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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]

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]

Background This paper reviews the early work of Griffith Edwards and his colleagues on alcohol in the criminal justice system and outlines the direction of research in this area in the Addiction Research Unit in the 1960s and 1970s. The paper outlines the link between that work and work undertaken in the more recent past in this area. Methods The key papers of the authors are reviewed and the impact of this work on policy and practice is discussed. Conclusions There is a rich seam of work on deprived and incarcerated populations that has been under way at the Addiction Research Unit and subsequently the National Addiction Centre, Institute of Psychiatry, London. Griffith Edwards initiated this work that explores the risks and problems experienced by people moving between the health and criminal justice system, and demonstrated the need for better care and continuity across this system [ABSTRACT FROM AUTHOR]

LINKED CONTENT This article is linked to Taxonera et al paper. To view this article, visit https://doi.org/10.1111/apt.15804 [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]

Context The National Institute for Health and Care Excellence ( NICE) has an explicit mandate to include patient and public involvement in the appraisal of medicines to be available for funding on the NHS. NICE involves an appraisal committee who are required to take on board experiential evidence from patient experts alongside population-based evidence on clinical and cost-effectiveness when making a decision whether to fund a drug. Objective This paper considers how NICE Single Technological Appraisal ( STA) committees attempt to incorporate the views of patients in making decisions about funding medicines on the NHS. Methods A prospective design was employed to follow three pharmaceutical products involving three different appraisal committees. Three data collection methods were used: analysis of documentary evidence sent by NICE, non-participant unstructured observations of the open and closed sessions of meetings and qualitative interviews. Settings and participants Unstructured non-participant observations were carried out at nine STA meetings, and 41 semi-structured interviews were undertaken with committee members from NICE's STA committees, patient experts, analysts from NICE's project team and drug manufacturers. Results Our analysis showed how the committees displayed a preference for an ideal-type of patient representative, disagreement among the committee when weighing-up patient statements in the STA process and more pre-preparation support for patient involvement. Conclusions Although NICE has attempted to adopt an approach flexible to patients and carers through formal decision-making arrangements that incorporate patient views, nonetheless, the processes of the STAs can in fact undermine the very evidence collected from patient representatives. [ABSTRACT FROM AUTHOR]

ADVERTISING frequently generates controversy. Few industries, however, have so much strong feeling aroused by their promotional activities as pharmaceuticals. This paper discusses some of the specific reasons why pharmaceutical promotion may provide cause for concern and tries by statistical investigation to establish whether or not grounds exist for some of the criticisms to which the industry has been subjected. The paper is in two main sections. Firstly, promotion in the industry and some of the specific arguments which are directed against it are examined. Secondly, the variables used in a cross- sectional, multiple regression analysis carried out on pharmaceutical promotion are described and the results of the analysis presented. The exercise was carried out using promotional data for the calendar year 1966. [ABSTRACT FROM AUTHOR]

The article presents the discussion on technologies, medicines and treatments. Topics include a strong family history of pancreatic cancer, hereditary pancreatitis, or other hereditary syndromes increasing the risk; and spread by aerosol, droplets, or direct contact with respiratory secretions of someone carrying the organism.

The article presents an interview with Professor David Webb president of the organization, British Pharmacological Society (BPS) and Christison professor of therapeutics and clinical pharmacology at the University of Edinburgh, Scotland. He discusses how he feels passionate about pharmocology. He discusses drug development including challenges faced by it, the impact of British exit from the European Union (BREXIT) on it, and its future. He discusses the representation of women in the field.

