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A variety of terms, such as "antiepileptic," "anticonvulsant," and "antiseizure" have been historically applied to medications for the treatment of seizure disorders. Terminology is important because using terms that do not accurately reflect the action of specific treatments may result in a misunderstanding of their effects and inappropriate use. The present International League Against Epilepsy (ILAE) position paper used a Delphi approach to develop recommendations on English‐language terminology applicable to pharmacological agents currently approved for treating seizure disorders. There was consensus that these medications should be collectively named "antiseizure medications". This term accurately reflects their primarily symptomatic effect against seizures and reduces the possibility of health care practitioners, patients, or caregivers having undue expectations or an incorrect understanding of the real action of these medications. The term "antiseizure" to describe these agents does not exclude the possibility of beneficial effects on the course of the disease and comorbidities that result from the downstream effects of seizures, whenever these beneficial effects can be explained solely by the suppression of seizure activity. It is acknowledged that other treatments, mostly under development, can exert direct favorable actions on the underlying disease or its progression, by having "antiepileptogenic" or "disease‐modifying" effects. A more‐refined terminology to describe precisely these actions needs to be developed. [ABSTRACT FROM AUTHOR]

Older people are often affected by impaired organ and bodily functions resulting in multimorbidity and polypharmacy, turning them into the main user group of many medicines. Very often, medicines have not specifically been developed for older people, causing practical medication problems for them like limited availability of easy to swallow formulations, easy to open packaging and dosing instructions for enteral administration. In 2020, the European Medicines Agency (EMA) published a reflection paper 'Pharmaceutical development of medicines for use in the older population', which discusses how the emerging needs of an ageing European population can be addressed by medicines regulation. The paper intends to help industry to better consider the needs of older people during pharmaceutical/clinical medicines development by summarising data on the most relevant topics, providing early suggestions on how to move forward and prompting expert discussions and studies into knowledge gaps. Topics include patient acceptability, (dis)advantages of an administration route, formulation, dosage form, packaging, dosing device and user instruction. While the paper is directed at older people and the pharmaceutical industry, the reflections are also relevant to younger patients with similar disease‐related needs and of value to other stakeholders parties, e.g., healthcare professionals, academics, patients and caregivers, as the paper makes clear what can be expected from industry and where collaborative work is needed. This commentary provides an overview of the different steps in the development of the reflection paper, discusses points considered most controversial and/or subject to (multidisciplinary) expert discussions and indicates their value for real world clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The Patient Information Leaflet (PIL) is an authoritative document that all people with epilepsy in the EU receive when prescribed antiseizure medication (ASM). We undertook the first independent, comprehensive assessment to determine how understandable they are. Regulators state that when patients are asked comprehension questions about them, ≥80% should answer correctly. Also, recommended is that PILs have a maximum reading requirement of US grade 8. Methods: Study 1: We obtained 140 current ASM PILs written in English. "Readability" was assessed using four tests, with and without adjustment for influence of familiar, polysyllabic words. A total of 179 online materials on epilepsy were also assessed. Study 2: Two PILs from Study 1 were randomly selected (Pregabalin Focus; Inovelon) and shown to 35 people from the UK epilepsy population. Their comprehension was assessed. Study 3: To understand whether the student population provides an accessible alternative population for future examination of ASM PILs, Study 3 was completed, using the same methods as Study 2, except that participants were 262 UK university students. Results: Study 1: No PIL had a reading level of grade 8. Median was grade 11. Adjusting for context, the PILs were still at grade 10.5. PILs for branded ASMs were most readable. PILs were no more readable than (unregulated) online materials. Study 2: Users struggled to comprehend the PILs' key messages. The eight questions asked about pregabalin were typically answered correctly by 54%. For Inovelon, it was 62%. Study 3: Most student participants comprehended the PILs' key messages. The questions about Inovelon were answered correctly by 90%; for pregabalin it was 86%. Significance: This is the first independent and comprehensive examination of ASM PILs. It found that PILs being used fail to meet recommendations and regulatory requirements and risk not being understandable to a substantial proportion of users. In finding that people from the epilepsy population differ markedly in comprehension of PILs compared to students, this study highlights the importance of completing user testing with the target population. [ABSTRACT FROM AUTHOR]

The benefit of using the adapters as opposed to patient self-reporting of medication use is objective monitoring of patient adherence to their assigned medication protocol. Keywords: dermatology; electronic monitoring; medication adherence; topical medication EN dermatology electronic monitoring medication adherence topical medication 371 373 3 03/25/22 20220301 NES 220301 INTRODUCTION Medication nonadherence is associated with increased disease severity and poor disease outcomes. [Extracted from the article]

Objective: Although Ireland has one of the highest levels of well‐being in Europe, having a health condition has been found to have a direct negative impact. The aim of this study is to evaluate the current situation and the experiences of patients with epidermolysis bullosa (EB), a rare genetic skin disease, and their relatives living in Ireland, with a focus on burdens and helpful practices. Methods and Measures: In a mixed‐methods design, a series of standardised questionnaires were combined with open‐ended questions. Via an online survey, data from n = 59 EB patients and relatives of EB patients living in Ireland were collected. Results: EB affects both the patients and their relatives. Burdens were found in relation to the visibility of EB, the degree of severity, the current health status, reduced mobility, the financial impact of EB, the psychosocial impact and personal and social resources. The paper also analyses existing resources and highlights opportunities for support and needs of improvement. Conclusion: Quality of life with EB is influenced by somatic symptoms and the psychosocial burden. Individual helpful practices in dealing with this rare disease can be considered as mediators, but they need to be supported by structural and healthcare improvements. Patient or Public Contribution: The perspective of EB patients, their relatives and EB experts were taken into account in the development of the study design via two feedback loops with the EB patient organisations DEBRA Ireland and DEBRA Austria. The design was adapted accordingly. Additionally, by including open‐ended questions, patients and relatives could contribute their individual perspectives and add insights into their lives with EB that might not have been captured with the structured online survey alone. [ABSTRACT FROM AUTHOR]

Microsampling has revolutionized pharmaceutical drug development and clinical research by reducing sample volume requirements, allowing sample collection at home or nontraditional sites, minimizing animal and patient burden, and enabling more flexible study designs. This perspective paper discusses the transformative impact of microsampling and patient‐centric sampling (PCS) techniques, emphasizing their advantages in drug development and clinical trials. We highlight the integration of liquid chromatography‐mass spectrometry (LC–MS) strategies for analyzing PCS samples, focusing on our research experience and a review of current literatures. The paper reviews commercially available PCS devices, their regulatory status, and their application in clinical trials, underscoring the benefits of PCS in expanding patient enrollment diversity and improving study designs. We also address the operational challenges of implementing PCS, including the need for bridging studies to ensure data comparability between traditional and microsampling methods, and the analytical challenges posed by PCS samples. The paper proposes future directions for PCS, including the development of global regulatory standards, technological advancements to enhance user experience, the increased concern of sustainability and patient data privacy, and the integration of PCS with other technologies for improved performance in drug development and clinical studies. By advancing microsampling and PCS techniques, we aim to foster patient‐centric approaches in pharmaceutical sciences, ultimately enhancing patient care and treatment efficacy. [ABSTRACT FROM AUTHOR]

