Recognizing sinonasal cancer in primary care: a matched case-control study using electronic records.

Background: Cancers of the nasopharynx, nasal cavity, and accessory sinuses ("sinonasal") are rare in England, with around 750 patients diagnosed annually. There are no specific National Institute for Health and Care Excellence (NICE) referral guidelines for these cancers and no primary care research published.

Objective: To identify and quantify clinical features of sinonasal cancer in UK primary care patients.

Modifiable risk factors for dementia and dementia risk profiling. A user manual for Brain Health Services-part 2 of 6.

We envisage the development of new Brain Health Services to achieve primary and secondary dementia prevention. These services will complement existing memory clinics by targeting cognitively unimpaired individuals, where the focus is on risk profiling and personalized risk reduction interventions rather than diagnosing and treating late-stage disease. In this article, we review key potentially modifiable risk factors and genetic risk factors and discuss assessment of risk factors as well as additional fluid and imaging biomarkers that may enhance risk profiling.

Behavioral and Neural Signatures of Visual Imagery Vividness Extremes: Aphantasia versus Hyperphantasia.

Although Galton recognized in the 1880s that some individuals lack visual imagery, this phenomenon was mostly neglected over the following century. We recently coined the terms "aphantasia" and "hyperphantasia" to describe visual imagery vividness extremes, unlocking a sustained surge of public interest. Aphantasia is associated with subjective impairment of face recognition and autobiographical memory.

Guideline interval: A new time interval in the diagnostic pathway for symptomatic cancer.

Background: A standard measure of the cancer diagnostic pathway, diagnostic interval, is the time from "first presentation of cancer" to diagnosis. Cancer presentation may be unclear in patients with multimorbidity or non-specific symptoms, signs or test results ("features"). We propose an alternative, guideline interval, with a more certain start date; namely, when the patient first meets suspected-cancer criteria for investigation or referral.

Primary care use by men with symptoms of possible prostate cancer: A multi-method study with an ethnically diverse sample in London.

Objective: The objective of this study is to investigate primary care use by men with recent onset of lower urinary tract symptoms (LUTS) to identify differences in presentation and investigation that may explain ethnic inequality in prostate cancer outcomes.

Methods: This is a multi-method study of men presenting LUTS to primary care. Two hundred seventy-four men completed a self-administered questionnaire, and 23 participated in face-to-face interviews.

Digital technologies to support people living with dementia in the care home setting to engage in meaningful occupations: protocol for a scoping review.

Background: People living with all stages of dementia should have the opportunity to participate in meaningful occupations. For those living in care homes, this may not always occur and residents may spend significant parts of the day unengaged, especially those living with more advanced dementia. Digital technologies are increasingly being used in health care and could provide opportunities for people living with dementia (PLWD) in care homes to engage in meaningful occupations and support care staff to provide these activities.

Methodology of exercise resources development for professionals providing services for people with Parkinson's: a technical report.

The complexity of motor and non-motor symptoms seen in Parkinson's, with their variability and progressive nature, have a significant and potentially detrimental effect on mobility and subsequent quality of life for those with the condition. A considerable body of evidence now exists advocating the positive value of physical activity and exercise on both the motor and non-motor symptoms of Parkinson's, whilst limiting the impact and effects of the secondary complications. The literature is signposting to early adoption of higher intensity exercise, with reported benefits at a neurophysiological level, and a potential to influence a diminution in the rate of progression of the condition.

A modified Delphi study to develop a practical guide for selecting patients with prostate cancer for active surveillance.

Background: Active surveillance (AS) is a management option for men diagnosed with lower risk prostate cancer. There is wide variation in all aspects of AS internationally, from patient selection to investigations and follow-up intervals, and a lack of clear evidence on the optimal approach to AS. This study aimed to provide guidance for clinicians from an international panel of prostate cancer experts.

Electroconvulsive therapy related autobiographical amnesia: a review and case report.

While short-term cognitive impairment following electroconvulsive therapy (ECT) is well described and acknowledged, the relationship between ECT and persistent memory impairment, particularly of autobiographical memory, has been controversial. We describe the case of a 70-year-old consultant neurophysiologist, AW, who developed prominent, selective autobiographical memory loss following two courses of ECT for treatment-resistant depression. His performance on standard measures of IQ, semantic and episodic memory, executive function and mood was normal, while he performed significantly below controls on measures of episodic autobiographical memory.

Association of non-malignant diseases with thrombocytosis: a prospective cohort study in general practice.

Background: Thrombocytosis is an excess of platelets, which is diagnosed as a platelet count >400 × 10/l. An association of thrombocytosis with undiagnosed cancer has recently been established, but the association with non-malignant disease has not been studied in primary care.

Aim: To examine, in English primary care, the 1-year incidence of non-malignant diseases in patients with new thrombocytosis and the incidence of pre-existing non-malignant diseases in patients who develop new thrombocytosis.

Economic evaluation of GPs' direct access to computed tomography for identification of brain tumours.

