71 results match your criteria: "Kings Cross Hospital[Affiliation]"

Background: Supported self-management (SSM) for asthma reduces the risk of asthma attacks and improves asthma control and quality of life. SSM optimally includes patient-centred communication and behaviour change support, however, the extent to which this occurs in routine primary care is unclear. This project was nested within the IMPlementing IMProved Asthma self-management as RouTine (IMPART) programme; a UK-wide trial evaluating an implementation strategy (including healthcare professional (HCP) training on behaviour change strategies and patient-centred care) to improve support for asthma self-management.

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Meeting the World Health Organisation 2030 target of treating 80% of people with hepatitis C virus (HCV) in Australia requires accessible testing and treatment services for at-risk populations. Previous clinical trials, including those in Australia, have demonstrated the efficacy of outreach programmes to community pharmacies offering opioid agonist therapy (OAT). This analysis evaluates the potential cost-effectiveness of introducing an outreach programme in community pharmacies.

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Background: Bacteriophage (phage) therapy is a promising alternative antimicrobial approach that has the potential to transform the way we treat bacterial infections. The antibiotic resistance crisis is driving renewed interest in phage therapy. There are currently no licensed phage therapy medicinal products and phage therapy is used in small but growing patient numbers on an unlicensed basis.

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Background: Globally, non-fatal overdose (NFOD) rates consequent to drug use, typically opioids, continue increasing at a startling rate. Existing quantitative research has revealed myriad factors and characteristics linked to experiencing NFOD, but it is critically important to explore the lived context underlying these associations. In this qualitative study, we sought to understand the experiences of NFOD among people who use drugs in a Scottish region in order to: enhance public policy responses; inform potential intervention development to mitigate risk; and contribute to the literature documenting the lived experience of NFOD.

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Objective: Consensus guidelines on the optimal management of infected arterial pseudoaneurysms secondary to groin injecting drug use are lacking. This pathology is a problem in the UK and globally, yet operative management options remain contentious. This study was designed to establish consensus to promote better management of these patients, drawing on the expert experience of those in a location with a high prevalence of illicit drug use.

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Background And Aims: Metabolic dysfunction associated steatotic liver disease (MASLD) increases the risk of incident chronic kidney disease (CKD). However, the relative risk of CKD associated with increasing hepatic fibrosis, and consequent mortality risk, remains underexplored in real-world cohorts. In this study, we sought to establish whether hepatic fibrosis is associated with increased CKD risk and explore differences in mortality risk in a cohort of people living with MASLD, contingent on liver fibrosis and CKD status.

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Background And Aims: Psychological and social status, and environmental context, may mediate the likelihood of experiencing overdose subsequent to illicit drug use. The aim of this systematic review was to identify and synthesise psychosocial factors associated with overdose among people who use drugs.

Methods: This review was registered on Prospero (CRD42021242495).

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Optimal ALT threshold for the automated diagnosis of MASLD: A population-based study using iLFT.

Ann Hepatol

March 2024

Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK; Department of Gastroenterology, NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK.

Introduction And Objectives: Early diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD), especially with advanced fibrosis, is crucial due to the increased risk of complications and mortality. Serum alanine aminotransferase (ALT) is commonly used; however, many patients have normal ranges (<55 U/L) who may remain undetected. We investigated the clinical implications of a lower ALT cut-off (>30 U/L) using intelligent liver function testing (iLFT) to identify MASLD patients with and without advanced fibrosis in primary care.

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New approaches to managing infections in cardiac and peripheral vascular surgery are required to reduce costs to patients and healthcare providers. Bacteriophage (phage) therapy is a promising antimicrobial approach that has been recommended for consideration in antibiotic refractory cases. We systematically reviewed the clinical evidence for phage therapy in vascular surgery to support the unlicensed use of phage therapy and inform future research.

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Introduction: There is an emerging need for plant-based, vegan options for patients requiring nutritional support.