Medication abortion with pills (mifepristone and misoprostol) challenges the spatiality of abortion provision because it creates the possibility for safe, self‐managed abortion outside of clinical infrastructure. This possibility has been contested by pro‐ and anti‐abortion actors for as long as medication abortion has been in existence. In this paper, I offer a legal geography account of medication abortion technology that examines how medication abortion has been regulated in the United States. Conceptually, the paper uses a legal geography methodology to probe the social spatialities that abortion laws construct. Empirically, the paper analyses trends in legislation to restrict medication abortion and two significant court challenges where abortion providers brought suit against medication abortion restrictions. Drawing on legislation and litigation over mifepristone, I demonstrate that restrictions on it function by anchoring mifepristone inside the clinical spaces and regulatory frameworks established for surgical abortion. In this way, mifepristone regulations circumscribe its availability in order to prevent the creation of alternative models for abortion provision that could re‐arrange its geography and expand abortion access. Medication abortion pills challenge the spatiality of abortion provision because they create the possibility for safe, self‐managed abortion outside of clinical infrastructures. This paper offers a legal geography account of medication abortion technology that examines how medication abortion has been regulated in the United States. The paper analyses trends in legislation to restrict medication abortion and two significant court challenges where abortion providers brought suit against medication abortion restrictions. [ABSTRACT FROM AUTHOR]

In recent years sexualised drug use, usually referred to as chemsex, has become the object of intense media health‐related panic and increasing academic scrutiny. Critical social scientists have challenged pathologising perspectives, analysing the socio‐cultural and political economy dimensions of chemsex. Against the silence of geographers in this emerging field, the paper develops a geographical relational analysis of chemsex, focusing on the experiences of gay men living with HIV in two Italian cities (Bologna; Milan) and Italian gay men living with HIV in three English cities (Leicester; London; Manchester). Demonstrating the constitutive role of place in the practice of chemsex, the paper frames place relationally, that is, as the encounter between here and there, the material and the virtual, imagined geographies and lived spaces. To emphasise the central role of place and geographical knowledge to understand chemsex, the paper builds on 'weak theory', as it conceives things as open, entangled, connected and in flux, while focusing on ordinary practices and heterogeneity in more‐than‐human worlds. Showing how chemsex represents an embodied, relational geographical encounter among different human and non‐human actors, places (both physical and digital), imaginations and desires, the paper highlights the role of sexual practices in the relational construction of place‐making, therefore calling for an increased engagement with sex itself within the field of geographies of sexualities. The paper introduces a relational geographical perspective to the analysis of chemsex. Demonstrating the constitutive role of place in the practice of chemsex, the paper frames place relationally, i.e. as the encounter between here and there, the material and the virtual, imagined geographies and lived spaces. The paper calls for an increased engagement with the materiality of sex within the field of geographies of sexualities. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between the illicit opium economy and processes of agrarian change in south‐western Shan State, Myanmar. This is a region where opium production has risen significantly since the 1990s despite the declining territorial control of insurgent groups long blamed for the country's illegal drug economy and alongside the deepening integration of the region's agriculture sector into national and global markets. This paper reveals how illicit opium cultivation has offered distressed smallholders a way to mitigate the worsening livelihood insecurities that have accompanied the commercialization of smallholder agriculture. Yet at the same time, opium cultivation has locked farmers into a set of highly unequal social relations that has enabled militias, businesspeople with ties to local (armed) authorities, moneylenders, and agricultural brokers to accumulate capital through their control over rural markets and credit systems while leaving poppy cultivators with little more than the means to reproduce their livelihoods. This paper thus shows how opium cultivation has enabled farmers to respond to worsening precarity by sustaining smallholder farming despite the worsening "reproduction squeeze" facing many households, although the opium economy has simultaneously played an instrumental role in reinforcing and deepening agrarian class relations. [ABSTRACT FROM AUTHOR]

Aims: Sewage treatment effluent with pharmaceutical residues is discharged into surface waters, raising societal concerns. The aim of this paper is to describe the Dutch chain approach on medicinal residues in water that has been implemented by the Dutch government. We show how stakeholders from both the health and water sectors have got actively involved. Within this chain approach, source measures as well as end‐of‐pipe measures are identified and, where feasible and effective, implemented. Methods: Descriptive paper on the Dutch chain approach. Results: Getting the water and health care sectors to talk with each other instead of about each other was the key accomplishment. Comprehension of each other's viewpoints, terminology, policy goals and span of control, was pivotal in setting shared goals, creating perspective about possible measures and actually taking (joint) action. Together, stakeholders agreed to act within their own possibilities, without pointing at others, and to focus on pragmatic measures. In this article, we provide examples of measures taken, pilot projects performed, and of measures that were not implemented. Besides this, we discuss the most important barriers encountered during this process and how they were overcome. Conclusion: The issue of pharmaceuticals in the environment is a wicked problem, which makes it necessary to work together with many stakeholders on possible solutions, avoiding paralysis by complexity. Most importantly, stakeholders need to invest in mutual understanding, keep an open communication, and feel invited to bring in solutions for their part of the chain. [ABSTRACT FROM AUTHOR]

Sirolimus is a mammalian target of rapamycin inhibitor (mTORI) with anti‐proliferative, antiangiogenic and immunosuppressive properties. While approved in Australia as an anti‐rejection medication for renal transplant patients, there is mounting evidence regarding the utility of oral and topical sirolimus in treating a plethora of dermatological conditions or conditions with cutaneous manifestations. Our aim was to present an overview of the evidence for current usage and breadth of the application of sirolimus in dermatology. We carried out a systematic review of all the literature published up to 31 August 2019 on oral and topical sirolimus with respect to dermatological conditions or conditions otherwise relevant to dermatology. While 3368 papers were initially produced in our search, 238 papers met our inclusion criteria and were examined in our review. The conditions examined were categorised into genodermatoses (9 conditions), infection (1 condition), inflammatory/autoimmune (10 conditions), neoplasm (3 conditions) and vascular (17 conditions). We extracted data on first author, publication year, journal, characteristics of the study and study patients, condition, drug modalities, drug efficacy, side effects, blood level of mTORI, co‐interventions and follow‐up. While there is level 1 evidence for the efficacy of sirolimus in conditions such as tuberous sclerosis complex (TSC) and GVHD prophylaxis, for many other conditions, the evidence is limited to level 4 evidence. Regarding oral systemic therapy, dosing regimens varied with the most common for children 0.8mg/m2 twice daily and for adults 1 mg twice daily. Doses were often adjusted to reach a typical trough level of between 5 and 15 ng/mL, though targets often varied. In the overall majority of cases, side effects were minimal or tolerable, including mucositis, cytopenias, lipid abnormalities and nausea/vomiting, and only a few cases had to stop due to adverse effects. Regarding topical therapy, concentration of formulations varied from 0.1% to 1% and were compounded into creams, ointments or gels and administered typically once or twice per day. The most common side effect was skin irritation. There were a number of limitations to our study. In particular, many of the published studies were case reports or case series with no comparator arm, leading to susceptibility of bias in conclusions drawn, in particular a high likelihood of publication bias. Given the heterogeneity amongst studies, comparisons or aggregation of results was difficult. There continues to be growing use of oral and topical sirolimus in dermatological conditions. It provides new therapeutic options to patients where previous therapies have either failed or are limited due to toxicity. However, further studies are warranted. [ABSTRACT FROM AUTHOR]