Background: The use of prescription drugs with anticholinergic properties has been associated with multiple negative health outcomes in older people. Moreover, recent evidence suggests that associated adverse effects may occur even decades after stopping anticholinergic use. Despite the implicated importance of examining longitudinal patterns of anticholinergic prescribing for different age groups, few such data are available. Methods: We performed an age‐period‐cohort (APC) analysis to study trends in an aggregate measure of anticholinergic burden between the years 1990 and 2015, utilising data from >220 000 UK Biobank participants with linked prescription data from primary care. Results: Anticholinergic burden in the sample increased up to 9‐fold over 25 years and was observed for both period and age effects across most classes of drugs. The greatest increase was seen in the prescribing of antidepressants. Female sex, lower education and greater deprivation were associated with greater anticholinergic burden. Conclusions: The increase in anticholinergic prescribing is mostly due to an increase in polypharmacy and is attributable to both ageing of participants and period‐related changes in prescribing practices. Research is needed to clarify the implications of rising anticholinergic use for public health and to contextualise this rise in light of other relevant prescribing practices. [ABSTRACT FROM AUTHOR]

This paper reports data from HM Customs and Excise (HMCE) of recorded cases of adolescent drug trafficking through all sea and air points of entry into the UK over a 10-year period (May 1992-May 2002). We report the characteristics of 38 cases of mixed gender and nationality ranging in age between 13 and 18 years who have been apprehended by HMCE due to the illegal importation of drugs. Highlighted is an increasing trend in UK national male and female adolescents being apprehended for drug trafficking. Of particular note is the observation that more young adolescent females were apprehended importing large consignments of Class A substances than their male counterparts. [ABSTRACT FROM AUTHOR]

Adherence to medicines tends to be envisaged as a matter of actors' reasoned actions, though there is increasing emphasis on situating adherence as a practice materialised in everyday routines. Drawing on the qualitative interview accounts of Black African women living with HIV in London, UK, we treat adherence to HIV medicines as not only situated in the practices of the immediate and everyday but also relating to a hinterland of historical and social relations. We move from accounts which situate adherence as an embodied matter of affect in the present, to accounts which locate adherence as a condition of precarity, which also trace to enactments of time and place in the past. Adherence is therefore envisaged as a multiple and fluid effect which is made‐up in‐the‐now and in relation to a hinterland of practices which locate elsewhere. [ABSTRACT FROM AUTHOR]

This was a rapid review of systematic reviews (SRs) on problematic polypharmacy (PP) in the UK. The commissioner‐defined topics were burden of PP, interventions to reduce PP, implementation activities to increase uptake of interventions, and efficient handover between primary and secondary care to reduce PP. Databases including Medline were searched to June 2019, SR quality was assessed using AMSTAR‐2 (A MeaSurement Tool to Assess systematic Reviews) and a narrative synthesis was undertaken. Except for burden of PP (SRs had to include UK studies), there were no restrictions on country, location of care or outcomes. Nine SRs were included. On burden, three SRs (including six UK studies) found a high prevalence of polypharmacy in long term care. PP was associated with mortality, although unclear if causal, with no information on costs or health consequences. On interventions, six reviews (27 UK studies) found that interventions can reduce PP, but no effects on health outcomes. On handover between primary and secondary care, one review (two UK studies) found medicine reconciliation activities to reduce medication discrepancies at care transitions reduce PP, although the evidence is low quality. No SRs on implementation activities to increase uptake of interventions were found. SR quality was variable, with some concerns regarding meta‐analysis methods. Evidence of the extent of PP in the UK, and what interventions to address it are effective in the UK, is limited. Future UK research is needed on the prevalence and consequences of PP, the effectiveness and cost‐effectiveness of interventions to reduce PP, and barriers and activities to ensure uptake. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) describes the evolution of treatment‐resistant pathogens, with potentially catastrophic consequences for human medicine. AMR is driven by the over‐prescription of antibiotics, and could be reduced through consideration of the ethical dimensions of the dilemma faced by doctors. This dilemma involves balancing apparently opposed interests of current and future patients, and unique contextual factors in different countries, which may modify the core dilemma. We describe three example countries with different economic backgrounds and cultures—South Africa, Sri Lanka and the United Kingdom. Then we discuss how country‐specific factors impact on the prominence of various ethical dimensions of the dilemma (visibility and moral equality of future generations; Rule of Rescue; prescribing autonomy and conflicts of interest; consensus on collective action). We conclude that a nuanced understanding of national prescribing dilemmas is critical to inform the design of effective stewardship approaches. [ABSTRACT FROM AUTHOR]

