Midlands Evidence Repository
Not a member yet
9653 research outputs found
Sort by
Opt-out of Stop Smoking Service referral via SMS: a controlled interrupted time series analysis
Full text linkObjectives: To evaluate the impact of opt-out and self-referral (opt-in) invitations to a Stop Smoking Service (SSS) delivered via Short Message Service (SMS) by 14 general practices in Nottinghamshire, United Kingdom, on 28-day self-reported smoking abstinence. Study design: Controlled and uncontrolled Interrupted Time series Analysis (ITSA) with cohort analysis. Methods: A controlled ITSA of 13 practices (N = 145,170) that delivered opt-out invitations to 3,994 patients (59 % men; mean age 42.0 years) and cohort analysis. An uncontrolled ITSA of one practice (N = 19,100) that delivered self-referral invitations to 3,676 patients (56 % men; mean age 43.8 years). Results: Most patients did not opt out (91.7 %; 3,663/3,994), were contactable and confirmed smoking (52.4 %; 1,918/3,659). Of this group 21.7 % (417/1918) booked SSS appointments, and 7.1 % (137/1918) abstained from smoking (29 messages per abstinence). Most abstainers (73 %; 100/137) lived in high deprivation areas (IMD 1/2). Controlled ITSA indicated an immediate level increase of 13.1 in the weekly count of SSS patients who subsequently achieved abstinence (95 % CI: 5.0-21.1; p = 0.002). In the intervention month, 168 patients reported abstinence, 142 more than the pre-intervention mean of 25.6 (95 % prediction interval: 20.1-40.1). Uncontrolled ITSA indicated self-referral invitations did not change the count of SSS patients who became abstinent (0.22 patients per week; 95 % CI: 0.61-1.16; p = 0.601). Conclusion: Proactive invitations to opt-out of SSS referral delivered via SMS by general practices were associated with a substantial increase in self-reported 28-day smoking abstinence. Self-referral invitations were not. The opt-out approach appears low-cost and scalable with potential to impact deprived populations
Characteristics and 12-month outcomes of clinically referred children and young people at risk of bipolar disorder
Full text link/© 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Introduction Bipolar disorder is uncommon in children and young people (CYP), but those at risk are likely to be clinically referred. However, the characteristics and outcomes of CYP at risk of bipolar disorder referred to UK Child and Adolescent Mental Health Services (CAMHS) remain understudied. Methods Participants were 305 CYP aged 11–17 years, with emotional difficulties, referred to CAMHS. CYP and/or parent/carers self-completed the Development and Wellbeing Assessment (DAWBA, including the mania section) at baseline, and follow-up measures at 12 months. Results A computerised algorithm categorised 9 (3.0 %, 95 % CI [1.4 %, 5.5 %]) CYP as ‘possible’, 66 as ‘uncertain’, and 230 as ‘unlikely’ for bipolar disorder, using symptom and impact scores. CYP in the ‘possible’ bipolar disorder subgroup were young (mean age = 13 years) and of high socioeconomic status. These CYP were likely to have their CAMHS referral accepted (89 %) and treatment/intervention offered (67 %) and started (56 %) within 12 months of referral. They had high levels of self-harm thoughts and behaviours at baseline and follow-up. The diagnostic algorithm indicated that they had social phobia, generalised anxiety disorder, and/or depression. A third of them were diagnosed with these disorders or obsessive-compulsive disorder by clinicians within 12 months, but not bipolar disorder. Limitations Our categories of likelihood subgroups were conservative as some participants only had DAWBAs completed by one informant. Subgroups were not compared statistically. Conclusion CYP in the ‘possible’ bipolar disorder subgroup were more likely to receive CAMHS input. They have high self-harm risk. Comorbid emotional disorders among these CYP should be considered.https://www.sciencedirect.com/science/article/pii/S016503272502346
The role of community nurses in rash examination, assessment and management
No full textCommunity nurses play a significant role in the identification, assessment and treatment of rashes and associated skin conditions. It is important for them to be familiar with the location, pattern, appearance and feel of different types of rashes for timely diagnoses and escalation, if required. This article explores the processes of inspection, palpation, diagnostic tools and management strategies relevant to community nursing practice.https://www.magonlinelibrary.com/doi/abs/10.12968/bjcn.2025.007
Course review: Yorkshire clinical courses - essential plastic surgery skills for junior doctors course
No full textCircumspectus Medicinae Course Review: Yorkshire Clinical Courses - Essential Plastic Surgery Skills for Junior Doctors Course Rajananthanan, Asveny MBChB Author Information Annals of Plastic Surgery 96(1):p 7-9, January 2026. | DOI: 10.1097/SAP.0000000000004543 Buy Abstract Plain Language Summary Contemporary medical curricula exhibits substantial gaps in plastic surgery education, with 70 percent of medical students completing their training without formal exposure to the specialty. The Essential Plastic Surgery Skills (EPS) course addresses these educational deficits through simulation-based learning for junior trainees. The 2-day program, conducted at Waterton Park Hotel, Wakefield, attracted a global audience from medical students to general practitioners. Faculty comprised 17 experienced educators providing 1:3 teacher to student ratios with continuous feedback and personalised instruction. Day 1 covered fundamental skills including skin closure, lesion excision, and tendon repair using biological specimens. Day 2 advanced to burns management, skin grafting, flap reconstruction and microsurgical techniques utilising porcine and poultry models. Course evaluation demonstrated adequate simulation equipment with sufficient time allocation for comprehensive skill development. The EPS course bridges the gap between undergraduate and postgraduate surgical training through simulation, addressing practical skill deficits while providing skill acquisition opportunities in a controlled learning environment. The program represents structured experience for those trainees interested in seeking broad plastic surgery exposure or transferable surgical skills.https://journals.lww.com/annalsplasticsurgery/abstract/2026/01000/course_review__yorkshire_clinical_courses__.3.asp
