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1. Measuring Shifts in Mental Models in the Prevention of Childhood Obesity in Rural Australia

Author

Felmingham, Tiana, Bolton, Kristy A., Fraser, Penny, Allender, Steven, and Brown, Andrew D.

Abstract

Group model building is a participatory workshop technique used in system dynamics for developing community consensus to address complex problems by consensus building on individual assumptions. This study examines changes in individual mental models of the complex problem of childhood obesity following participation in group model building (GMB), as part of a larger community-based system dynamics project. Data are drawn from GMB participants across six community sites in the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) in rural and regional Victoria, Australia. Each community participated in two GMB sessions resulting in a causal loop diagram (CLD) of drivers of childhood obesity for each community. Presurvey and postsurvey captured participants' perspectives before and after (n = 25) participation in both GMB sessions and a blend of inductive and deductive qualitative content analysis was used to code individual responses. Three calculations were used to determine the number of responses, whether responses were a result of persuasion from others, and comparison of responses to those found in the CLD. Our study found participant mental models shifted during the course of the GMB sessions, with some responses persuaded by others and 75% of new insights identified in CLDs created by communities. The GMB process created a platform for participants to share ideas and learn from each other. In addition, participants listed new insights about childhood obesity in their community through developing CLDs.

Published
2023
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3. Changes in opioid prescribing during the COVID-19 pandemic in England: an interrupted time-series analysis in the OpenSAFELY-TPP cohort

Author

Bridges, Lucy, Butler-Cole, Benjamin FC, Davy, Simon, Dillingham, Iain, Evans, David, Fisher, Louis, Green, Amelia, Hart, Liam, Hickman, George, Maude, Steven, O'Dwyer, Thomas, Smith, Rebecca M, Stokes, Pete, Ward, Tom, Cockburn, Johnathan, Harper, Sam, Hester, Frank, Parry, John, Schaffer, Andrea L, Andrews, Colm D, Brown, Andrew D, Croker, Richard, Hulme, William J, Nab, Linda, Quinlan, Jane, Speed, Victoria, Wood, Christopher, Wiedemann, Milan, Massey, Jon, Inglesby, Peter, Bacon, Seb C J, Mehrkar, Amir, Bates, Chris, Goldacre, Ben, Walker, Alex J, and MacKenna, Brian

Published
2024
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4. Food policies for Aboriginal and Torres Strait Islander health (FoodPATH): A systems thinking approach

Author

Browne, Jennifer, Walker (Yorta Yorta), Troy, Hill (Torres Strait Islander), Karen, Mitchell (Mununjali), Fiona, Beswick, Holly, Thow (Pennemuker, Ngāti Porou), Stephanie, Ryan (Gunditjmara), Joleen, Sherriff (Wotjobaluk), Simone, Rossignoli, Amy, Ropitini (Ngāti Kahungunu, Ngāti Maniapoto), Abe, Johnstone, Michael, Paradies (Wakaya), Yin, Backholer, Kathryn, Allender, Steven, and Brown, Andrew D.

Published
2024
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6. Clinical and health inequality risk factors for non-COVID-related sepsis during the global COVID-19 pandemic: a national case-control and cohort study

Author

Walker, Alex J., MacKenna, Brian, Inglesby, Peter, Goldacre, Ben, Curtis, Helen J., Morley, Jessica, Mehrkar, Amir, Bacon, Sebastian C.J., Hickman, George, Croker, Richard, Evans, David, Ward, Tom, DeVito, Nicholas J., Fisher, Louis, Green, Amelia C.A., Massey, Jon, Smith, Rebecca M., Hulme, William J., Davy, Simon, Andrews, Colm D., Hopcroft, Lisa E.M., Dillingham, Iain, Higgins, Rose, Cunningham, Christine, Wiedemann, Milan, Nab, Linda, Maude, Steven, Macdonald, Orla, Butler-Cole, Ben F.C., O'Dwyer, Thomas, Stables, Catherine L., Wood, Christopher, Brown, Andrew D., Speed, Victoria, Bridges, Lucy, Schaffer, Andrea L., Walters, Caroline E., Bates, Christopher, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, Zhong, Xiaomin, Ashiru-Oredope, Diane, Pate, Alexander, Martin, Glen P., Sharma, Anita, Dark, Paul, Felton, Tim, Lake, Claire, Hand, Kieran, Bladon, Sian, Cunningham, Neil, Gilham, Ellie, Brown, Colin S., Mirfenderesky, Mariyam, Palin, Victoria, and van Staa, Tjeerd Pieter

