Perceived mental health literacy as a mediator between cognitive behavioural therapy (CBT) and depressive symptoms: a secondary data analysis of CoBalT trial data.

Cognitive behavioural therapy (CBT) is an effective treatment for depression, but little is known about mediators of treatment response. Undertaking a secondary analysis of CoBalT trial data (CBT for treatment-resistant depression), we examined: (1) whether perceived mental health literacy (PMHL) at 6-months mediates CBT effect on depressive symptoms at 12-months; and (2) whether PMHL is an independent mediator after accounting for dysfunctional attitudes (DA) and metacognitive awareness (MA). Linear regression models were fitted between treatment allocation and outcome, analysing the impact of PMHL, DA, and MA.

Predicting risk of psychosis in primary care: a qualitative study.

Background P Risk is a new tool which aims to help GPs identify people at risk of developing psychosis using electronic health record data of nonpsychotic symptom consultations, medications and sociodemographic factors. Aim To explore clinicians' and patients' views of the acceptability and usefulness of using P Risk in primary care. Design and setting Semi-structured interviews with GPs, Early Intervention (EI) team clinicians and patients from Bristol and London area.

Application of the METRICS Framework to Build Programs of Healthcare Simulation Research.

The evidence base supporting the adoption of simulation in health care has not kept pace with the rapid growth of the field. Although there is a growing body of research in health care simulation, many published studies describe small-scaled, underpowered projects with insufficient methodological rigor to inform our understanding of simulation. This problem is indicative of a larger challenge: the lack of focused, cohesive programs of research designed to advance the science of simulation.

The dominant-egalitarian transition in species-rich communities.

Diverse communities of competing species are generally characterized by substantial niche overlap and strongly stochastic dynamics. Abundance fluctuations are proportional to population size, so the dynamics of rare populations is slower. Hence, once a population becomes rare, its abundance gets stuck at low values.

Pramipexole augmentation for the acute phase of treatment-resistant, unipolar depression: a placebo-controlled, double-blind, randomised trial in the UK.

Background: About 30% of patients with depression treated with antidepressant medication do not respond sufficiently to the first agents used. Pramipexole might usefully augment antidepressant medication in such cases of treatment-resistant depression, but data on its effects and tolerability are scarce. We aimed to assess the efficacy and tolerability of pramipexole augmentation of ongoing antidepressant treatment, over 48 weeks, in patients with treatment-resistant depression.

Mental health consultations during the perimenopausal age range - Are GPs and patients on the same page?: A qualitative study.

Background There is an increased risk of mood changes in perimenopause. There is evidence that patients and General Practitioners (GPs) may overlook this association and that there is a lack of confidence in managing such perimenopausal symptoms. Aim This study aimed to explore the experiences of clinical consultations in 1) patients in the perimenopausal age range presenting with mental health symptoms, and 2) GPs providing care to patients with mental health symptoms in the perimenopausal age range.

Primary care practitioners' and patients' views on the benefits and challenges of remote consulting for anxiety and depression in UK general practice: a qualitative interview study.

Objective: To explore primary care patients' and practitioners' views and experiences of remote consulting for common mental disorders (CMDs), to optimise their management in primary care.

Design: Qualitative study using in-depth interviews and thematic analysis. A topic guide was used to ensure consistency across interviews.

Standards for Point-of-care Ultrasound Research Reporting (SPUR): A modified Delphi to develop a framework for reporting point-of-care ultrasound research.

Background: Point-of-care ultrasound (POCUS) is a bedside diagnostic modality that depends on technical, operator-specific, patient-specific, and clinical context factors. Existing research reporting guidelines do not explicitly address these considerations as they pertain to replicability and generalizability of POCUS studies. The objective of this study was to create a framework to assist investigators, reviewers, and clinicians in reporting and evaluating the quality of POCUS research.

Solutions of first-passage time problems: A biscaling approach.

We study the first-passage time (FPT) problem for widespread recurrent processes in confined though large systems and present a comprehensive framework for characterizing the FPT distribution over many timescales. We find that the FPT statistics can be described by two scaling functions: one corresponds to the solution for an infinite system, and the other describes a scaling that depends on system size. We find a universal scaling relationship for the FPT moments 〈t^{q}〉 with respect to the domain size and the source-target distance.

Clinical and cost-effectiveness of lithium versus quetiapine augmentation for treatment-resistant depression in adults: LQD a pragmatic randomised controlled trial.

Background: Lithium and several atypical antipsychotics are the recommended first-line augmentation options for treatment-resistant depression; however, few studies have compared them directly, and none for longer than 8 weeks. Consequently, there is little evidence-based guidance for clinicians when choosing an augmentation option for patients with treatment-resistant depression.

Objectives: This trial examined whether it is more clinically and cost-effective to prescribe lithium or quetiapine augmentation therapy for patients with treatment-resistant depression over 12 months.

Interaction network structures in competitive ecosystems.

We present a numerical analysis of local community assembly through weak migration from a regional species pool. At equilibrium, the local community consists of a subset ("clique") of species from the regional community. Our analysis, based on numerical integration of the generalized Lotka-Volterra equations, reveals that the interaction networks of these cliques exhibit nontrivial architectures.

First Passage Times in Compact Domains Exhibit Biscaling.

The study of first passage time for diffusing particles reaching target states is foundational in various practical applications, including diffusion-controlled reactions. In large systems, first passage times statistics exhibit a biscaling behavior, challenging the use of a single timescale. In this work, we present a biscaling theory for the probability density function of first passage times in confined compact processes, applicable to both Euclidean and fractal domains and for diverse geometries.