Since it was first published in 1949, the British National Formulary (BNF) has been the lead authority on the selection and use of medicines for health professionals in the UK. Here, Joy Ogden discusses how the BNF has evolved, from its first inception to the modern age of digital publishing. [ABSTRACT FROM AUTHOR]

Objectives The aim of the study was to assess, among people living with HIV, knowledge of their latest HIV viral load ( VL) and CD4 count. Methods Agreement between self-report and clinic record was assessed among 2771 HIV-diagnosed individuals on antiretroviral treatment ( ART) in the UK Antiretrovirals, Sexual Transmission Risk and Attitudes Study (2011-2012). A confidential self-completed questionnaire collected information on demographic, socioeconomic, HIV-related and health-related factors. Participants were asked to self-report their latest VL [undetectable (≤ 50 copies/mL), detectable (> 50 copies/mL) or 'don't know'] and CD4 count (< 200, 200-350, 351-500 or > 500 cells/μL, or 'don't know'). Latest clinic-recorded VL and CD4 count were documented. Results Of 2678 participants on ART, 434 (16.2%) did not accurately report whether their VL was undetectable. Of 2334 participants with clinic-recorded VL ≤ 50 copies/mL, 2061 (88.3%) correctly reported undetectable VL; 49 (2.1%) reported detectable VL; 224 (9.6%) did not know their VL. Of 344 participants with clinic-recorded VL > 50 copies/mL, 183 (53.2%) correctly reported detectable VL; 76 (22.1%) reported undetectable VL; 85 (24.7%) did not know their VL. Of 2137 participants who reported undetectable VL, clinic-recorded VL was ≤ 50 copies/mL for 2061 (96.4%) and <1000 copies/mL for 2122 (99.3%). In analyses adjusted for gender/sexual orientation, ethnicity, age and time since starting ART, factors strongly associated with inaccurate self-report of VL (including 'don't know') included socioeconomic disadvantage [prevalence ratio (95% CI) for 'not' vs. 'always' having enough money for basic needs: 2.4 (1.9, 3.1)], poor English fluency [3.5 (2.4, 5.1) vs. UK born], nondisclosure of HIV status [1.7 (1.3, 2.1)], ART nonadherence [2.1 (1.7, 2.7) for three or more missed doses vs. none in the past 2 weeks] and depressive symptoms ( PHQ-9 score ≥ 10) [1.9 (1.6, 2.2)]. Overall, 612 (22.9%) of 2667 participants on ART did not accurately self-report whether or not their CD4 count was ≤ 350 cells/μL. Conclusions There is a high level of accuracy of a self-report of undetectable VL in people on ART in the UK. Overall, accurate knowledge of personal VL level varied according to demographic, socioeconomic, HIV-related and health-related factors. Active identification of people who may benefit from increased levels of support and engagement in care is important. [ABSTRACT FROM AUTHOR]

The article focuses on the need of implementation of pharmacist prescribing (PP) in Australia. It notes the importance of PP in providing access to care, improving safety and reducing variability in care delivery. It mentions Third Patient Safety Challenge, Medication Without Harm released by World Health Organization Medication with a goal to reduce medication-related harm. It notes the advancements in digital health initiatives in Australia and its contribution to quality use of medicine.

Aims To determine whether the provision of contingencymanagement using financial incentives to improve hepatitis B vaccine completion in people who inject drugs entering community treatment represents a cost-effective use of healthcare resources. Design A probabilistic cost-effectiveness analysis was conducted, using a decision-tree to estimate the short-term clinical and health-care cost impact of the vaccination strategies, followed by a Markov process to evaluate the long-term clinical consequences and costs associated with hepatitis B infection. Settings and participants Data on attendance to vaccination from a UK cluster randomized trial. Intervention Two contingency management options were examined in the trial: fixed versus escalating schedule financial incentives. Measurement Life-time health-care costs and quality-adjusted life years discounted at 3.5% annually; incremental cost-effectiveness ratios. Findings The resulting estimate for the incremental life-time health-care cost of the contingency management strategy versus usual care was £21.86 [95% confidence interval (CI) = -£12.20 to 39.86] per person offered the incentive. For 1000 people offered the incentive, the incremental reduction in numbers of hepatitis B infections avoided over their lifetime was estimated at 19 (95% CI = 8-30). The probabilistic incremental cost per quality adjusted life-year gained of the contingency management programmewas estimated to be £6738 (95% CI = £6297-7172),with an 89% probability of being considered cost-effective at a threshold of £20 000 per quality-adjusted life years gained (97.60% at £30 000). Conclusions Using financial incentives to increase hepatitis B vaccination completion in people who inject drugs could be a cost-effective use of health-care resources in the UK as long as the incidence remains above 1.2%. [ABSTRACT FROM AUTHOR]