Published
2023
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7. Healthy weight, health behaviours and quality of life among Aboriginal children living in regional Victoria

Author

Browne, Jennifer, Becker, Denise, Orellana, Liliana, Ryan, Joleen, Walker, Troy, Whelan, Jill, Alston, Laura, Egan, Mikaela, Johnson, Brittney, Rossignoli, Amy, Crooks, Nicholas, Brown, Andrew D., Bolton, Kristy A., Fraser, Penny, Le, Ha, Bell, Colin, Hayward, Josh, Sanigorski, Andrew, Backholer, Kathryn, Allender, Steven, and Strugnell, Claudia

Subjects
Victoria -- Health aspects -- Social aspects, Australian aborigines -- Health aspects -- Social aspects -- Behavior, Health behavior -- Social aspects, Children of minorities -- Health aspects -- Social aspects -- Behavior, Quality of life -- Health aspects -- Psychological aspects, Health
Abstract

: Objective: To report the prevalence of healthy weight and related behaviours among Victorian Aboriginal and non‐Aboriginal children and explore associations between these factors and health‐related quality of life (HRQoL). Methods: Analysis of cross‐sectional data from two cluster randomised controlled trials using logistic and linear mixed models. The sample included Aboriginal (n=303) and non‐Aboriginal (n=3,026) children aged 8–13 years. Results: More than two‐thirds of Aboriginal children met guidelines for fruit (75.9%), sweetened drinks (66.7%), sleep (73.1%), screen time (67.7%) and objectively measured physical activity (83.6%); and 79.1% reported consuming take‐away foods less than once per week. Aboriginal children were more likely to meet vegetable consumption guidelines (OR=1.42, 95%CI: 1.05, 1.93), but less likely to have a healthy weight (OR=0.66, 95%CI: 0.52, 0.85) than non‐Aboriginal children. Mean HRQoL scores were significantly higher among non‐Aboriginal children and both Aboriginal and non‐Aboriginal children meeting health guidelines. Conclusions: Most Aboriginal children in this study met guidelines for fruit, physical activity, screen time and sleep, and those meeting these guidelines had significantly higher HRQoL. Implications for public health: Promoting nutrition, physical activity and sleep is likely to benefit all children. Aboriginal community‐controlled organisations can use these data to design culturally‐specific programs that may improve disparities in healthy weight and HRQoL., Aboriginal and Torres Strait Islander peoples have lived on the lands, now known as Australia, for over 65,000 years, and are one of the world's oldest continuous populations.[sup.1] Compared to [...]

Published
2022
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9. Ethnic differences in the indirect effects of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: a population-based, observational cohort study using the OpenSAFELY platform

