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Introduction The prevalence of sleep disorders and use of sleep medication, particularly melatonin, are rising among adolescents and young adults (13–24 years). In Denmark, melatonin is approved for use in children with autism and ADHD up to 18 years of age, with other prescriptions being off-label in these age groups. The perspectives of medical practitioners on prescribing sleep medications to this age group remain largely unexplored.Aim This study aims to investigate the considerations of general practitioners (GPs) and child and adolescent psychiatrists (psychiatrists) when prescribing and deprescribing sleep medications for 13–24-year-olds.Methods We conducted qualitative semi-structured interviews with 10 GPs and six psychiatrists. Data were analyzed using an inductive approach.Results Psychiatrists typically prescribed melatonin with the expectation that deprescription would occur in general practice. Despite the universal goal of deprescription, it was hindered by various challenges. GPs identified patient motivation and a clear focus on deprescription as facilitative factors and expressed a need for enhanced emphasis on these aspects in general practice.Discussion and implications The findings align with existing prescription trends and literature on factors that promote and inhibit deprescription. The study underscores the complexities of deprescribing sleep medications for adolescents and young adults, suggesting the need for expanded guidelines and enhanced continuing education for GPs.Conclusions The research highlights significant discrepancies among medical practitioners regarding the deprescription process of sleep medications for young individuals, complicated by multiple factors. This underscores the need for better guidelines and further studies.

This paper investigates the competition between two charge point operators at the same site for future battery electric long-haul trucks. The charge point operators are located along one of the busiest highways in Sweden. The investigation is carried out using an agent-based model where trucks select charge point operators based on charging prices and the length of any queues, while charge point operators adjust their prices and number of chargers to improve their profitability. The study aims to predict conditions for trucks and charge point operators in a future public fast-charging market. Our findings indicate the potential for a well-functioning future public fast-charging market with small queuing problems, high utilisation, and reasonable prices for public fast charging. Assuming a price for electricity of EUR 0.08/kWh and a minimum profit margin of EUR 0.001/kWh for charge point operators, the findings indicate that the price level outside rush hours will be low, approximately EUR 0.1/kWh. The prices during rush hours will likely be much higher, but it is harder to predict the value due to uncertainties of how charge point operators will act in the future market. Still, from the model result, the price during rush hours is suggested to be just above EUR 0.5/kWh, with an average charging price of around EUR 0.15/kWh. It also seems likely that it is profitable for charge point operators to build enough chargers so that charging queues are short.

Introduction Patients with complex multimorbidity face a high treatment burden and frequently have low quality of life. General practice is the key organisational setting in terms of offering people with complex multimorbidity integrated, longitudinal, patient-centred care. This protocol describes a pragmatic cluster randomised controlled trial to evaluate the effectiveness of an adaptive, multifaceted intervention in general practice for patients with complex multimorbidity.Methods and analysis In this study, 250 recruited general practices will be randomly assigned 1:1 to either the intervention or control group. The eligible population are adult patients with two or more chronic conditions, at least one contact with secondary care within the last year, taking at least five repeat prescription drugs, living independently, who experience significant problems with their life and health due to their multimorbidity. During 2023 and 2024, intervention practices are financially incentivised to provide an extended consultation based on a patient-centred framework to eligible patients. Control practices continue care as usual. The primary outcome is need-based quality of life. Outcomes will be evaluated using linear and logistic regression models, with clustering considered. The analysis will be performed as intention to treat. In addition, a process evaluation will be carried out and reported elsewhere.Ethics and dissemination The trial will be conducted in compliance with the protocol, the Helsinki Declaration in its most recent form and good clinical practice recommendations, as well as the regulation for informed consent. The study was submitted to the Danish Capital Region Ethical Committee (ref: H-22041229). As defined by Section 2 of the Danish Act on Research Ethics in Research Projects, this project does not constitute a health research project but is considered a quality improvement project that does not require formal ethical approval. All results from the study (whether positive, negative or inconclusive) will be published in peer-reviewed journals.Trial registration number NCT05676541.

This paper investigates the competition between two charge point operators at the same site for future battery electric long-haul trucks. The charge point operators are located along one of the busiest highways in Sweden. The investigation is carried out using an agent-based model where trucks select charge point operators based on charging prices and the length of any queues, while charge point operators adjust their prices and number of chargers to improve their profitability. The study aims to predict conditions for trucks and charge point operators in a future public fast-charging market. Our findings indicate the potential for a well-functioning future public fast-charging market with small queuing problems, high utilisation, and reasonable prices for public fast charging. Assuming a price for electricity of EUR 0.08/kWh and a minimum profit margin of EUR 0.001/kWh for charge point operators, the findings indicate that the price level outside rush hours will be low, approximately EUR 0.1/kWh. The prices during rush hours will likely be much higher, but it is harder to predict the value due to uncertainties of how charge point operators will act in the future market. Still, from the model result, the price during rush hours is suggested to be just above EUR 0.5/kWh, with an average charging price of around EUR 0.15/kWh. It also seems likely that it is profitable for charge point operators to build enough chargers so that charging queues are short. [ABSTRACT FROM AUTHOR]

AbstractIntroductionAimMethodsResultsDiscussion and implicationsConclusionsThe prevalence of sleep disorders and use of sleep medication, particularly melatonin, are rising among adolescents and young adults (13–24 years). In Denmark, melatonin is approved for use in children with autism and ADHD up to 18 years of age, with other prescriptions being off-label in these age groups. The perspectives of medical practitioners on prescribing sleep medications to this age group remain largely unexplored.This study aims to investigate the considerations of general practitioners (GPs) and child and adolescent psychiatrists (psychiatrists) when prescribing and deprescribing sleep medications for 13–24-year-olds.We conducted qualitative semi-structured interviews with 10 GPs and six psychiatrists. Data were analyzed using an inductive approach.Psychiatrists typically prescribed melatonin with the expectation that deprescription would occur in general practice. Despite the universal goal of deprescription, it was hindered by various challenges. GPs identified patient motivation and a clear focus on deprescription as facilitative factors and expressed a need for enhanced emphasis on these aspects in general practice.The findings align with existing prescription trends and literature on factors that promote and inhibit deprescription. The study underscores the complexities of deprescribing sleep medications for adolescents and young adults, suggesting the need for expanded guidelines and enhanced continuing education for GPs.The research highlights significant discrepancies among medical practitioners regarding the deprescription process of sleep medications for young individuals, complicated by multiple factors. This underscores the need for better guidelines and further studies. [ABSTRACT FROM AUTHOR]