Methods: Twenty-four adults at risk of malnutrition (age: 59 years (SD 18); Sex: 18 female, 6 male; BMI: 19.0 kg/m (SD 3.

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Bacterial resistance or tolerance to antibiotics is costly to patients and healthcare providers. With the impact of antibiotic resistance forecast to grow, alternative antimicrobial approaches are needed to help treat patients with antibiotic refractory infections and reduce reliance upon existing antibiotics. There is renewed interest in bacteriophage (phage) therapy as a promising antimicrobial strategy.

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A multicomponent holistic care pathway for people who use drugs in Tayside, Scotland.

Int J Drug Policy

October 2023

Division of Molecular and Clinical Medicine, University of Dundee, Dundee, Scotland; Department of Gastroenterology, Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland.

Background: People Who Use Drugs (PWUD) are at high risk of non-fatal overdose and other drug-related harms. The United Kingdom drugs policy landscape makes it challenging to support those at risk. Tayside, in East Scotland, has a sizeable population at risk of drug-related harms.

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Managing Patient and Clinician Expectations of Phage Therapy in the United Kingdom.

Antibiotics (Basel)

March 2023

Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children, 1345 Govan Road, Glasgow G51 4TF, UK.

Bacteriophage (phage) therapy is a promising alternative antimicrobial approach which has the potential to transform the way we treat bacterial infections. Phage therapy is currently being used on a compassionate basis in multiple countries. Therefore, if a patient has an antibiotic refractory infection, they may expect their clinician to consider and access phage therapy with the hope of improvement.

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Background: Hepatitis C Virus (HCV) is a public health threat which contributes substantially to the global burden of liver disease. There is much debate about effective approaches to scaling up diagnosis of HCV among risk groups. Tayside, a region in the East of Scotland, developed low-threshold community pathways for HCV to lay the foundations of an elimination strategy.

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The risk of Hepatitis C Virus (HCV) acquisition among People Who Inject Drugs (PWID) remains high when injecting risk behavior within networks endures. Several psychosocial factors influence such behavior. Following a drive within Tayside, a geographic region in Scotland, to achieve World Health Organization HCV elimination targets, addressing HCV re-infection risk as a barrier to elimination is critically important.

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The Safety and Efficacy of Phage Therapy: A Systematic Review of Clinical and Safety Trials.

Antibiotics (Basel)

September 2022

Infection Medicine, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.

Trials of phage therapy have not consistently reported efficacy. This contrasts with promising efficacy rates from a sizeable and compelling body of observational literature. This systematic review explores the reasons why many phage trials have not demonstrated efficacy.

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Reaching people receiving opioid agonist therapy at community pharmacies with hepatitis C virus: an international randomised controlled trial.

Aliment Pharmacol Ther

June 2022

Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.

Background: Conventional healthcare models struggle to engage those at risk of hepatitis C virus (HCV) infection. This international study evaluated point-of-care (PoC) HCV RNA diagnostic outreach and direct-acting antiviral (DAA) treatment for individuals receiving opioid agonist therapy (OAT) in community pharmacies.

Aims: We assessed the effectiveness of a roving nurse-led pathway offering PoC HCV RNA testing to OAT clients in community pharmacies relative to conventional care.

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Authors, peer reviewers, and readers: What is expected from each player in collaborative publishing?

Pharm Pract (Granada)

January 2021

PhD, MPharm, MBA. Editor-in-chief, Pharmacy Practice. Center for Health Technology and Services Research (CINTESIS), Laboratory of Pharmacology, Faculty of Pharmacy, University of Porto . Porto ( Portugal ).

Scholarly publishing is in a crisis, with the many stakeholders complaining about different aspects of the system. Authors want fast publication times, high visibility and publications in high-impact journals. Readers want freely accessible, high-quality articles.

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Effectiveness of the use of implementation intentions on reduction of substance use: A meta-analysis.

Drug Alcohol Depend

September 2020

Adult Psychological Therapies Service, NHS Tayside, 15 Dudhope Terrace, Dundee, DD3 6HH, United Kingdom; Faculty of Natural Sciences (Psychology), University of Stirling, Stirling, FK9 4LA, United Kingdom.