Author

Chaturvedi, Nishi, Park, Chloe, Carnemolla, Alisia, Williams, Dylan, Knueppel, Anika, Boyd, Andy, Turner, Emma L., Evans, Katharine M., Thomas, Richard, Berman, Samantha, McLachlan, Stela, Crane, Matthew, Whitehorn, Rebecca, Oakley, Jacqui, Foster, Diane, Woodward, Hannah, Campbell, Kirsteen C., Timpson, Nicholas, Kwong, Alex, Soares, Ana Goncalves, Griffith, Gareth, Toms, Renin, Jones, Louise, Annie, Herbert, Mitchell, Ruth, Palmer, Tom, Sterne, Jonathan, Walker, Venexia, Huntley, Lizzie, Fox, Laura, Denholm, Rachel, Knight, Rochelle, Northstone, Kate, Kanagaratnam, Arun, Horne, Elsie, Forbes, Harriet, North, Teri, Taylor, Kurt, Arab, Marwa A.L., Walker, Scott, Coronado, Jose I.C., Karthikeyan, Arun S., Ploubidis, George, Moltrecht, Bettina, Booth, Charlotte, Parsons, Sam, Wielgoszewska, Bozena, Bridger-Staatz, Charis, Steves, Claire, Thompson, Ellen, Garcia, Paz, Cheetham, Nathan, Bowyer, Ruth, Freydin, Maxim, Roberts, Amy, Goldacre, Ben, Walker, Alex, Morley, Jess, Hulme, William, Nab, Linda, Fisher, Louis, MacKenna, Brian, Andrews, Colm, Curtis, Helen, Hopcroft, Lisa, Green, Amelia, Patalay, Praveetha, Maddock, Jane, Patel, Kishan, Stafford, Jean, Jacques, Wels, Tilling, Kate, Macleod, John, McElroy, Eoin, Shah, Anoop, Silverwood, Richard, Denaxas, Spiros, Flaig, Robin, McCartney, Daniel, Campbell, Archie, Tomlinson, Laurie, Tazare, John, Zheng, Bang, Smeeth, Liam, Herrett, Emily, Cowling, Thomas, Mansfield, Kate, Costello, Ruth E., Wang, Kevin, Mansfield, Kathryn, Mahalingasivam, Viyaasan, Douglas, Ian, Langan, Sinead, Brophy, Sinead, Parker, Michael, Kennedy, Jonathan, McEachan, Rosie, Wright, John, Willan, Kathryn, Badrick, Ellena, Santorelli, Gillian, Yang, Tiffany, Hou, Bo, Steptoe, Andrew, Giorgio, Di Gessa, Zhu, Jingmin, Zaninotto, Paola, Wood, Angela, Cezard, Genevieve, Ip, Samantha, Bolton, Tom, Sampri, Alexia, Rafeti, Elena, Almaghrabi, Fatima, Sheikh, Aziz, Shah, Syed A., Katikireddi, Vittal, Shaw, Richard, Hamilton, Olivia, Green, Michael, Kromydas, Theocharis, Kopasker, Daniel, Greaves, Felix, Willans, Robert, Glen, Fiona, Sharp, Steve, Hughes, Alun, Wong, Andrew, Howes, Lee Hamill, Rapala, Alicja, Nigrelli, Lidia, McArdle, Fintan, Beckford, Chelsea, Raman, Betty, Dobson, Richard, Folarin, Amos, Stewart, Callum, Ranjan, Yatharth, Carpentieri, Jd, Sheard, Laura, Fang, Chao, Baz, Sarah, Gibson, Andy, Kellas, John, Neubauer, Stefan, Piechnik, Stefan, Lukaschuk, Elena, Saunders, Laura C., Wild, James M., Smith, Stephen, Jezzard, Peter, Tunnicliffe, Elizabeth, Sanders, Zeena-Britt, Finnigan, Lucy, Ferreira, Vanessa, Green, Mark, Rhead, Rebecca, Kibble, Milla, Wei, Yinghui, Lemanska, Agnieszka, Perez-Reche, Francisco, Piehlmaier, Dominik, Teece, Lucy, Parker, Edward, Walker, Alex J., Inglesby, Peter, Curtis, Helen J., Morton, Caroline E., Morley, Jessica, Mehrkar, Amir, Bacon, Sebastian C.J., Hickman, George, Croker, Richard, Evans, David, Ward, Tom, DeVito, Nicholas J., Green, Amelia C.A., Massey, Jon, Smith, Rebecca M., Hulme, William J., Davy, Simon, Andrews, Colm D., Hopcroft, Lisa E.M., Drysdale, Henry, Dillingham, Iain, Park, Robin Y., Higgins, Rose, Cunningham, Christine, Wiedemann, Milan, Maude, Steven, Macdonald, Orla, Butler-Cole, Ben F.C., O'Dwyer, Thomas, Stables, Catherine L., Wood, Christopher, Brown, Andrew D., Speed, Victoria, Bridges, Lucy, Schaffer, Andrea L., Walters, Caroline E., Rentsch, Christopher T., Bhaskaran, Krishnan, Schultze, Anna, Williamson, Elizabeth J., McDonald, Helen I., Tomlinson, Laurie A., Mathur, Rohini, Eggo, Rosalind M., Wing, Kevin, Wong, Angel Y.S., Grieve, Richard, Grint, Daniel J., Mansfield, Kathryn E., Douglas, Ian J., Evans, Stephen J.W., Walker, Jemma L., Cowling, Thomas E., Herrett, Emily L., Parker, Edward P.K., Bates, Christopher, Cockburn, Jonathan, Parry, John, Hester, Frank, Harper, Sam, O'Hanlon, Shaun, Eavis, Alex, Jarvis, Richard, Avramov, Dima, Griffiths, Paul, Fowles, Aaron, Parkes, Nasreen, Nicholson, Brian, Perera, Rafael, Harrison, David, Khunti, Kamlesh, Sterne, Jonathan AC., Quint, Jennifer, Henderson, Alasdair D., Carreira, Helena, Bidulka, Patrick, Warren-Gash, Charlotte, Hayes, Joseph F., Quint, Jennifer K., Katikireddi, Srinivasa Vittal, and Langan, Sinéad M.