The article offers information on the guidelines from the British HIV Association concerning the use of antiretroviral therapy for the treatment of adults with HIV-1 positive in 2015. Topics discussed include the areas of treatment and care identified by the guidelines, the factors affecting the outcomes of treatment and adverse effects, and the direct impact of the socio-economic status of an individual on adherence.

The article presents drug and pharmaceutical industry news briefs as of August 2016. Great Britain has introduced uniform packaging regulations for tobacco products. The U.S. Food and Drug Administration (FDA) has released regulations on vaping products and electronic cigarettes (e-cigarettes). The European Monitoring Centre on Drugs and Drug Abuse (EMCDDA) released its "European Drug Report" which found a rise in ectasy and synthetic cannabis use in European Union member states.

This section offers news briefs on relating to addiction as of June 2016. It announces the implementation of the Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules 2014 in India. It reports the prescription drug monitoring to be introduced in Victoria to prevent overdoses, as well as the ruling by the Texas Supreme Court upholding a state Supreme Court decision to impose a special tax on cigarette makers.

Background: An increasing part of prescribing of medicines is done for the purpose of managing risk for disease and is motivated by clinical and economic benefit on a long‐term, population level. This makes benefit from medicines less tangible for individuals. Sociology of pharmaceuticals includes personal and social perspectives in the study of how medicines are used. We use two characterizations of patients' expectations of medicines to start forming a description of how individuals conceptualize benefits from risk management medicines. Search strategy and synthesis: We reviewed the literature on patients' expectations with a focus on the influences on expectations regarding medicines prescribed for long‐term conditions. Searches in Medline and Scopus identified 20 studies for inclusion, describing qualitative aspects of beliefs, views, thoughts and expectations regarding medicines. Results: A qualitative synthesis using a constant comparative thematic analysis identified four themes describing influences on expectations: a need to achieve a specific outcome; the development of experiences and evaluation over time; negative values such as dependency and social stigma; and personalized meaning of the necessity and usefulness of medicines. Conclusions: The findings in this synthesis resonate with previous research into expectations of medicines for prevention and treatment of different conditions. However, a gap in the knowledge regarding patients' conceptualization of future benefits with medicines is identified. The study highlights suggestions for further empirical work to develop a deeper understanding of the role of patients' expectations in prescribing for long‐term risk management. [ABSTRACT FROM AUTHOR]

Responding effectively to children and young people's (CYP's) needs in relation to the overlapping issues of parental substance use (alcohol and other drugs) and domestic abuse requires an understanding of their perspectives and experiences. This study set out to explore the views of CYP on the impact of substance use on violent and abusive behaviours within intimate relationships in order to inform practice and policy development. Fourteen young people attended focus groups at three different specialist substance use support services for families in England. The results showed clear ambivalence about alcohol use in particular and its impact on violent and abusive behaviours. They did not blame substances for subsequent violent or abusive behaviour overall, however, the quantities and type of substances used were considered key to such behaviour. Most importantly, the CYP reported that getting help with substance problems does not automatically improve relationships, indeed, there are situations when pressure to change substance use can make relationships worse. The implications for social care practice are discussed. [ABSTRACT FROM AUTHOR]