The role of membrane transporters on pharmacokinetics (PKs), drug–drug interactions (DDIs), pharmacodynamics (PDs), and toxicity of drugs has been broadly recognized. However, our knowledge of modulation of transporter expression and/or function in the diseased patient population or specific populations, such as pediatrics or pregnancy, is still emerging. This white paper highlights recent advances in studying the changes in transporter expression and activity in various diseases (i.e., renal and hepatic impairment and cancer) and some specific populations (i.e., pediatrics and pregnancy) with the focus on clinical implications. Proposed alterations in transporter abundance and/or activity in diseased and specific populations are based on (i) quantitative transporter proteomic data and relative abundance in specific populations vs. healthy adults, (ii) clinical PKs, and emerging transporter biomarker and/or pharmacogenomic data, and (iii) physiologically‐based pharmacokinetic modeling and simulation. The potential for altered PK, PD, and toxicity in these populations needs to be considered for drugs and their active metabolites in which transporter‐mediated uptake/efflux is a major contributor to their absorption, distribution, and elimination pathways and/or associated DDI risk. In addition to best practices, this white paper discusses current challenges and knowledge gaps to study and quantitatively predict the effects of modulation in transporter activity in these populations, together with the perspectives from the International Transporter Consortium (ITC) on future directions. [ABSTRACT FROM AUTHOR]

The progress the Internet has experienced in recent years has brought about huge changes and social transformation in all aspects of our lives. One such aspect greatly impacted has been our health, where we can talk about the existence of an ‘Internet of Medical Things’. Amid this digital drift, we have seen the development of pharmaceutical drugs that provide information to patients and their attending healthcare teams concerning medication, doses ingested, and time of ingestion. These are digital pills or digital medication. In this context, the purpose of my paper is to analyze the ethical and legal impact of digital medication, further analyzing the implications concerning the right of service users to make decisions over their own health in Spain. [ABSTRACT FROM AUTHOR]

The national quality framework (NQF) has been implemented to improve the safety and quality of alcohol and other drug (AOD) treatment and provide a nationally consistent approach to treatment quality in Australia. At the same time, concerns have been raised that, in the absence of appropriate regulatory structures to support the NQF, the quality and safety of AOD treatment services cannot be guaranteed in Australia. An effective enforcement strategy is critical to the ability of the NQF to provide a nationally consistent approach to the delivery of AOD treatment in Australia. The monitoring and enforcement strategy proposed by the NQF encompasses two different mechanisms. For specialist AOD treatment providers in receipt of government funding, monitoring and enforcement of the NQF will occur via contractual arrangements. For providers not in receipt of government funding, monitoring and enforcement will be managed by regulatory mechanisms as decided by each jurisdiction. This proposed enforcement strategy raises the question of whether contractual arrangements are the most effective mechanism for monitoring and enforcing the NQF in publicly funded specialist AOD treatment providers. This paper considers whether a licensing regime may address the shortcomings that arise from the proposed strategy. It argues that the pluralistic approach to the monitoring and enforcement of the NQF will result in substantive differences in how the NQF is enforced both within individual jurisdictions and on a broader national level. A licensing regime, therefore, would be a more appropriate monitoring and enforcement strategy. [ABSTRACT FROM AUTHOR]

Upscaling of medication adherence interventions to routine care is still challenging. This realist theory‐inspired review aimed to assess which intervention aspects are potentially important for the scalability of effective cardiovascular disease (CVD) medication adherence interventions and how they are reported in effectiveness studies. A total of 4097 articles from four databases were screened of which ultimately 31 studies were included. Relevant information on scalability was extracted using a theoretic framework based on the scalability assessment tool used in the QUALIDEC study for the following domains: (i) innovation, (ii) implementers and patients, (iii) adopting organizations and health system, and (iv) socio‐political context. Extracted articles were analysed for themes and chains of inference, which were grouped based on commonality and source of evidence to form new hypotheses. Six different domains relevant for scalability of adherence interventions were identified: (1) Complexity of the intervention; (2) training; (3) customization of the intervention; (4) drivers of the intervention; (5) technical interventions; and (6) stakeholder involvement. These six domains might be useful for the development of more scalable interventions by bridging the gap between research and practice. Data relevant for scalability is not well reported on in effectiveness trials for CVD medication adherence interventions and only limited data on scalability has been published in additional papers. We believe the adoption and reach of effective CVD medication adherence interventions will improve with increased awareness for the necessity of scalability in all phases of intervention development. [ABSTRACT FROM AUTHOR]

The most intuitive question for market access for medicinal products is the benefit/risk (B/R) balance. The B/R assessment can conceptually be divided into subquestions related to establishing efficacy and safety. There are additional layers to the B/R ratio for medical products, including questions related to dose selection, clinical and nonclinical pharmacology, and drug quality. Explicitly stating the actual questions and how they contribute to the overall B/R provides a structure that fosters better informed cross‐domain discussions. There is currently no systematic approach in the regulatory setting to assess and establish the acceptability of alternative methods and data sources. In most cases, the medicinal product sponsors tend to prioritize traditional data types and methods, which are well accepted by regulators for inclusion in regulatory submissions. This, in addition to the absence of rigor in the use and validation of new data types and methods, and the limited training of assessors in related fields can lead to increased regulatory skepticism toward new data types and methods. A data‐knowledge backbone is needed to mitigate the uncertainty in efficacy and safety characterization. This white paper discusses the value of explicitly redefining and restructuring the regulatory scientific decision making around the scientific question to be addressed. The ecosystem proposed is based on three pillars: (i) a repository connecting questions, data, and methods; (ii) the development and validation of high‐quality standards for data and methods; and (iii) credibility assessment. The ecosystem is applied to four use cases for illustration. The need for training and regulatory guidance is also discussed. [ABSTRACT FROM AUTHOR]

Background and Aims: Long‐acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder that is generating positive outcomes. Negative effects are typically mild and transient, but can occasionally be serious, resulting in treatment discontinuation/non‐adherence. This paper aims to analyse patients' accounts of how they felt during the first 72 h after initiating LAIB. Methods: Semi‐structured interviews were conducted (June 2021–March 2022) with 26 people (18 males and 8 females) who had started LAIB within the previous 72 h. Participants were recruited from treatment services in England and Wales and were interviewed by telephone using a topic guide. Interviews were audio‐recorded, transcribed and coded. The concepts of embodiment and embodied cognition framed the analyses. Data on participants' substance use, initiation onto LAIB and feelings were tabulated. Next, participants' accounts of how they felt were analysed following the stages of Iterative Categorization. Results: Participants reported complex combinations of changing negative and positive feelings. Bodily experiences included withdrawal symptoms, poor sleep, injection‐site pain/soreness, lethargy and heightened senses inducing nausea ('distressed bodies'), but also enhanced somatic wellbeing, improved sleep, better skin, increased appetite, reduced constipation and heightened senses inducing pleasure ('returning body functions'). Cognitive responses included anxiety, uncertainties and low mood/depression ('the mind in crisis') and improved mood, greater positivity and reduced craving ('feeling psychologically better'). Whereas most negative effects reported are widely recognized, the early benefits of treatment described are less well‐documented and may be an overlooked distinctive feature of LAIB. Conclusions: During the first 72 h after initiating long‐acting injectable buprenorphine, new patients report experiencing a range of interconnected positive and negative short‐term effects. Providing new patients with information about the range and nature of these effects can prepare them for what to expect and help them manage feelings and reduce anxiety. In turn, this may increase medication adherence. [ABSTRACT FROM AUTHOR]