Prospective Observational Study of Emergency Department Point-of-Care Ultrasound to Differentiate Between Complicated and Uncomplicated Appendicitis.

Objectives: Acute appendicitis is a common surgical emergency in children. Prior radiology studies have described Puylaert staging on ultrasound to determine the severity of appendicitis. We investigated the feasibility and utility of assessing Puylaert staging on emergency department (ED) point-of-care ultrasound (POCUS) to differentiate uncomplicated from complicated appendicitis in children.

Clinical and cost-effectiveness of lithium versus quetiapine augmentation for treatment-resistant depression: a pragmatic, open-label, parallel-group, randomised controlled superiority trial in the UK.

Background: Lithium and quetiapine are first-line augmentation options for treatment-resistant depression; however, few studies have compared them directly, and none for longer than 8 weeks. We aimed to assess whether quetiapine augmentation therapy is more clinically effective and cost-effective than lithium for patients with treatment-resistant depression over 12 months.

Methods: We did this pragmatic, open-label, parallel-group, randomised controlled superiority trial at six National Health Service trusts in England.

intEgrating Smoking Cessation treatment As part of usual Psychological care for dEpression and anxiety (ESCAPE): A randomised and controlled, multi-centre, acceptability and feasibility trial with nested qualitative methods.

Background And Aim: There is evidence that smoking cessation may improve depression and anxiety symptoms. We assessed the feasibility of implementing and trialling a smoking cessation intervention in services providing cognitive behavioural therapy (CBT) for common mental illness.

Design, Setting And Participants: This study was a pragmatic, two-armed, randomised, multi-centre, acceptability and feasibility trial of a co-designed smoking cessation intervention (ISRCTN99531779) involving United Kingdom National Health Service (NHS)-funded services treating depression or anxiety among four NHS Trusts.

Pediatric Difficult Intravenous Access Scores in a Low-Resource Setting: An External Validation Study.

Objectives: This study aims to establish and evaluate validity data for pediatric difficult intravenous access (DIVA) scores in low-resource emergency care settings within low- to middle-income countries (LMIC). We also sought to explore associated factors for DIVA that could contribute to a modified pediatric DIVA score with optimal performance in our setting.

Methods: We performed a prospective cross-sectional study in children aged 0 to 15 years who required urgent or emergent peripheral intravenous access (PIVA) over a 10-month period in a large university hospital in Bangkok, Thailand.

Patients' reasons for declining a primary care trial online therapy: a mixed-methods study.

Background: Integrating therapist-led sessions and cognitive behavioural therapy (CBT) materials within one online platform may be effective for people with depression. A trial evaluating this mode of delivering CBT is being conducted. To maximise future trial recruitment and understand patients' views of health interventions, it is important to explore reasons for declining to participate.

Maternal perinatal anxiety and infant primary care use in 1998-2016: a UK cohort study.

Background: There is some evidence that perinatal anxiety (PNA) is associated with lower rates of infant vaccinations and decreased access to preventative infant healthcare, but results across studies have not been conclusive.

Objective: To investigate the relationship between maternal PNA and infant primary care use.

Methods: Cohort study of mother-infant pairs identified between 1998 and 2016 using IQVIA Medical Research Database (IMRD).

Effectiveness and cost-effectiveness of guided self-help for depression for autistic adults: the Autism Depression Trial (ADEPT-2) - protocol for a multicentre, randomised controlled trial of a remotely delivered low-intensity intervention.

Introduction: Depression is three to four times more prevalent in autistic people and is related to reduced quality of life. There is a need for empirically supported psychological interventions for depression specifically adapted to meet the needs of autistic adults. ADEPT-2 aims to establish the clinical and cost-effectiveness of an adapted low-intensity psychological intervention (guided self-help) for depression in autistic adults.

Identifying priorities for future research on reducing and stopping psychiatric medication: results of a James Lind Alliance priority-setting partnership.

Objective: The objective of this study is to identify the top 10 research priorities on reducing and stopping psychiatric medication that reflect the perspectives and unmet needs of three key stakeholder groups (people with lived experience, family members/carers/supporters and healthcare professionals).

Methods: A priority-setting partnership was conducted using the James Lind Alliance's seven-step process. This involved (1) creating an international Steering Group of key stakeholder representatives and (2) identifying potential partners; (3) gathering stakeholders' uncertainties about reducing and stopping psychiatric medication using an online survey and summarising the survey responses; (4) checking the summary questions against existing evidence and verifying uncertainties; (5) shortlisting the questions using a second online survey; (6) determining the top 10 research questions through a prioritisation workshop; and (7) disseminating the results.

The CO-produced Psychosocial INtervention delivered by GPs to young people after self-harm (COPING): protocol for a feasibility study.

Background: Self-harm in young people is a growing concern and reducing rates a global priority. Rates of self-harm documented in general practice have been increasing for young people in the UK in the last two decades, especially in 13-16-year-olds. General practitioners (GPs) can intervene early after self-harm but there are no effective treatments presently available.

Beta-blockers for the treatment of anxiety disorders: A systematic review and meta-analysis.

Background: Beta-blocker prescriptions for patients with anxiety increased substantially between 2003 and 2018, yet there is no clinical guidance concerning their use. A previous review of propranolol - a beta-blocker - in the treatment of anxiety concluded there was insufficient evidence to support its use. Additional data have been published in the eight years since that review including some evidence for other beta-blockers.