Real-world evaluation of at-home cranial electrotherapy stimulation (CES) for the management of sleep, anxiety, depression, stress, quality of life, and self-efficacy
No full textBackground Direct-to-consumer neuromodulation technologies are transforming how sleep and mood disorders are self-managed outside clinical settings. Cranial electrotherapy stimulation (CES) is a low-intensity, portable intervention with growing accessibility but limited evidence in non-clinical populations and real-life contexts. This naturalistic cohort study investigated the effects of CES on sleep, anxiety, depression, stress, quality of life, and self-efficacy in a real-world, community-based setting. Methods Sixty adults agreed to use the Alpha-Stim AID CES device daily for 21 days (40–60 min/day). Validated self-report measures were completed at baseline, day 21 (end-of-treatment), and day 42 (follow-up). A subsample (n = 27) wore actigraphy devices to monitor objective sleep changes. Results By day 21, sleep quality significantly improved, with 48 % achieving insomnia remission and 50 % a reduction in daytime sleepiness. Actigraphy data corroborated subjective sleep improvements. Anxiety and depression remission rates were 72.3 % and 71.2 %, with improvements maintained three weeks post-intervention. Stress levels decreased, while self-efficacy, wellbeing, and quality of life improved, with moderate to large effect sizes. CES was rated as safe, acceptable, and easy to use: 48 % of participants preferred it over psychotherapy or medication. Discussion CES is a safe, self-administered intervention that benefits sleep, mental health, and quality of life. This study presents the first actigraphy evidence of CES effects on sleep in a diverse, non-clinical population. Findings support a novel framework for accessible, non-pharmacological interventions for sleep and wellbeing with sustained impact at three-week follow-up. Results have significant implications for sleep quality and mental health, especially for populations underserved by traditional healthcare.https://www.sciencedirect.com/science/article/pii/S0165032725023018?via%3Dihu
Safety and efficacy of IL-23 inhibitors in patients with moderate to severe ulcerative colitis: a systematic review and meta-analysis of randomized controlled trials
No full textBackground and objective Targeting the interleukin-23 (IL-23) pathway is an emerging therapeutic strategy for moderate to severe ulcerative colitis (UC). This systematic review and meta-analysis evaluated the efficacy and safety of IL-23 inhibitors for induction and maintenance therapy in UC. Methods A systematic search of PubMed, Cochrane, and Google Scholar was conducted up to May 2025 to identify randomized controlled trials (RCTs) of IL-23 inhibitors (mirikizumab, risankizumab, guselkumab) in UC. Data were analyzed using Review Manager (RevMan 5.4) with a random-effects model. Results Seven RCTs (four induction, three maintenance) including 4203 patients were analyzed. IL-23 inhibitors significantly increased clinical remission during both induction (RR 1.52) and maintenance (RR 1.62). Rates of histo-endoscopic healing were also higher with IL-23 blockade in both induction (RR 2.53) and maintenance (RR 1.81). Importantly, IL-23 inhibitors were associated with a reduced risk of serious adverse events during induction (RR 0.39), with no significant difference observed during maintenance (RR 0.68). Other outcomes, including clinical response and corticosteroid-free remission, also consistently favored IL-23 blockade. Conclusion IL-23 inhibitors provide significant improvements in clinical remission and mucosal healing, with a favorable safety profile, particularly during induction therapy in moderate to severe UC.https://link.springer.com/article/10.1007/s00384-025-05014-
Transcriptomic analysis of plasma small extracellular vesicles identifies potential diagnostic biomarkers for Parkinson's disease dementia
No full text© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)IntroductionBlood-based biomarkers that can aid diagnosis of Parkinson's Disease (PD) dementia (PDD), and predict PDD onset in people with PD are urgently needed. Plasma small extracellular vesicles (SEV) reflect molecular changes in living human brain. Next-generation RNA-sequencing (RNA-Seq) of PDD plasma SEV can advance our understanding of PDD molecular pathology, and identify blood-based biomarkers. Hence, we conducted the first comprehensive transcriptomic analysis of PDD plasma SEV.https://www.prd-journal.com/article/S1353-8020(25)00899-5/fulltex
Video narrative exposure therapy (NET) with children and young people who witnessed domestic violence: A naturalistic single case study series