Objective: Background: Substance use, such as alcohol drinking, tobacco smoking and illicit drug use, have been associated with severe health conditions and an annual estimated 12 % of all deaths worldwide. Implementation intentions are self-regulatory processes which help achieve health-related behaviour change.

Objectives: To investigate the effectiveness of forming implementation intentions to reduce substance use.

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Background: Highly effective direct-acting antiviral drugs provide the opportunity to eliminate hepatitis C virus (HCV) infection, but established pathways can be ineffective. We aimed to examine whether a community pharmacy care pathway increased treatment uptake, treatment completion, and cure rates for people receiving opioid substitution therapy, compared with conventional care.

Methods: This cluster-randomised trial was done in Scottish community pharmacies.

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There is emerging evidence that Hepatitis C (HCV) treatment engagement is associated with change in drug behaviours and reduced drug-related death rates among people who inject drugs (PWID). The project aims to investigate whether HCV diagnosis and treatment engagement reduces all-cause mortality and drug-related death, and whether any effect is dependent on treatment regimen and intensity of engagement with staff. Case-control studies comparing: PWID with active HCV infection (PCR positive) to PWID HCV infected but spontaneously resolved (PCR negative); PCR-positive patients who engaged with treatment services to nonengagers; and patients who received interferon vs direct-acting antiviral (DAA) based treatment.

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Article Synopsis
  • - The study aimed to determine the effectiveness of flexible sigmoidoscopy as an addition to traditional faecal occult blood test (FOBT) screening for colorectal cancer in individuals around age 60.
  • - Conducted in Scotland with over 51,000 participants, the trial found that flexible sigmoidoscopy had a low uptake (17.8%), with higher rates in men and less in more deprived areas; however, it did detect more neoplasia compared to FOBT alone.
  • - Results showed no difference in overall colorectal cancer detection between the two groups, but flexible sigmoidoscopy did significantly increase adenoma and total neoplasia detection rates, indicating it may be a beneficial complementary screening method.
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Background: Direct Acting Antiviral (DAAs) drugs have a much lower burden of treatment and monitoring requirements than regimens containing interferon and ribavirin, and a much higher efficacy in treating hepatitis C (HCV). These characteristics mean that initiating treatment and obtaining a virological cure (Sustained Viral response, SVR) on completion of treatment, in non-specialist environments should be feasible. We investigated the English-language literature evaluating community and primary care-based pathways using DAAs to treat HCV infection.

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Interventions to Treat Erectile Dysfunction and Premature Ejaculation: An Overview of Systematic Reviews.

Sex Med

September 2019

Sexual Health and Blood Borne Virus Managed Care Network, Public Health Directory, NHS Tayside, Kings Cross Hospital, Dundee, United Kingdom.

Introduction: Sexual dysfunction in men is common, and optimal treatment is complex. Although several systematic reviews concerning treatment approaches exist, a comprehensive overview without limitations concerning the population, interventions, or outcomes is lacking.

Aim: To conduct a "review of reviews" to compare the effectiveness of pharmacologic, non-pharmacologic, and combined interventions.

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Impact of Hepatitis C treatment on behavioural change in relation to drug use in people who inject drugs: A systematic review.

Int J Drug Policy

October 2019

School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom; Department of Gastroenterology, NHS Tayside, Ninewells Hospital, Dundee, Scotland, United Kingdom.

Background: A systematic review was conducted to determine the impact of Hepatitis C (HCV) treatment on substance use behaviour in people who inject drugs (PWID).

Methods: A search for peer reviewed journal articles from 1991 to present day was conducted using the following databases: PubMed, EMBASE, CINAHL and PsycINFO. Studies were appraised against the following inclusion criteria: recruitment of PWID for HCV treatment (either interferon alpha or direct acting antivirals based); measurement of behavioural change in relation to drug use; studies published in English.

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