Any drug can potentially induce a hypersensitivity reaction. If after the allergological work‐up the drug hypersensitivity reaction is confirmed, in most cases, the simple avoidance of the culprit drug and a suggestion of an unrelated alternative is enough. However, there are circumstances where the choice to stop the treatment affects the survival, the safety and/or the quality of life of the patient and the global outcome of the disease in question. When this occurs, drug desensitization can be the answer and should not be viewed as an extravagance, nor the pediatric age should be considered a contraindication. Drug desensitization in children can be safely and successfully performed, having a positive impact on the survival and overall prognosis. In general, the indications for DDS are the same in adults as in children. However, in this age group there are specificities that this paper aimed to describe, reviewing the mechanisms behind drug hypersensitivity and rapid drug desensitization, types of protocols, indications, and contraindications, as well as several technical aspects that are specific to the pediatric age. [ABSTRACT FROM AUTHOR]

Background: As people age, they are more likely to develop multiple long‐term conditions that require complicated medicine regimens. Safely self‐managing multiple medicines at home is challenging and how older people can be better supported to do so has not been fully explored. Aim: This study aimed to identify interventions to improve medicine self‐management for older people living at home and the aspects of medicine self‐management that they address. Design: A rapid review was undertaken of publications up to April 2022. Eight databases were searched. Inclusion criteria were as follows: interventions aimed at people 65 years of age or older and their informal carers, living at home. Interventions needed to include at least one component of medicine self‐management. Study protocols, conference papers, literature reviews and articles not in the English language were not included. The results from the review were reported through narrative synthesis, underpinned by the Resilient Healthcare theory. Results: Database searches returned 14,353 results. One hundred and sixty‐seven articles were individually appraised (full‐text screening) and 33 were included in the review. The majority of interventions identified were educational. In most cases, they aimed to improve older people's adherence and increase their knowledge of medicines. Only very few interventions addressed potential issues with medicine supply. Only a minority of interventions specifically targeted older people with either polypharmacy, multimorbidities or frailty. Conclusion: To date, the emphasis in supporting older people to manage their medicines has been on the ability to adhere to medicine regimens. Most interventions identify and target deficiencies within the patient, rather than preparing patients for problems inherent in the medicine management system. Medicine self‐management requires a much wider range of skills than taking medicines as prescribed. Interventions supporting older people to anticipate and respond to problems with their medicines may reduce the risk of harm associated with polypharmacy and may contribute to increased resilience in the system. Patient or Public Contribution: A patient with lived experience of medicine self‐management in older age contributed towards shaping the research question as well as the inclusion and exclusion criteria for this review. She is also the coauthor of this article. A patient advisory group oversaw the study. [ABSTRACT FROM AUTHOR]

Although the digital revolution has transformed many areas of human endeavor, pharmaceutical drug development has been relatively slow to embrace the emerging technologies to enhance efficiency and optimize value in clinical trials. The topic has garnered even greater attention in the face of the coronavirus disease 2019 (COVID‐19) outbreak, which has caused unprecedented disruption in the conduct of clinical trials and presented considerable challenges and opportunities for clinical trialists and data analysts. In this paper, we highlight the potential opportunity with virtual or digital clinical trials as viable options to enhance efficiency in drug development and, more importantly, in offering diverse patients easier and attractive means to participate in clinical trials. Special reference is made to the implication of artificial intelligence and machine‐learning tools in trial execution and data acquisition, processing, and analysis in a virtual trial setting. Issues of patient safety, measurement validity, and data integrity are reviewed, and considerations are put forth with reference to the mitigation of underlying regulatory and operational barriers. [ABSTRACT FROM AUTHOR]

Aims: To review and synthesise the contemporary qualitative evidence, relating to the individual, healthcare professional and system‐level barriers and facilitators to injectable therapies in people with type 2 diabetes, and evaluate (using an intersectional approach to explore the diverse perspectives of different identities) whether views have changed with treatment and guideline advancements. Methods: A meta‐ethnography approach used. Eight databases searched from the years 2006 (GLP‐1 analogues introduced) to February 2021. Study selection (using a pre‐defined inclusion criteria), quality appraisal and data extraction, conducted independently by two reviewers. Results: Screened 7143 abstracts, assessed 93 full‐text papers for eligibility and included 42 studies—using data from 818 individuals with type 2 diabetes and 160 healthcare professionals. Studies covered a diverse range of views from healthcare professionals and individuals, including those relating to older adults and people from ethnic migrant backgrounds, and 10 studies rated moderate to strong research value. Key themes abstracted: barriers (physical/psychological/social) and facilitators (motivation/capability/opportunity). Conclusions: The first synthesis of contemporary qualitative data to adopt an intersectionality approach and explore diverse views relating to barriers and facilitators that influence engagement with injectable treatments for type 2 diabetes. A model is presented to help patients, health practitioners and policy makers identify barriers and facilitators and understand the complex interplay of physical, psychological and social factors involved when prescribing injectable therapies. Despite advances in injectable treatments and guidelines, findings highlight the many barriers that still exist and show how strongly held culturally‐specific health beliefs of people from diverse socio‐economic and ethnic backgrounds can become substantial obstacles to treatment. [ABSTRACT FROM AUTHOR]

Aim: To determine the efficacy of fenfluramine on seizure frequency in patients with Sunflower syndrome. Secondary endpoints were changes in electroencephalogram (EEG) characteristics, cognitive functioning, executive functioning, and quality of life. Method: In this open‐label study, patients underwent a 4‐week baseline period, followed by 3 months of treatment. An oral solution of fenfluramine was administered twice daily for 3 months. The dose was titrated up to a maximum dose of 0.7mg/kg/day or 26mg/day. Cardiac safety was monitored by transthoracic echocardiogram and electrocardiogram. EEGs, abbreviated neuropsychological testing, and questionnaires were administered before starting the study medication and again at the end of the treatment period. Results: Ten patients (eight females, two males; mean age 13y 4mo [SD 4y 11mo], range 7–24y) were enrolled in the study. Nine of the 10 patients completed the core study, eight of whom met the primary endpoint. There were no observations of cardiac valvulopathy or pulmonary hypertension during the study. Interpretation: Treatment with low‐dose fenfluramine resulted in a clinically significant reduction in seizure frequency, including hand‐waving episodes. Fenfluramine may be an effective treatment option for patients with Sunflower syndrome. What this paper addsNine patients with Sunflower syndrome were treated with fenfluramine.Eight patients were responders, displaying a ≥30% reduction in seizure activity.Six patients experienced a ≥70% reduction in hand‐waving episodes.Improvements on electroencephalogram were observed after treatment with fenfluramine.None of the patients developed evidence of cardiac valvulopathy or pulmonary hypertension. What this paper adds: Nine patients with Sunflower syndrome were treated with fenfluramine.Eight patients were responders, displaying a ≥30% reduction in seizure activity.Six patients experienced a ≥70% reduction in hand‐waving episodes.Improvements on electroencephalogram were observed after treatment with fenfluramine.None of the patients developed evidence of cardiac valvulopathy or pulmonary hypertension. [ABSTRACT FROM AUTHOR]