The UK's Life Sciences Strategy provides UK clinical pharmacologists with a unique opportunity to enhance the impact of their discipline on patients and the NHS as well as the pharmaceutical industry. The full benefits of electronic prescribing systems, supported by artificial intelligence, will require clinical pharmacological expertise. Similarly, the Strategy's support for ‘healthy ageing’ will only be realized if clinical pharmacologists are able to use their expertise in promoting the safe and effective use of medicines in older people. Furthermore, their needs to be an active – and continuing – collaboration between clinical pharmacologists in the NHS and the pharmaceutical industry in general as well as with the discipline of pharmaceutical medicine. [ABSTRACT FROM AUTHOR]

In this feature guest writers Michael Raynor and Jenny Craven from the National Institute for Health and Care Excellence ( NICE) present an overview of their evaluative research study on the value and impact of the information skills training courses they provide at NICE. In particular, this small study used a combination of qualitative and quantitative data to look beyond satisfaction and confidence levels and identify whether learning had actually taken place as a result of attending the sessions, and how new skills were used by the attendees in their day-to-day work. H.S. [ABSTRACT FROM AUTHOR]

The article presents updates on the medicines, technologies and treatments of diabetes in Great Britain as of July 2021. Also cited are the roll-out of the Diabetes e-Passport program in several National Health Service (NHS) trusts and the requirements for the applications of new active substances and indications for existing medicines from the Medicines and Healthcare products Regulatory Agency (MHRA).

A national war formulary, published during the Second World War, was succeeded by hardback books called British National Formularies (BNFs), which were produced by the British Medical Association and the Royal Pharmaceutical Society about every 3 years until 1976. In 1981 a greatly revised and improved softback version was published and it has been revised and published twice a year since. It has acquired a reputation for being reliable, relevant and up to date. In 2005 the BNF for Children (BNFC) appeared and it has been revised and published every year since. Both BNFs have been used extensively in training prescribers and dispensers, they have supported increasing numbers of 'non-medical' prescribers and overseas use has grown. The current challenge is to provide the BNF data electronically, as three examples show. First, the contents of the BNF and BNFC are available digitally at BNF.org and BNFC.org, and via mobile devices, which require internet access, or as a download, which does not. Secondly, FormularyComplete is a system that enables hospitals, regions, or even countries to create their own formularies, by adding information on costs, local policies and drug availability to an intranet version of the BNF, a data source that cannot be modified. Thirdly, the BNF is working with others to provide the BNF data as computer-readable content, to support electronic prescribing and medicines management. Whatever systems are used, the information on drugs must be reliable and, ideally, all prescribers and dispensers in the UK should be guided by the same data source. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Decisions on whether and how to 'schedule' drugs (i.e. to determine their legal status and penalties to be applied for sale or possession) are often heavily criticized. We sought to assess more comprehensively the results of such decisions for newly emerging drugs. Methods Through analysis of legislation and secondary sources, we identified 63 substances that have emerged since 1971, including all that have been added to the most restrictive schedule by the United Nations, United States, United Kingdom, Canada, Australia and/or New Zealand. Measurements For each jurisdiction we recorded whether, when, and how the substance was scheduled and note what decisions engendered substantial criticism or controversy within the international treaties' framework of balancing medical benefits with risk of abuse. Findings (i) The rate of emergence of new drugs has been fairly steady. (ii) There is broad cross-national agreement on what should be scheduled. (iii) The United States often acts first. (iv) Temporary bans that delay final decisions by 12-18 months can sometimes allow final decisions to be grounded on a substantially expanded research base. (v) It appears that no more than seven of the decisions reached by the United States with respect to the 63 substances are candidates for being considered errors, and arguably the United States has committed at most one serious Type I and one serious Type II error. Results for other countries are broadly similar. Conclusions The process for determining the legal status of new psychoactive substances appears to function reasonably well, within the framework of international treaty obligations. Most criticisms relate to one or a few substances (e.g. 3,4-methylenedioxymethamphetamine) and/or complaints that the decisions discount benefits that are not recognized by the treaties (e.g. recreational or religious use). [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the pharmacokinetics of intranasal crushed oxycontin and intravenous oxycodone in nondependent prescription opioid abusers. Researchers evaluated eight healthy volunteers. They found that the intranasal and intravenous methods of delivery of the drugs resulted in the drugs getting into the subjects' bloodstreams faster than if they had been administered in tablet form and that all drug doses were well tolerated by subjects.

