inequalities in adolescent smoking and binge drinking.

Background: Large differences in substance use between educational levels originate at a young age, but there is limited evidence explaining these inequalities. The aim of this study was to test whether a) smoking and binge drinking are associated with lower levels of self-control and cognitive functioning, and b) associations between educational track and smoking and binge drinking, respectively, are attenuated after controlling for self-control and cognitive functioning.

Methods: This study used cross-sectional survey data of 15 to 20-year-olds (N = 191) from low, middle, and high educational tracks.

A Screening Study to Determine the Prevalence of Airway Disease in Heroin Smokers.

Over the last 20 years smoking has become the most common method of heroin use and increasing numbers of heroin smokers are presenting to local medical services, before the age of 40 years, with severe airway disease. To determine COPD prevalence we recruited 129 subjects from two local community drug services, of whom 107 were heroin smokers. We collected demographic, medical and treatment data, smoking history (including cannabis and opiates) and details of symptoms including MRC dyspnoea.

Use of low-dose oral theophylline as an adjunct to inhaled corticosteroids in preventing exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial.

Background: Chronic obstructive pulmonary disease (COPD) is associated with high morbidity, mortality, and health-care costs. An incomplete response to the anti-inflammatory effects of inhaled corticosteroids is present in COPD. Preclinical work indicates that 'low dose' theophylline improves steroid responsiveness.

Use of 24 kHz ultrasound to improve sulfate precipitation from wastewater.

Elevated sulfate concentrations in industrial effluent can lead to a number of significant problems, the most serious of which is the corrosion of concrete sewers as a result of hydrogen sulfide induced biogenic sulfuric acid attack; hydrogen sulfide can also create odor nuisance problems. The most common treatment process for sulfate removal from wastewaters is to precipitate it as gypsum using lime addition. Nevertheless, meeting discharge consent limits for sulfate can often present practical challenges due to the solubility of gypsum and so there is a need to investigate technological solutions that might provide for more consistent sulfate removal.

Feasibility and impact of a computer-guided consultation on guideline-based management of COPD in general practice.

Background: Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution.

Aims: To determine if the use of a computer-guided consultation that facilitates the National Institute for Health and Clinical Excellence-based chronic obstructive pulmonary disease (COPD) guidance and prompts clinical decision-making is feasible in primary care and to assess its impact on diagnosis and management in reviews of COPD patients.

Population Impact Analysis: a framework for assessing the population impact of a risk or intervention.

Background: To describe an organizing framework, Population Impact Analysis, for applying the findings of systematic reviews of public health literature to estimating the impact on a local population, with the aim of implementing evidence-based decision-making.

Methods: A framework using population impact measures to demonstrate how resource allocation decisions may be influenced by using evidence-based medicine and local data. An example of influenza vaccination in the over 65s in Trafford to reduce hospital admissions for chronic obstructive pulmonary disease (COPD) is used.

A study of patient attitudes in the United Kingdom toward ventilatory support in chronic obstructive pulmonary disease.

Introduction: Informed patient choice is central to modern clinical care but there is a paucity of data about how patients respond to information regarding complex therapies. This qualitative study aimed to understand the attitudes of patients with chronic obstructive pulmonary disease (COPD) toward acute ventilatory support and assess how aids to decision making regarding ventilation affect patients' views of therapy.

Methods: A standardized five-stage interview process was used to explore attitudes toward noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) in 50 stable COPD patients.

Stalking behaviour by patients towards psychiatrists in a large mental health organization.

Background: Mental health professionals are at greater risk than the general population of being stalked, particularly by patients.

Aims: To assess the prevalence of stalking behaviour by patients towards psychiatrists and ascertain patient characteristics.

Method: Semi-structured questionnaire to all psychiatrists (n = 324) working in a large mental health organization.

New mutations in the Wilson disease gene, ATP7B: implications for molecular testing.

Wilson disease (WND), an autosomal recessive disorder of copper transport with a broad range of genotypic and phenotypic characteristics, results from mutations in the ATP7B gene. ATP7B encodes a copper transporting P-type ATPase involved in the transport of copper into the plasma protein ceruloplasmin, and for excretion of copper from the liver. Defects in ATP7B lead to copper storage in liver, brain and kidney.

A case series of patients with Tourette's syndrome in the United Kingdom treated with aripiprazole.

Objective: These cases illustrate that a new neuroleptic, aripiprazole, may be an effective treatment for the motor and vocal tics of Tourette Syndrome (TS), even in younger people.

Method: A case series of 11 consecutive patients with TS (age range 7-50 years; M = 7) who were felt to require neuroleptic medication, were treated with aripiprazole, the majority of whom had been refractory to treatment with other neuroleptics, and in one case, Habit Reversal Training as well.

Results: Ten out of the 11 patients who were treated with aripiprazole improved, although to differing degrees.