Background: When GPs suspect a brain tumour, a referral for specialist assessment and subsequent brain imaging is generally the first option. NICE has recommended that GPs have rapid direct access to brain imaging for adults with progressive sub-acute loss of central nervous function; however, no studies have evaluated the cost-effectiveness.

Methods: We developed a cost-effectiveness model based on data from one region of the UK with direct access computed tomography (DACT), routine data from GP records and the literature, to explore whether unrestricted DACT for patients with suspected brain tumour might be more cost-effective than criteria-based DACT or no DACT.

At what times during infection is SARS-CoV-2 detectable and no longer detectable using RT-PCR-based tests? A systematic review of individual participant data.

Background: Tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral ribonucleic acid (RNA) using reverse transcription polymerase chain reaction (RT-PCR) are pivotal to detecting current coronavirus disease (COVID-19) and duration of detectable virus indicating potential for infectivity.

Methods: We conducted an individual participant data (IPD) systematic review of longitudinal studies of RT-PCR test results in symptomatic SARS-CoV-2. We searched PubMed, LitCOVID, medRxiv, and COVID-19 Living Evidence databases.

An app-, web- and social support-based weight loss intervention for adults with obesity: the 'HelpMeDoIt!' feasibility randomised controlled trial.

Background: Social support has an important role in successful weight loss. The aim of this study was to assess the feasibility and acceptability of an app-, web- and social support-based intervention in supporting adults with obesity to achieve weight loss.

Methods: The intervention and evaluation methods were tested in a feasibility randomised controlled trial.

Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006-17.

Background: UK primary-care referral guidance describes the signs, symptoms, and test results ("features") of undiagnosed cancer. Guidance revision in 2015 liberalised investigation by introducing more low-risk features. We studied adults with cancer whose features were in the 2005 guidance ("Old-NICE") or were introduced in the revision ("New-NICE").

Phantasia-The psychological significance of lifelong visual imagery vividness extremes.

Visual imagery typically enables us to see absent items in the mind's eye. It plays a role in memory, day-dreaming and creativity. Since coining the terms aphantasia and hyperphantasia to describe the absence and abundance of visual imagery, we have been contacted by many thousands of people with extreme imagery abilities.

Identifying policies and strategies for general practitioner retention in direct patient care in the United Kingdom: a RAND/UCLA appropriateness method panel study.

Background: The United Kingdom (UK) is experiencing a general practitioner (GP) workforce retention crisis. Research has focused on investigating why GPs intend to quit, but less is known about the acceptability and effectiveness of policies and strategies to improve GP retention. Using evidence from research and key stakeholder organisations, we generated a set of potential policies and strategies aimed at maximising GP retention and tested their appropriateness for implementation by systematically consulting with GPs.

Navigating the maze: Qualitative research methodologies and their philosophical foundations.

Objectives: One of the three objectives of the Society and College of Radiographers is the promotion and dissemination of research in radiography and radiotherapy. This article aims to assist in the production of high standard research by explaining how transparency in reporting the underpinning philosophical basis of a qualitative study can be achieved in addition to the more customary descriptions of how data were collected and analysed.

Key Findings: Unlike their quantitative equivalent, qualitative research methodologies are less well understood and reported in radiography research, in particular the philosophical and epistemological assumptions which underpin the methods used.

Emotional disorder and absence from school: findings from the 2004 British Child and Adolescent Mental Health Survey.

Emotional disorder may be associated with absence from school, but the existing evidence is methodologically weak. We studied the relationships between anxiety, depression and emotional difficulties, and school absence (total, authorised and unauthorised) using data from the 2004 British Child and Adolescent Mental Health Survey (BCAMHS). The BCAMHS was a cross-sectional, community survey of 7977 5- to 16-year-olds.

The agreement between the referrer, practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services.

We aimed to explore the levels of agreement about the diagnoses of Autistic Spectrum Conditions between the referrer, CAMHS practitioner and a research diagnosis, as well as the stability of the practitioner's diagnosis over time in a secondary analysis of data from 302 children attending two Child and Adolescent Mental Health Services over two years. Kappa coefficient was used to assess the agreement between the referrer and research diagnosis. Kendall's tau b coefficient was used to assess the agreement between the practitioner and the research diagnosis assigned using the Development and Well-Being Assessment, as well as the agreement between the referrer's indication of presenting problems and the practitioner diagnosis.

Modelling spatio-temporal data of dengue fever using generalized additive mixed models.

Epidemiological studies have revealed a complex association between weather and dengue transmission. Our aim is the development of a Spatio-temporal modelling of dengue fever via a Generalized Additive mixed model (GAMM). The structure is based on unknown smoother functions for climatic and a set of non-climatic covariates.

Golimumab in the treatment of ulcerative colitis.

Golimumab was approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of moderate-to-severe ulcerative colitis in 2013 and was the third antitumour-necrosis-factor therapy after adalimumab and infliximab licensed for this indication. However, given it is the most recent of these drugs to become available, evidence regarding its optimal use and its positioning in relation to other biological therapies is only now emerging. In this article, we review the efficacy, effectiveness and safety of golimumab both in the setting of clinical trials and in 'real world' observational studies.