Published
2023
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12. The impact of the COVID-19 pandemic on Antidepressant Prescribing with a focus on people with learning disability and autism: An interrupted time-series analysis in England using OpenSAFELY-TPP

Author

Cunningham, Christine, primary, Macdonald, Orla, additional, Schaffer, Andrea L, additional, Brown, Andrew D, additional, Wiedemann, Milan, additional, Fisher, Louis, additional, Curtis, Helen J, additional, Mehrkar, Amir, additional, Higgins, Rose, additional, Hulme, William J, additional, Speed, Victoria, additional, Ward, Thomas, additional, Croker, Richard, additional, Walker, Alex J, additional, Butler-Cole, Benjamin, additional, Andrews, Colm D, additional, Parry, John, additional, Bates, Chris, additional, Evans, David, additional, Inglesby, Peter, additional, Dillingham, Iain, additional, Davy, Simon, additional, Bridges, Lucy, additional, O'Dwyer, Thomas, additional, Maude, Steven, additional, Smith, Rebecca, additional, Hart, Liam, additional, Goldacre, Ben, additional, Bacon, Sebastian, additional, and MacKenna, Brian, additional

Published
2024
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13. Incidence and treatment of group A streptococcal infections during covid-19 pandemic and 2022 outbreak: retrospective cohort study in England using OpenSAFELY-TPP

Author

Cunningham, Christine, primary, Fisher, Louis, additional, Wood, Christopher, additional, Speed, Victoria, additional, Brown, Andrew D, additional, Curtis, Helen, additional, Higgins, Rose, additional, Croker, Richard, additional, Butler-Cole, Ben FC, additional, Evans, David, additional, Inglesby, Peter, additional, Dillingham, Iain, additional, Bacon, Sebastian CJ, additional, Beech, Elizabeth, additional, Hand, Kieran, additional, Davy, Simon, additional, Ward, Tom, additional, Hickman, George, additional, Bridges, Lucy, additional, O'Dwyer, Thomas, additional, Maude, Steven, additional, Smith, Rebecca M, additional, Mehrkar, Amir, additional, Hart, Liam C, additional, Bates, Chris, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, Goldacre, Ben, additional, and MacKenna, Brian, additional