The public health sector, considered to be vital, especially in this pandemic crisis of COVID‐19, requires automation and control of drug distribution in pharmacies commonly called: "Dispensing." In this paper, we address the medication assignment problem for automated dispensing cabinets (ADCs). First, we use a network of conflicting timed event graphs (CTEGs), a class of timed Petri nets with shared resources, to model pharmaceutical cabinets. Second, we develop a new method for controlling CTEGs under mutual exclusion constraints (MECs) to solve the problem of drug assignment, using a control approach based on Min‐Plus algebra. Finally, a case study of assigning drugs is given to illustrate the proposed methodology and show the efficiency of the developed control laws. [ABSTRACT FROM AUTHOR]

Aims: To systematically review the literature investigating the links between stigma and the management of type 1 diabetes. Methods: A systematic literature review was conducted in accordance with PRISMA guidelines. Both quantitative and qualitative data were considered. Included papers were subject to quality assessment using the Mixed Methods Appraisal Tool (MMAT), and a narrative synthesis of results was reported. Results: Nineteen articles met the inclusion criteria and were included in the final analysis. Amongst these, one study used mixed methods, nine were qualitative, and nine were quantitative. All studies found a negative relationship between stigma and type 1 diabetes management. Qualitative studies provided a further understanding of the effects observed in the quantitative studies and found that stigma can affect self‐care activities, disclosure of diabetes, and the uptake of diabetes technology. Systemic causes of stigma and intersectional stigma were also observed. Conclusions: This review highlights that people with type 1 diabetes are negatively affected by stigma, irrespective of their age, gender, culture, or use of diabetes technology. Quantitative studies were limited, in that all studies were cross‐sectional, and there was a lack of standardisation across outcome measures. There is a need for interventions to target stigma on both an individual and a systemic level, particularly where people experience multiple intersecting stigmas. [ABSTRACT FROM AUTHOR]

Depression is a serious public health problem, and adolescence is an 'age of risk' for the onset of Major Depressive Disorder. Recently, we and others have proposed neuroimmune network models that highlight bidirectional communication between the brain and the immune system in both mental and physical health, including depression. These models draw on research indicating that the cellular actors (particularly monocytes) and signaling molecules (particularly cytokines) that orchestrate inflammation in the periphery can directly modulate the structure and function of the brain. In the brain, inflammatory activity heightens sensitivity to threats in the cortico‐amygdala circuit, lowers sensitivity to rewards in the cortico‐striatal circuit, and alters executive control and emotion regulation in the prefrontal cortex. When dysregulated, and particularly under conditions of chronic stress, inflammation can generate feelings of dysphoria, distress, and anhedonia. This is proposed to initiate unhealthy, self‐medicating behaviors (e.g. substance use, poor diet) to manage the dysphoria, which further heighten inflammation. Over time, dysregulation in these brain circuits and the inflammatory response may compound each other to form a positive feedback loop, whereby dysregulation in one organ system exacerbates the other. We and others suggest that this neuroimmune dysregulation is a dynamic joint vulnerability for depression, particularly during adolescence. We have three goals for the present paper. First, we extend neuroimmune network models of mental and physical health to generate a developmental framework of risk for the onset of depression during adolescence. Second, we examine how a neuroimmune network perspective can help explain the high rates of comorbidity between depression and other psychiatric disorders across development, and multimorbidity between depression and stress‐related medical illnesses. Finally, we consider how identifying neuroimmune pathways to depression can facilitate a 'next generation' of behavioral and biological interventions that target neuroimmune signaling to treat, and ideally prevent, depression in youth and adolescents. [ABSTRACT FROM AUTHOR]

Empowerment theories provide the conceptual framework to understand the process of change among marginalized groups in rehabilitation. Sociopolitical control is an element of the intrapersonal component of psychological empowerment (PE). The current study analyzes the psychometric properties of the Brazilian version of the Sociopolitical Control Scale for Youth (SPCS‐Y) in a sample of institutionalized young male offenders (N = 190) and examines its relationships with well‐being, perception of educational environment, self‐efficacy, and drug consumption. The results of the confirmatory factor analysis supported the two‐dimensional structure of the SPCS‐Y (leadership competence and policy control). Linear regression models indicated that consumption of drugs contribute positively to leadership competence, and policy control was explained by well‐being, positive perception of educational environment, and enlisting social support. The results are consistent with previous studies from other countries and indicate that the SPCS‐Y is a valid measure to assess sociopolitical control among adolescents in rehabilitation. Additionally, theoretical implications and directions for practice are discussed in the paper. [ABSTRACT FROM AUTHOR]

Aim: To assess the effectiveness and safety of levetiracetam when used as first‐line treatment of neonatal seizures. Method: Four electronic databases, Medline, Embase, Web of Science, and ClinicalTrials.gov were systematically searched from inception until 20th November 2020. Randomized controlled trials (RCTs) and observational studies that included neonates born preterm and term were eligible for inclusion. The primary outcome measure was levetiracetam effectiveness, defined as seizure cessation within 24 hours of starting treatment. Secondary outcomes included short‐term adverse events, mortality before discharge, and long‐term neurodevelopmental outcomes. Results: Fourteen studies assessing 1188 neonates were included: four RCTs, three observational trials with phenobarbital as the control arm, and seven observational studies of levetiracetam with no control arm. Pooled efficacy of levetiracetam from observational studies was 45% (95% confidence interval [CI] 34–57%) (GRADE – very low). Meta‐analysis of RCTs evaluating levetiracetam versus phenobarbital showed that both were equally effective (risk ratio [95% CI] 0.6 [0.30–1.20]) (GRADE – very low). Levetiracetam resulted in a lower risk of short‐term adverse events compared to phenobarbital (risk ratio [95% CI] 0.24 [0.06–0.92]) (GRADE – moderate). Interpretation: Very low certainty of evidence suggests levetiracetam might not be more effective than phenobarbital. Moderate certainty of evidence indicates levetiracetam is associated with a lower risk of adverse events. Future trials on neonatal antiseizure medication therapy should include continuous electroencephalogram (EEG) monitoring as standard of care and enrol a homogenous population with similar seizure aetiology. What this paper addsLevetiracetam is effective in 45% of neonatal seizures.Levetiracetam might not be more effective than phenobarbital.Levetiracetam is likely to be safer than phenobarbital.Evidence available is limited and of very low certainty. What this paper adds: Levetiracetam is effective in 45% of neonatal seizures.Levetiracetam might not be more effective than phenobarbital.Levetiracetam is likely to be safer than phenobarbital.Evidence available is limited and of very low certainty. [ABSTRACT FROM AUTHOR]

Objective: To formalize comparative interrupted time series (CITS) using the potential outcomes framework; compare two version of CITS--a standard linear version and one that adds postperiod group-by-time parameters--to two versions of difference-in-differences (DID)--a standard version with time fixed effects and one that adds group-specific pretrends; and reanalyze three previously published papers using these models. Data Sources: Outcome data for reanalyses come from two counties' jail booking and release data, Medicaid prescription drug rebate data from the Centers for Medicare and Medicaid Services (CMS), and acute hepatitis C incidence from the Centers for Disease Control and Prevention. Study Design: DID and CITS were compared using potential outcomes, and reanalyses were conducted using the four described pre--post study designs. Data Collection/Extraction Methods: Data from county jails were provided by sheriffs. Data from CMS are publicly available. Data for the third reanalysis were provided by the authors of the original study. Principal Findings: Though written differently and preferred by different research communities, the general version of CITS and DID with group-specific pretrends are the same: they yield the same counterfactuals and identify the same treatment effects. In a reanalysis with evidence of divergent preperiod trends, failing to account for this in standard DID led to an 84% smaller effect estimate than the more flexible models. In a second reanalysis with evidence of nonlinear outcome trends, failing to account for this in linear CITS led to a 28% smaller effect estimate than the more flexible models. Conclusion: We recommend detailing a causal model for treatment selection and outcome generation and the required counterfactuals before choosing an analytical approach. The more flexible versions of DID and CITS can accommodate features often found in real data, namely, nonlinearities and divergent preperiod outcome trends. [ABSTRACT FROM AUTHOR]

The article comments on the paper by B. Pardo and colleagues about the production of methamphetamine in Afghanistan. Topics discussed include the role of ephedra in the expansion of methamphetamine production in the country, the uncertainty of the Taliban's ban on drug production, and the possible increase in the manufacture of methamphetamine or other synthetic substances using synthetic precursors.