Full text linkOpen Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.This study investigated the potential effectiveness, feasibility, acceptability, and putative mechanisms of change of Narrative Exposure Therapy (NET) delivered via videoconferencing with young people who witnessed domestic violence. A naturalistic, mixed-method, AB, interventional single case design was used. Five female adolescents aged 13–17 years were recruited from a Child and Adolescent Mental Health Service in the United Kingdom and attended 4–10 video-sessions of the child-friendly NET protocol. Participants completed questionnaires assessing posttraumatic stress symptoms (PTSS), general psychological distress, and trauma memory quality, wore a heart rate (HR) monitor assessing habituation, and were offered a Change Interview. At post-intervention, three participants showed reliable improvement in PTSS, but only one showed clinically significant change. One participant also demonstrated reliable improvement in general psychological distress. Effect size estimates ranged from moderate to very large and indicated change in the desired direction for all but one participant; estimated effects for general psychological distress were more modest. Three participants showed reductions in trauma memory quality, indicating increased integration. Within-session habituation was observed for all participants with available HR data; between-session habituation was also recorded for two of them. The lifeline was mentioned as a helpful aspect of NET, the video delivery was considered both a barrier and a facilitator to engagement, and positive or mixed changes were reported by two participants. Future research with more control and larger samples is needed to answer questions on generality of findings and impact of online delivery; future studies may also include longer follow-up periods and investigate other outcomes.https://link.springer.com/article/10.1007/s40653-024-00681-
Barriers and facilitators to increasing physical activity in medium secure mental health settings: An exploration of staff perceptions
Full text link© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)Purpose: The benefits of physical activity for people with severe mental illness (SMI) is widely recognised but for those in medium secure settings there are additional environmental barriers to being active that have not been fully explored. The aim of this study was to explore the perceived barriers and facilitators from the perspective of staff within the medium secure setting. Method(s): Semi-structured focus groups were conducted with qualified and unqualified staff (n = 24) across two UK medium secure NHS settings. Michie's COM-B framework was used to inform the topic guide and the analysis of the data. Result(s): The opportunities to be active in medium secure settings depend not only on access to facilities but also staff availability and willingness to support such activities. When an individualised approach is taken, and staff are skilled and motivated to support such activities then it is possible for people with SMI in medium secure settings to be physically active. Conclusion(s): People with SMI in secure settings have reduced autonomy to increase their own physical activities but it was suggested that with the appropriate opportunities and the motivation of staff their capability to be active could be enhanced.https://www.sciencedirect.com/science/article/pii/S1755296624000905?via%3Dihu
Bridging the gap: A qualitative study exploring the impact of the involvement of researchers with lived experience on a multisite randomised control trial in the national probation service in England and Wales
Full text linkThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly
cited.
© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.INTRODUCTION: Methodological and ethical arguments support the involvement of individuals with lived experience in research to reduce engagement barriers and ensure those directly affected by studies contribute to knowledge generation. However, there is limited evidence on the impact of including researchers with lived experience of serving a prison or community sentence in clinical trials. This qualitative study aimed to explore the value of involving researchers with lived experience of the criminal justice system as data collectors in the Mentalization for Offending Adult Males (MOAM), a multisite RCT conducted in the National Probation Service in England and Wales. METHODS: Semi-structured interviews were conducted with 30 trial participants and 17 key stakeholders, either in person or via telephone. The interviews were transcribed verbatim and analysed thematically. FINDINGS: Five themes emerged for trial participants and 11 for key stakeholders. For some, lived experience researchers helped overcome engagement barriers by fostering common ground with participants who were serving a prison or community sentence during recruitment. Participants reported that the involvement of lived experience researchers enhanced the study by facilitating knowledge transfer in certain instances. However, their inclusion did not eliminate all barriers and, for some participants, introduced new challenges to engagement. CONCLUSION: Forensic lived experience researchers bridged the gap by fostering trust between data collectors and participants. Future studies should ensure that lived experience researchers receive adequate clinical supervision to support their role. The adopted methodology challenged assumptions about knowledge generation and stereotypes associated with being an ex-offender, benefiting both lived experience and traditional researchers. PATIENT OR PUBLIC CONTRIBUTION: The study was developed in collaboration with User Voice (charity number: 1136047), who contributed to the study's design and conduct. The service user organisation co-designed the interview schedule and directed the protocol for participant payments, emphasising a consistent approach to avoid tokenism and ensure equal recognition of all contributions. The dissemination plan was developed in partnership with individuals with lived experience of the criminal justice system.https://onlinelibrary.wiley.com/doi/10.1111/hex.7016