Parental misuse of drugs or alcohol is known to be a common issue for child care social workers, yet there has been surprisingly little British research on the topic. The study reported here attempts to address this gap. All files going for long-term allocation in four London boroughs over on average 1 year were examined (290 files). Parental substance misuse (PSM) emerged as a major feature of social work caseloads. Of the 290 cases, 100 (34%) involved concerns about parental substance misuse. The families involving substance misuse were more vulnerable on a variety of measures: the children were younger, the parents had more individual problems and the families lived in more difficult social situations. PSM cases tended to be ‘heavy end’ at the point of allocation: they accounted for 62% of all children subject to care proceedings and 40% of those placed on the child protection register. There was a fairly even spread between alcohol and drug misuse, and a number of cases involved both. Substance misuse specialists were rarely involved in working with families, primarily because parents said that they did not think that they had a problem. Suggestions for ways in which policy and practice with PSM might be improved are made in light of these findings. [ABSTRACT FROM AUTHOR]

The European research-based pharmaceutical industry has been declining relative to its US counterpart for more than a decade. It remains a substantial and successful industry, and the UK continues to be a particular success story, but many challenges lie ahead in an increasingly competitive global environment. Recent attempts to reinvigorate and support pharmaceutical and biotech research and development have been numerous, and in the UK now include the R&D tax credit. But it is the operating environment and the structure of the market for pharmaceuticals that represent the biggest challenges for the industry and policy-makers. [ABSTRACT FROM AUTHOR]

Aim To investigate the persistence of use of heroin, cocaine and amphetamine drugs during imprisonment, and to identify factors associated with increased levels of persistence. Design The use of heroin, cocaine and amphetamine by current prison inmates has been examined and, in particular, the relationship between drug use within prison and the type of drug used prior to imprisonment, recency of use and severity of dependence. Setting and participants A randomly selected sample of 1009 adult male prisoners in 13 prisons in England and Wales during 1994/95; structured confidential interviews conducted by independent research staff. Enquiry about prior use of heroin, cocaine or amphetamine focused on three time-periods (ever, last year and last month pre-prison) and the use of these drugs during the first month of imprisonment. Findings A total of 557 (55%) of the 1009 prisoners had used previously one of the three drugs selected for study: 58% had used heroin, 69% cocaine and 75% amphetamine. More than half (59%; 327/557) had used these drugs in the month before the current imprisonment. Drug use in prisons was most likely to occur among those who had used in the month prior to imprisonment. The persistence of heroin use in prison occurred more frequently (70%) than use of cocaine (20%) or amphetamine (15%). Of those using heroin pre-imprisonment, 67% considered they were dependent, compared to 15% and 22%, respectively, for cocaine and amphetamine users. Conclusions Changes in the drug-taking behaviour of drug users after imprisonment vary according to the type of drug being taken. Prisoners were much more likely to continue to use heroin than either cocaine or amphetamines while in prison. Heroin was most likely to be used by those who had been using heroin during the immediate pre-imprisonment period, and particularly by the two-thirds of heroin users who considered themselves dependent. In view of the high prevalence of prior use of these drugs by individuals currently imprisoned, continuing attention is required to study of their behaviour and of the impact of interventions that may be introduced during or following their incarceration. [ABSTRACT FROM AUTHOR]

This article proposes a new index that seeks to measure the national strength of the pharmaceutical intellectual property environment of a given country. This Pharmaceutical IP Index focuses on four countries: the US, the UK, Singapore and Israel. [ABSTRACT FROM AUTHOR]

Comments on the use of drug sniffer dogs in mental health settings in Great Britain. Prevalence use of substance by people with mental illness; Functions of sniffer dogs in detecting illicit drugs on wards and hospital grounds; Implications of using drug sniffer dogs.