Aims: A key reason for the failure of antituberculosis (anti‐TB) treatment is missed doses (instances where medication is not taken). Adverse drug reactions (ADRs) are 1 cause of missed doses, but the global evidence, their relative contribution to missed doses vs. other causes, the patterns of missed doses due to ADRs and the specific ADRs associated with missed doses have not been appraised. We sought to address these questions through a scoping review. Methods: MEDLINE, Embase and Web of Science were searched on 3 November 2021 using terms around active TB, missed doses and treatment challenges. Studies reporting both ADR and missed dose data were examined (PROSPERO: CRD42022295209). Results: Searches identified 108 eligible studies: 88/108 (81%) studies associated ADRs with an increase in missed doses; 33/61 (54%) studies documenting the reasons for missed doses gave ADRs as a primary reason. No studies examined patterns of missed doses due to ADRs; 41/108 (38%) studies examined associations between 68 types of ADR (across 15 organ systems) and missed doses. Nuance around ADR‐missed doses relations regarding drug susceptibility testing profile and whether the missed doses originated from the patient, healthcare professionals, or both were found. Conclusion: There is extensive evidence that ADRs are a key driver for missed doses of anti‐TB treatment. Some papers examined specific ADRs and none evaluated the patterns of missed doses due to ADRs, demonstrating a knowledge deficit. Knowing why doses both are and are not missed is essential in providing targeted interventions to improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Patient education (PE) is a key role of nurses, which includes providing information, training, and support about methotrexate (MTX), an anchor drug in rheumatology. However, there is a wide variation in the access to rheumatology nurse consultations in Europe, and there is a lack of consensus regarding the delivery, context and timing of PE in these cases. This study aimed to provide a comprehensive overview of the existing research on nurse education of MTX for children/youth and adults with Rheumatic and Musculoskeletal Diseases (RMDs). Methods: This scoping review was conducted in accordance with Arksey and O'Malley's framework. A search on PubMed (MEDLINE), Scopus and Cochrane Database, and CINAHL, from inception until March 2022 was conducted. Articles on PE with a focus on MTX exclusively were included. Published and unpublished studies, from any world region, conducted with a qualitative, quantitative, or mixed‐methods design and focused on defined research questions, were eligible for inclusion. Broad inclusion criteria were used if a research paper on PE focused on MTX for people with RMDs (PE or patient engagement, self‐management, medication knowledge, or health literacy in patients). The reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses ‐ Extension for Scoping Reviews (PRISMA‐ScR) checklist. Two independent reviewers performed standardized data extraction and synthesis. Results: From 292 references identified, the total number of studies which met the inclusion criteria was relatively small (n = 14). The results identified that knowledge of MTX improves when education by nurses is provided. Conclusion: This scoping review showed that there is no universal worldwide strategy for MTX education of children/youths and adults with RMDs. However, PE regarding MTX can be delivered in different forms, resulting in better satisfaction and adherence. More randomized controlled trials with powered samples are required. [ABSTRACT FROM AUTHOR]

Aim: To provide an overview of responsibilities and tasks of nurses in pharmaceutical care. Design: Scoping review. Methods: Two databases were systematically searched (MEDLINE and Scopus) for recent original research papers concerning nurses' responsibilities and tasks in pharmaceutical care. The definition of responsibility was based on literature, moral and ethical discussions. Existing responsibilities and tasks beyond preparation and administration of medication were collected and synthesized. This main study outcome was extracted from titles and abstracts only. Results were reported in accordance with PRISMA‐ScR guidelines. Results: Of the 3,805 titles and abstracts reviewed, 453 abstracts were included. A total of seven responsibilities were identified: (a) management of therapeutic and adverse effects of medication, (b) management of medication adherence, (c) management of patient medication self‐management, (d) management of patient education and information about medication, (e) prescription management, (f) medication safety management and (g) (transition of) care coordination. Within these responsibilities, all tasks performed by nurses were described. [ABSTRACT FROM AUTHOR]

Objectives: Drug treatment for children with epilepsy should, ideally, be governed by evidence from adequate and well‐controlled clinical studies. However, these studies are difficult to conduct, and so direct evidence supporting the informed use of specific drugs is often lacking. The Research Roundtable for Epilepsy (RRE) met in 2020 to align on an approach to therapy development for focal seizures in children age 1 month <2 years of age. Methods: The RRE reviewed the regulatory landscape, epidemiology, seizure semiology, antiseizure medicine pharmacology, and safety issues applicable to this population. Results: After reviewing evidence, the conclusion was that pediatric efficacy trials would be impracticable to conduct but a waiver of the regulatory requirement to conduct any study would lead to an absence of information to guide dosing in a critical population. Review of available data and discussion of RRE attendees led to the conclusion that the requirements for extrapolation of efficacy from older children down to infants from age 1 month to <2 years old appeared to be met. After the RRE, the US Food and Drug Administration (FDA) approved brivaracetam for use in children with focal epilepsy above the age of 1 month in August 2021 and lacosamide in October 2021, both based on the principle of extrapolation from data in older children. Significance: These recommendations should result in more rapid accessibility of antiseizure medications for infants. [ABSTRACT FROM AUTHOR]

Every year more and more innovative pharmacological agents are introduced medicine, to treat systemic diseases. Due to these rapid and recent advancements, many patients are receiving treatment with a high variety of drugs, such as selective serotonin reuptake inhibitors, bisphosphonates, tumor necrosis factor (TNF)-α inhibitors, cyclosporine, and steroids. Since implant and osseous surgery are common treatment modalities used, within dentistry, it is of critical important to acknowledge and discuss the potential effects of selective serotonin reuptake inhibitors, bisphosphonates, TNF-α inhibitors, cyclosporine, and steroids, on bone healing. The present paper discusses the possible detrimental ramifications and risks these drug classes may have on bone healing. [ABSTRACT FROM AUTHOR]