Published
2024
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18. Binaural Hearing with Temporally Complex Signals

Author

Stecker, G. Christopher, Bernstein, Leslie R., Brown, Andrew D., Fay, Richard R., Series Editor, Popper, Arthur N., Series Editor, Avraham, Karen, Editorial Board Member, Bass, Andrew, Editorial Board Member, Cunningham, Lisa, Editorial Board Member, Fritzsch, Bernd, Editorial Board Member, Groves, Andrew, Editorial Board Member, Hertzano, Ronna, Editorial Board Member, Le Prell, Colleen, Editorial Board Member, Litovsky, Ruth, Editorial Board Member, Manis, Paul, Editorial Board Member, Manley, Geoffrey, Editorial Board Member, Moore, Brian, Editorial Board Member, Simmons, Andrea, Editorial Board Member, Yost, William, Editorial Board Member, Litovsky, Ruth Y., editor, and Goupell, Matthew J., editor

Published
2021
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19. The impact of COVID‐19 on medication reviews in English primary care. An OpenSAFELY‐TPP analysis of 20 million adult electronic health records.

Author

Wood, Christopher, Speed, Victoria, Fisher, Louis, Curtis, Helen J., Schaffer, Andrea L., Walker, Alex J., Croker, Richard, Brown, Andrew D., Cunningham, Christine, Hulme, William J., Andrews, Colm D., Butler‐Cole, Ben F. C., Evans, David, Inglesby, Peter, Dillingham, Iain, Bacon, Sebastian C. J., Davy, Simon, Ward, Tom, Hickman, George, and Bridges, Lucy

Subjects
MEDICATION reconciliation, ELECTRONIC health records, PRIMARY care, COVID-19 pandemic, COVID-19, CUCUMBER mosaic virus
Abstract

Aims: The COVID‐19 pandemic caused significant disruption to routine activity in primary care. Medication reviews are an important primary care activity ensuring safety and appropriateness of prescribing. A disruption could have significant negative implications for patient care. Using routinely collected data, our aim was first to describe codes used to record medication review activity and then to report the impact of COVID‐19 on the rates of medication reviews. Methods: With the approval of NHS England, we conducted a cohort study of 20 million adult patient records in general practice, in‐situ using the OpenSAFELY platform. For each month, between April 2019 and March 2022, we report the percentage of patients with a medication review coded monthly and in the previous 12 months with breakdowns by regional, clinical and demographic subgroups and those prescribed high‐risk medications. Results: In April 2019, 32.3% of patients had a medication review coded in the previous 12 months. During the first COVID‐19 lockdown, monthly activity decreased (−21.1% April 2020), but the 12‐month rate was not substantially impacted (−10.5% March 2021). The rate of structured medication review in the last 12 months reached 2.9% by March 2022, with higher percentages in high‐risk groups (care home residents 34.1%, age 90+ years 13.1%, high‐risk medications 10.2%). The most used medication review code was Medication review done 314530002 (59.5%). Conclusions: There was a substantial reduction in the monthly rate of medication reviews during the pandemic but rates recovered by the end of the study period. Structured medication reviews were prioritized for high‐risk patients. [ABSTRACT FROM AUTHOR]

Published
2024
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21. A protocol of a pilot randomised trial (Action-RESPOND) to support rural and regional communities with implementing community-based systems thinking obesity prevention initiatives.

