Clinical and cost-effectiveness of first contact physiotherapy for musculoskeletal disorders in primary care: the FRONTIER, mixed method realist evaluation.

Background: First-contact physiotherapists assess and diagnose patients with musculoskeletal disorders, determining the best course of management without prior general practitioner consultation.

Objectives: The primary aim was to determine the clinical and cost-effectiveness of first-contact physiotherapists compared with general practitioner-led models of care.

Design: Mixed-method realist evaluation of effectiveness and costs, comprising three main phases: A United Kingdom-wide survey of first contact physiotherapists.

Structured tailored rehabilitation after hip fragility fracture: The 'Stratify' feasibility and pilot randomised controlled trial protocol.

Background: Rehabilitation in hospital is effective in reducing mortality after hip fracture. However, there is uncertainty over optimal in-hospital rehabilitation treatment ingredients, and the generalizability of trial findings to subgroups of patients systematically excluded from previous trials. The aim of this study is to determine the feasibility of a randomized controlled trial which aims to assess the clinical- and cost-effectiveness of adding a stratified care intervention to usual care designed to improve outcomes of acute rehabilitation for all older adults after hip fracture.

The effects of autistic traits in adolescents on the efficacy of paediatric Intensive Interdisciplinary Pain Treatment (IIPT).

Autistic adolescents are at greater risk of chronic pain, but it is unclear how autistic features may relate to individual aspects of chronic pain. As autism traits exist in the general population as well, it is important to know if autistic traits could impact how effective chronic pain management is for adolescents. Here we examined autistic traits in 112 patients (12-18yrs) recruited from a UK national specialist adolescent pain rehabilitation programme.

Prioritising domains of glucocorticoid therapy to measure in trials: Results from a modified delphi exercise from the OMERACT glucocorticoid impact working group.

Introduction: There is no consensus amongst patients and healthcare professionals about how to measure important adverse effects of glucocorticoids (GCs) that includes the patient's perspective. The OMERACT GC Impact working group sought to identify the domains of greatest importance to both patients and healthcare professionals for use in a proposed core outcome set.

Methods: Patients and healthcare professionals participated in a Delphi consensus exercise to rate the importance of previously identified candidate domains.

Paramedic or GP consultations in primary care: prospective study comparing costs and outcomes.

Background: General Practice faces pressures due to increased demand and a shortage of GPs. Paramedics in General Practice (PGPs), increasingly contribute to managing minor illnesses, conducting home visits, and providing urgent consultations.

Aim: Explore the impact of paramedic-consultations on patient-reported experience, safe management and NHS costs.

Effect of combined Tai Chi and repetitive transcranial magnetic stimulation for sleep disturbance in older adults: A randomized controlled trial.

Background And Aims: Novel approaches to improve sleep disturbance in older adults are needed. Our study comprises a pioneering attempt to test the efficacy of Tai Chi (TC) combined with repetitive transcranial magnetic stimulation (rTMS) in improving sleep disturbance in older adults. The influence of baseline depressive symptoms was tested in a subset of the sample.

Mindfulness-based family psychoeducation intervention for caregivers of young adults with first-episode psychosis: results at 9-month follow-up.

Objectives: To investigate the effects of a mindfulness-based family psychoeducation (MBFPE) intervention on caregivers and the young adults with first-episode psychosis in mental health care.

Methods: Sixty-five caregivers were randomly assigned to the MBFPE program (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32). Eighteen young adults in recovery (YAIR) also participated in the study.

Integration of tai chi and repetitive transcranial magnetic stimulation for sleep disturbances in older adults: A pilot randomized controlled trial.

Background: The arousal state has been demonstrated to be involved in the fundamental pathophysiological mechanism of sleep disturbances. Tai chi (TC) and repetitive transcranial magnetic stimulation (rTMS) have been documented to alleviate sleep disturbances by interfering with different arousal components. It is reasonable to assume that combining TC and rTMS could induce synergistic and longer-lasting benefits for sleep disturbances.

The experiences of patients with musculoskeletal conditions accessing first contact physiotherapy practitioner appointments in general practice in the UK: A qualitative study.

Background: First Contact Physiotherapy Practitioners (FCPPs) provide expert care for patients with musculoskeletal (MSK) conditions in General Practice. Access to FCPPs can facilitate timely care and efficient use of health services. However, there is little evidence about patient experiences of accessing FCPP appointments.

A multicentre survey investigating the knowledge, behaviour, and attitudes of surgical healthcare professionals to frailty assessment in emergency surgery: DEFINE(surgery).

Purpose: Screening for frailty in people admitted with emergency surgical pathology can initiate timely referrals to enhanced perioperative services such as intensive care and geriatric medicine. However, there has been little research exploring surgical healthcare professionals' opinions to frailty assessment, or accuracy in identification. This study aimed to assess the knowledge, behaviour, and attitudes of healthcare professionals to frailty assessment in emergency surgical admissions.