Background: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that can persist into adulthood. Young people often stop taking ADHD medication during adolescence despite evidence that continuation would be beneficial. Increasingly, young people are restarting medication in early adulthood suggesting that cessation was premature. In this paper we explore the reasons given by young people for discontinuing ADHD medication. Methods: Qualitative data from the Children and Adolescents with ADHD in Transition between Children's and Adult Services (CATCh‐uS) project was analysed to look for reasons for stopping medication. Semi‐structured interviews with three groups of young people were analysed using thematic and framework analysis; this included young people prior to transition (n = 21); young people that had successfully transitioned to adult services (n = 22); and young people who left children's services prior to transition but re‐entered adult services later (n = 21). Results: Reasons given by young people for stopping ADHD medication included the following: the perceived balance between benefits and adverse effects of medication; perceptions of ADHD as a childhood or educational disorder; life circumstance of the young person and challenges young people faced in accessing services. Conclusions: A multidimensional approach is needed to address discontinuation of ADHD medication in order to improve the long‐term prospects and quality of life for these young people. Possible approaches include access to non‐pharmacological treatments and improved psychoeducation. As many reasons given by young people are not unique to ADHD, these findings are also of relevance to medication adherence in other chronic childhood conditions. [ABSTRACT FROM AUTHOR]

In this paper, we describe the spiritual and kinship alliances between heads of an urban Santo Daime church from Rio de Janeiro and some leaders of the Yawanawá people from the Amazonian region. We suggest that these alliances involve exchanges and dialogical relationships that hold different meanings for the diverse social actors that take part in them. Further, we argue that equivocation and functional misunderstandings have an important role in these multidirectional dialogues. Based on this case study, we approach the Yawanawá strategies for capturing otherness, and the insertion of the daimistas in the indigenous sociality networks. We focus especially on the Yawanawá mode of producing kin by capturing non‐indigenous people and their participation in exchange networks that encompass multiple regimes of value. From the daimista point of view, we describe these relationships using the native category of "eclecticism." We suggest that the daimistas attempt to translate the Yawanawá shamanic knowledge and the consumption of the "forest medicines," experiencing the performance of "becoming indigenous." [ABSTRACT FROM AUTHOR]

This is a highlight on the paper by Bonnet et al.: A Lock‐and‐Kill Anticancer Photoactivated Chemotherapy Agent. which constitutes an important step toward establishing photoactivated chemotherapy (PACT) as a widespread tool to treat different health issues, specially tumors. PACT can be a useful technique to deliver already tested drugs, where the effect of the desired molecule is directed only to its target after light irradiation, even in the cases in which it is difficult to achieve a precise delivery in the desired organ or tissue. Ruthenium‐polipyridyl caged‐compounds are near ideal devices to deliver a drug in that precise fashion, albeit they usually fail in revealing their actual location due to their weak light emission properties. The mentioned work introduces a simple and clever idea: the use of a covalently linked fluorophore to map the caged‐compounds in‐vivo distribution prior to the eventual irradiation to activate the chemotherapy. [ABSTRACT FROM AUTHOR]

Introduction: British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner‐city areas of Bradford. Methods: Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. Results: This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women‐only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. Conclusion: These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. Patient or Public Contribution: Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis. [ABSTRACT FROM AUTHOR]

There is an increasing level of various pollutants and their persistence in aquatic environments. The improper use of antibiotics and their inefficient metabolism in organisms result in their release into aquatic environments. Antibiotic abuse has led to hazardous effects on human health. Thereby, efficient removal of pharmaceuticals, particularly antibiotics, from wastewater and contaminated water bodies is greatly interested in international research communities. Metal-organic framework (MOF) materials, as a hybrid group of material containing metallic center and organic linkers, offer a porous structure that is highly efficient for removing different pollutants from contaminated water and wastewater streams. This article aims to review the recent advancement in using MOF-based adsorbents and catalysts for the removal of pharmaceuticals, especially antibiotics, from polluted water. Applying MOFs-based structures for removing antibiotics using photocatalytic removal and adsorptive removal techniques will be discussed and evaluated in this review paper. Various MOF-based materials such as functionalized MOFs, MOF-based composites, magnetic MOF-based composites, MOFs templated-metal oxide catalysts for removing pharmaceuticals, personal care products, and antibiotics from contaminated aqueous media are discussed. Furthermore, effective operational parameters on the adsorption, adsorption mechanisms, adsorption isotherms, and thermodynamic parameters are explained and discussed. Finally, in the concluding remarks, the challenges and future outlooks of using MOFs-based adsorbents and catalysts for removing antibiotics are summarized. [ABSTRACT FROM AUTHOR]

A balanced approach using an integrated combination of strategies, namely, demand reduction, supply reduction and harm reduction, was suggested to be implemented in a balanced way to the policy vision of a South Africa 'free of substance abuse'. Responding on the call for a comprehensive review of the National Drug Master Plan 2013–2017 to ensure consistency in policy approach, this article explores the integrative propositional analysis (IPA)‐based analysis to evaluate 'how systemic' and integrated were the policy strategies applied. The analysis draws insights from the internal consistency of the policy and provides complementary evidence on the systemic breakdown of the policy, which correlates with previous studies. The findings are indicative of the usefulness of the IPA‐based tools to more pragmatically develop policy that better reflects the systemic/integrated relationship of the three strategies based on their conceptual systemic integrity. This research has implications for interdisciplinary scholars and practitioners, of policy and theory. [ABSTRACT FROM AUTHOR]

Introduction: The positive impact of substance use treatment is well‐evidenced but there has been substantial disinvestment from publicly funded treatment services in England since 2013/2014. This paper examines whether this disinvestment from adult alcohol and drug treatment provision was associated with changes in treatment and health outcomes, including: treatment access, successful completions from treatment, alcohol‐specific hospital admissions, alcohol‐specific mortality and drug‐related deaths. Methods: Annual administrative data from 2013/2014 to 2018/2019 was matched at local government level and multi‐level time series analysis using linear mixed‐effect modelling conducted for 151 upper‐tier local authorities in England. Results: Between 2013/2014 and 2018/2019, £212.2 million was disinvested from alcohol and drug treatment services, representing a 27% decrease. Concurrently, 11% fewer people accessed, and 21% fewer successfully completed, treatment. On average, controlling for other potential explanatory factors, a £10 000 disinvestment from alcohol and drug treatment services was associated with reductions in all treatment outcomes, including 0.3 fewer adults in treatment (95% confidence interval 0.16–0.45) and 0.21 fewer adults successfully completing treatment (95% % confidence interval 0.12–0.29). A £10 000 disinvestment from alcohol treatment was not significantly associated with changes in alcohol‐specific hospital admissions or mortality, nor was disinvestment from drug treatment associated with the rate of drug‐related deaths. Discussion and Conclusions: Local authority spending cuts to alcohol and drug treatment services in England were associated with fewer people accessing and successfully completing alcohol and drug treatment but were not associated with changes in related hospital admissions and deaths. [ABSTRACT FROM AUTHOR]

Cancer is a deadly disease. There is no drug yet for the treatment of some types of cancer. New drug trials are being conducted to treat this disease. One of them is HDAC‐based multi‐target drugs. Topological indices (TIs) are the numerical descriptors of a molecular structure obtained by the molecular graph. TIs can be used in the structure–property relationship (QSPR) and structure–activity relationship studies to provide information about the physicochemical properties and biological properties of molecules. In this paper, vorinostat, tucidinostat, triciferol, and CUDC‐101 and CUDC‐907, which are seen as an important light in cancer treatment, are studied. M‐polynomials based on degree and NM‐polynomials based on the sum of degrees of neighboring vertices for chemical graphs of these drugs are calculated. By using these polynomials, many TIs that depend on the degree and the sum of neighboring degrees are obtained. Moreover, The QSPR models are designed using these TIs to estimate some physicochemical properties of these drugs. The QSPR studies are obtained using the curvilinear regression method. [ABSTRACT FROM AUTHOR]