Author

Yoong, Sze Lin, Brown, Andrew D., Leung, Gloria K. W., Hillenaar, Monique, David, Jennifer L., Hayward, Josh, Strugnell, Claudia, Bell, Colin, Brown, Vicki, Jackson, Michelle, and Allender, Steven

Subjects
*PREVENTION of obesity, *SYSTEMS theory, *OVERWEIGHT children, *CHILDHOOD obesity, *HEALTH care teams, *RESEARCH teams, *RESEARCH implementation
Abstract

Background: Over a quarter of children aged 2–17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods. Methods: This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via 'facilitation' methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community's specific needs and iii) are suitable for local context. Strategies also aimed to increase the community's capacity to implement, through iv) improving the health promotion team's implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team. Discussion: By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria. [ABSTRACT FROM AUTHOR]

Published
2024
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22. OpenSAFELY: The impact of COVID‐19 on azathioprine, leflunomide and methotrexate monitoring, and factors associated with change in monitoring rate.

Author

Brown, Andrew D., Fisher, Louis, Curtis, Helen J., Wiedemann, Milan, Hulme, William J., Speed, Victoria, Hopcroft, Lisa E. M., Cunningham, Christine, Costello, Ruth E., Galloway, James B., Russell, Mark D., Bechman, Katie, Kurt, Zeyneb, Croker, Richard, Wood, Chris, Walker, Alex J., Schaffer, Andrea L., Bacon, Seb C. J., Mehrkar, Amir, and Hickman, George

Abstract

Aims Methods Results Conclusion The COVID‐19 pandemic created unprecedented pressure on healthcare services. This study investigates whether disease‐modifying antirheumatic drug (DMARD) safety monitoring was affected during the COVID‐19 pandemic.A population‐based cohort study was conducted using the OpenSAFELY platform to access electronic health record data from 24.2 million patients registered at general practices using TPP's SystmOne software. Patients were included for further analysis if prescribed azathioprine, leflunomide or methotrexate between November 2019 and July 2022. Outcomes were assessed as monthly trends and variation between various sociodemographic and clinical groups for adherence with standard safety monitoring recommendations.An acute increase in the rate of missed monitoring occurred across the study population (+12.4 percentage points) when lockdown measures were implemented in March 2020. This increase was more pronounced for some patient groups (70–79 year‐olds: +13.7 percentage points; females: +12.8 percentage points), regions (North West: +17.0 percentage points), medications (leflunomide: +20.7 percentage points) and monitoring tests (blood pressure: +24.5 percentage points). Missed monitoring rates decreased substantially for all groups by July 2022. Consistent differences were observed in overall missed monitoring rates between several groups throughout the study.DMARD monitoring rates temporarily deteriorated during the COVID‐19 pandemic. Deterioration coincided with the onset of lockdown measures, with monitoring rates recovering rapidly as lockdown measures were eased. Differences observed in monitoring rates between medications, tests, regions and patient groups highlight opportunities to tackle potential inequalities in the provision or uptake of monitoring services. Further research should evaluate the causes of the differences identified between groups. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Clinical and health inequality risk factors for non-COVID-related sepsis during the global COVID-19 pandemic: a national case-control and cohort study

Author

Zhong, Xiaomin, primary, Ashiru-Oredope, Diane, additional, Pate, Alexander, additional, Martin, Glen P., additional, Sharma, Anita, additional, Dark, Paul, additional, Felton, Tim, additional, Lake, Claire, additional, MacKenna, Brian, additional, Mehrkar, Amir, additional, Bacon, Sebastian C.J., additional, Massey, Jon, additional, Inglesby, Peter, additional, Goldacre, Ben, additional, Hand, Kieran, additional, Bladon, Sian, additional, Cunningham, Neil, additional, Gilham, Ellie, additional, Brown, Colin S., additional, Mirfenderesky, Mariyam, additional, Palin, Victoria, additional, van Staa, Tjeerd Pieter, additional, Walker, Alex J., additional, Curtis, Helen J., additional, Morley, Jessica, additional, Hickman, George, additional, Croker, Richard, additional, Evans, David, additional, Ward, Tom, additional, DeVito, Nicholas J., additional, Fisher, Louis, additional, Green, Amelia C.A., additional, Smith, Rebecca M., additional, Hulme, William J., additional, Davy, Simon, additional, Andrews, Colm D., additional, Hopcroft, Lisa E.M., additional, Dillingham, Iain, additional, Higgins, Rose, additional, Cunningham, Christine, additional, Wiedemann, Milan, additional, Nab, Linda, additional, Maude, Steven, additional, Macdonald, Orla, additional, Butler-Cole, Ben F.C., additional, O'Dwyer, Thomas, additional, Stables, Catherine L., additional, Wood, Christopher, additional, Brown, Andrew D., additional, Speed, Victoria, additional, Bridges, Lucy, additional, Schaffer, Andrea L., additional, Walters, Caroline E., additional, Bates, Christopher, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, and Harper, Sam, additional