First contact physiotherapy: an evaluation of clinical effectiveness and costs.

Background: First contact physiotherapy practitioners (FCPPs) are embedded within general practice, providing expert assessment, diagnosis, and management plans for patients with musculoskeletal disorders (MSKDs), without the prior need for GP consultation.

Aim: To determine the clinical effectiveness and costs of FCPP models compared with GP-led models of care.

Design And Setting: Multiple site case-study design of general practices in the UK.

Improving patients' experiences of diagnosis and treatment of vertebral fracture: co-production of knowledge sharing resources.

Background: Osteoporosis involves changes to bones that makes them prone to fracture. The most common osteoporotic fracture is vertebral, in which one or more spinal vertebrae collapse. People with vertebral fracture are at high risk of further fractures, however around two-thirds remain undiagnosed.

Understanding the impacts of chronic pain on autistic adolescents and effective pain management: a reflexive thematic analysis adolescent-maternal dyadic study.

Objective: Sensory elements are core features in chronic pain and autism, yet knowledge of the pain experience in autistic adolescents is limited. Little is known regarding how autistic adolescents experience chronic pain, manage their pain and perceive psychological treatment for their chronic pain.

Methods: Ten autistic adolescents (6 female, 3 male, and 1 self-identified as agender) with chronic pain and their mothers (n = 10) participated in semistructured interviews concerning their perceptions of living with chronic pain.

Understanding paramedic work in general practice in the UK: a rapid realist synthesis.

Background: General practice in the UK is under substantial pressure and practices are increasingly including paramedics as part of their workforce. Little is known about how different models of paramedic working may affect successful implementation of the role, as viewed from patient, clinician and system perspectives. This realist synthesis developed theories about 'models of paramedic working in general practice' in different UK contexts to understand their impact.

Optimising the implementation of evidence-based osteoarthritis guidelines in primary care: Development of a Knowledge Mobilisation Toolkit.

Objective: Implementing clinical guidelines for osteoarthritis (OA) in primary care is complex. Whilst international guidelines detail what best practice for OA looks like, little is known about how this is best implemented. Limited resources are available to guideline developers, practitioners, researchers, or the public to facilitate implementation.

Challenges and enablers to implementation of the Additional Roles Reimbursement Scheme in primary care: a qualitative study.

Background: The Additional Roles Reimbursement Scheme (ARRS) was set up to recruit 26 000 additional staff into general practice by 2024, with the aim of increasing patient access to appointments. Despite the potential benefits of integrating ARRS practitioners into primary care, their implementation has not always been straightforward.

Aim: To explore the challenges and enablers to implementation of the ARRS including its impact on primary and secondary care systems.

Consensus of the definitions of the OMERACT glucocorticoid impact core domain set for people with rheumatic and musculoskeletal diseases.

Background: The Outcome Measures in Rheumatology (OMERACT) Glucocorticoid (GC) Impact Working Group has been working to develop a core domain set to measure the impact of GCs on patients living with rheumatic and musculoskeletal diseases. The mandatory domains previously identified for inclusion in all clinical trials measuring the GC effects include infection, bone fragility, mood disturbance, hypertension, diabetes, weight, fatigue, and mortality. Before progressing to instrument selection, the Working Group sought to establish precise definitions of all mandatory domains within the core domain set.

From sceptic to believer: Acceptability of cognitive muscular therapy , a new intervention for knee osteoarthritis.

Background: Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT.

Relapse after cessation of weekly tocilizumab for giant cell arteritis: a multicentre service evaluation in England.

Objectives: The National Health Service in England funds 12 months of weekly subcutaneous tocilizumab (qwTCZ) for patients with relapsing or refractory giant cell arteritis (GCA). During the COVID-19 pandemic, some patients were allowed longer treatment. We sought to describe what happened to patients after cessation of qwTCZ.

Patient access to first contact practitioner physiotherapists in the UK: A national survey.

Background: First Contact Practice Physiotherapists (FCPPs) offer expert care for patients with musculoskeletal (MSK) conditions in Primary Care, usually within GP practices. This is a rapidly expanding area of practice endorsed by NHS England, the Chartered Society of Physiotherapy (CSP) and the British Medical Association (BMA). Efficient and appropriate access is important for optimising FCPP practice, but there is little published information about how patients currently access FCPP appointments.

Systematic co-development and testing of a digital behaviour change intervention for osteoarthritis and physical activity: Theoretical mapping and acceptability study.

Objective: Osteoarthritis (OA) affects 8.75 million people in the UK. Physical activity (PA) is recommended as a core treatment, yet nearly half of people with OA are inactive.

Is there a role for citizen science in death and dying research?

The COVID-19 pandemic has brought conversations about death and dying to the fore in a way not experienced for generations. This raises questions around perceptions of death and dying; the role of healthcare and the community in care; and the use of digital media for information and support. Public engagement can provoke a two-way conversation between researchers and the public and includes techniques that can engage the community not only with the topic but also in research.