Corticosteroids are an essential component of treatment for acute lymphoblastic leukaemia (ALL). Prednisolone is the most commonly used steroid, particularly in the maintenance phase of therapy. There is increasing evidence that, even in equipotent dosage for glucocorticoid effect, dexamethasone has enhanced lymphoblast cytotoxicity and penetration of the central nervous system (CNS) compared with prednisolone. Substitution of dexamethasone for prednisolone in the treatment of ALL might, therefore, result in improved event-free and overall survival. Children with newly diagnosed ALL were randomly assigned to receive either dexamethasone or prednisolone in the induction, consolidation (all received dexamethasone in intensification) and continuation phases of treatment. Among 1603 eligible randomized patients, those receiving dexamethasone had half the risk of isolated CNS relapse ( P = 0·0007). Event-free survival was significantly improved with dexamethasone (84·2% vs. 75·6% at 5 years; P = 0·01), with no evidence of differing effects in any subgroup of patients. The use of 6·5 mg/m2 dexamethasone throughout treatment for ALL led to a significant decrease in the risk of relapse for all risk-groups of patients and, despite the increased toxicity, should now be regarded as part of standard therapy for childhood ALL. [ABSTRACT FROM AUTHOR]

The research potential of many UK clinical databases is not being realized. A recent report published by the Royal College of Paediatrics&Child Health stated that there is a need to build research capacity and support in the area of paediatric pharmacology, with specific emphasis on the use of clinical databases. This article presents the databases available in the UK for medication research and gives some examples of paediatric studies conducted. The databases discussed include the Prescription Pricing Authority database, the General Practice Research Database, IMS Health databases (Medical Data Index, MIDAS Prescribing Insights, Disease-Analyser-Mediplus) and the Yellow Card Scheme. Other databases such as the Medicines Monitoring Unit (MEMO) and the Scottish Primary Care Computer System also have research potential in paediatric pharmacoepidemiology, but their population sizes are relatively small. [ABSTRACT FROM AUTHOR]

Questions concerning sexual abuse before and after the age of 16 years were included in a general population survey of a representative sample of 1052 UK women and 975 UK men. A total of 12.5% of women reported experiencing some form of sexual abuse before the age of 16 years. The corresponding figures for men in this category were 11.7%. After the age of 16, the figure for women remained at this level. However, the proportion of men reporting these traumatic experiences dropped to 3.2%. Sexual abuse both pre and post age 16 was associated with being single or cohabiting, with higher levels of cigarette-smoking, alcohol consumption, experience of alcohol-related problems and use of illicit drugs. The relationship between drinking and other forms of psychoactive drug use and sexual abuse is complex. Some possible explanations for this connection and its therapeutic and practical implications are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Describes a medicine return campaign in Great Britain. Encouragement of people to return surplus or out-dated medicines; Encouragement of more responsible attitude toward the care of medicines; Discouragement of people from accepting medicaments which had been prescribed for other people; Organization of the campaign; Results of the campaign.

Steve Chaplin examines NICE's proposals to introduce two weighting systems into its technology appraisal process in order to better reflect the value of new treatments. [ABSTRACT FROM AUTHOR]

Thirty-one percent of patients within a male medium secure unit (MMSU) were identified with treatment resistant schizophrenia. Almost half of these patients had not received clozapine treatment at least once during the course of their treatment history. The authors recommend that early identification of these patients and the appropriate use of therapeutic treatments, including clozapine, could lead to better outcomes for patients and significant cost savings for the NHS. [ABSTRACT FROM AUTHOR]

The article offers information on the Big Bang national science and engineering fair that was held in Great Britain in March 2009. The event featured several projects related to chemistry made by students ages 11-19 years old, including gas diffusion layer (GDL) device for fuel cells, development of malaria drugs with the use of microwaves and catalyst deactivation. The students who won at the fair is also presented, such as Peter Hatfield as the Young Scientist of the Year.

Compares the analgesic effects of opioid and non-steroidal anti-inflammatory drugs in the prevention of postoperative pain in dogs undergoing orthopedic surgery in Great Britain.