Aim: The White Paper on Crime 2019 from the Japanese Ministry of Justice reported that the percentage of crimes committed by people with mental disabilities was only 1.0%. In contrast, the findings of a statistical survey of correctional facilities reported that 15.1% of the prisoners were diagnosed with a mental illness. This study aimed at clarifying the relationship between mental illness and crime among suspects in a detention house and explaining this large gap. Methods: Criminal suspects who were newly admitted in the Gifu detention house in Japan were eligible for the study. The status of psychotropic drug use was investigated, and its relationship with age, sex, offense history, and type of crime was analyzed. Newly prescribed medications in detention houses or police stations were excluded. Results: In total, 26.5% of the residents in a detention house used psychotropic drugs. The psychotropic drug use rate was 16.7% (excluding the sleeping pill use rate). The use rates of sleeping pills, anxiolytics, antidepressants, and antipsychotics were 22.6%, 11.1%, 3.0%, and 9.6%, respectively. Psychotropic drug use was high in illicit drug users and low in suspects for immigration violence. Psychotropic drug use was higher among female suspects, suspects in their 40s and 50s, and suspects with a multiple crime history. Anxiolytic (17.0%) and antipsychotic (11.9%) use rates were high among suspects for violence. Conclusion: In total, 26.5% of the subjects used psychotropic drugs. Psychotropic drug use was high in illicit drug users and low in suspects for immigration violence. [ABSTRACT FROM AUTHOR]

Introduction: There is increasing demand for effective sleep health and promotion strategies that are accessible to the general population. Sleep hygiene has traditionally focused on promoting behaviours that facilitate good sleep and avoiding behaviours that interfere with sleep. However, simply following good sleep hygiene practices has proven largely ineffective in clinical samples suffering insomnia, and effectiveness of these recommendations in the general population has also been questioned. One reason for this may be the lack of consideration with respect to interactions between these different factors, as many elements determine a 'good' and a 'bad' night's sleep. Methods: The present paper utilised a mixed methods approach using a combination of framework approach thematic analysis (qualitative) and the number of mentions of different characteristics defining a good and bad night's sleep (quantitative) in participants' (N = 282 (157 females), mean age 27 years) accounts of their last good and bad night's sleep, and how (if at all) alcohol or drugs played a role. Results: We found that both good and bad night's sleep were influenced by multiple factors and that often the same factors were implicated in both. A significant number of participants described elements of the sleep episode (e.g., timing pre- vs. postmidnight, consistency of routine, sleep onset latency, sleep environment), or other behavioural or environmental factors (e.g., alcohol or drug use, mood, food consumed prior to sleep) they perceived were involved in their experience of a good or bad night's sleep. Conclusions: Rather than isolating factors as is typically done in sleep hygiene principles, or viewing these factors as discrete and/or having predictable effects on sleep, it is important to examine how these factors coalesce to shape a good and bad night's sleep. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities (PwID) have a bidirectional relationship with epilepsy. Nearly 25% of PwID have seizures and 30% people with epilepsy are thought to have a significant intellectual impairment. Furthermore, 70% of PwID are thought to have treatment‐resistant epilepsy. In the United Kingdom, antiseizure medications (ASMs) are the second most widely prescribed psychotropic agent for PwID. However, it is unclear what the current evidence and patterns is on current prescribing of ASMs, including when and how a case is made to withdraw them. A narrative review along with an analysis of large‐scale NHS Digital published data (2015–2020) on several aspects of ASM prescribing by general practices for PwID was undertaken. The review results and data analysis are consolidated and presented as 11 themes to provide a comprehensive overview of the study topic. Recent studies estimate that one‐third and one‐fifth of PwID are prescribed ASMs. A history of epilepsy is seen as the primary prescribing reason; however, often it is a legacy, and the indication is no longer clear. The proportion receiving ASMs continues to rise with age. This pattern of use does not correlate well with seizure onset. There are limited data on de‐prescribing ASMs in PwID. The study population heterogenicity, associated polypharmacy, multimorbidity and higher sudden unexpected death in epilepsy risks are outlined. Suggestions are made from available evidence for improving prescribing practices for PwID and seizures, and key areas for further research in this complex clinical area are outlined. [ABSTRACT FROM AUTHOR]

The results of the traditional prediction method for the activity of aminoquinoline drugs are inaccurate, so the prediction method for the activity of aminoquinoline drugs based on the deep learning is designed. The molecular holographic distance vector method was used to describe the molecular structure of 40 aminoquinoline compounds, and the principal component regression method was used for modeling and quantitative analysis. Two methods were used to predict the activity of aminoquinoline drugs. The correlation coefficients of the results obtained from the two sets of activity data and the cross test were 0.9438 and 0.9737, and 0.8305 and 0.9098, respectively. Our data suggested that method for the activity prediction of aminoquinoline drugs based on deep learning studied in this paper can better predict the activity of aminoquinoline drugs and provide a strong basis for the activity prediction of aminoquinoline drugs. [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Jølving et al paper. To view this article, visit https://doi.org/10.1111/apt.16578 [ABSTRACT FROM AUTHOR]

Camera‐based Driver Monitoring Systems (DMS) have the potential to exploit eye tracking correlates of alcohol intoxication to detect drunk driving. This study investigates how glance, blink, saccade, and fixation metrics are affected by alcohol, and whether possible effects remain stable across three different camera setups, as well as when the driver is out‐of‐the‐loop during level 4 automated driving (Wizard‐of‐Oz setup). Thirty‐five participants drove on a test track first sober and then with increasing intoxication levels reaching a breath alcohol concentration (BrAC) of 1‰. Linear Mixed‐Effects Regression analyses showed that with increasing intoxication levels, eye blinks became longer and slower, glances and fixations became fewer and longer, and more attention was directed to the road area, at the expense of more peripheral areas. Fixation and blink metrics were more robust to changes in automation mode, whereas glance‐based metrics were highly context dependent. Not all effects of alcohol intoxication could be measured with all eye tracking setups, where one‐camera systems showed lower data availability and higher noise levels compared to a five‐camera system. This means that lab findings based on higher quality eye tracking data might not be directly applied to production settings because of hardware limitations. [ABSTRACT FROM AUTHOR]

Nowadays, the focus of diabetes treatment has switched from lowering the glucose level to preserving glycemic homeostasis and slowing the disease progression. The main pathophysiology of both type 1 diabetes and long‐standing type 2 diabetes is pancreatic β‐cell mass loss and dysfunction. According to recent research, human pancreatic β‐cells possess the ability to proliferate in response to elevated insulin demands. It has been demonstrated that in insulin‐resistant conditions in humans, such as obesity or pregnancy, the β‐cell mass increases. This ability could be helpful in developing novel treatment approaches to restore a functional β‐cell mass. Treatment strategies aimed at boosting β‐cell function and mass may be a useful tool for managing diabetes mellitus and stopping its progression. This review outlines the processes of β‐cell failure and detail the many β‐cell abnormalities that manifest in people with diabetes mellitus. We also go over standard techniques for determining the mass and function of β‐cells. Lastly, we provide the therapeutic implications of utilizing antidiabetic drugs in controlling the mass and function of pancreatic β‐cells. [ABSTRACT FROM AUTHOR]