Published
2023
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31. Designer benzodiazepine dependence and the difficulties of outpatient management; a case report.

Author

Reeves, James J., Brown, Andrew D., and Collier, Brent S.

Subjects
*DRUG addiction, *DRUG withdrawal symptoms, *BENZODIAZEPINES, *TREATMENT effectiveness, *DRUG therapy, *ANXIETY, *TRANQUILIZING drugs, *OUTPATIENT services in hospitals, *GABAPENTIN
Abstract

Novel psychoactive substances, such as designer benzodiazepines (DBZD), are a growing public health concern. There are about 30 different DZBDs reported, which can vary widely in their effect and potential for harmful outcomes, ranging from agitation to confusion to coma. Despite the scope of this widespread phenomena, little information on the management of DBZD dependence is available in the literature. In this case report, we present a patient with DBZD dependence requesting assistance tapering off the DBZD, clonazolam. He began self-medicating with clonazolam seven years prior for panic attacks to the point he was using 40 drops per day and having significant withdrawal during the day. He was prescribed gabapentin for his underlying anxiety while he tapered his clonazolam dose. Once he achieved a 75% reduction in his use of clonazolam, he had trouble managing withdrawal and anxiety symptoms and could not taper further. We discuss the challenges of treating patients with DBZD use disorder in an outpatient setting. Switching a patient from a DZBD to a prescription benzodiazepine for the purposes of a taper can be dangerous as an outpatient due to the inability to monitor at-home DBZD usage and the resulting risk of overdose. DBZDs can also be highly potent and make it difficult to achieve success using current withdrawal guidelines. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Ethnic differences in the indirect effects of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: a population-based, observational cohort study using the OpenSAFELY platform

Author

Costello, Ruth E., primary, Tazare, John, additional, Piehlmaier, Dominik, additional, Herrett, Emily, additional, Parker, Edward P.K., additional, Zheng, Bang, additional, Mansfield, Kathryn E., additional, Henderson, Alasdair D., additional, Carreira, Helena, additional, Bidulka, Patrick, additional, Wong, Angel Y.S., additional, Warren-Gash, Charlotte, additional, Hayes, Joseph F., additional, Quint, Jennifer K., additional, MacKenna, Brian, additional, Mehrkar, Amir, additional, Eggo, Rosalind M., additional, Katikireddi, Srinivasa Vittal, additional, Tomlinson, Laurie, additional, Langan, Sinéad M., additional, Mathur, Rohini, additional, Chaturvedi, Nishi, additional, Park, Chloe, additional, Carnemolla, Alisia, additional, Williams, Dylan, additional, Knueppel, Anika, additional, Boyd, Andy, additional, Turner, Emma L., additional, Evans, Katharine M., additional, Thomas, Richard, additional, Berman, Samantha, additional, McLachlan, Stela, additional, Crane, Matthew, additional, Whitehorn, Rebecca, additional, Oakley, Jacqui, additional, Foster, Diane, additional, Woodward, Hannah, additional, Campbell, Kirsteen C., additional, Timpson, Nicholas, additional, Kwong, Alex, additional, Soares, Ana Goncalves, additional, Griffith, Gareth, additional, Toms, Renin, additional, Jones, Louise, additional, Annie, Herbert, additional, Mitchell, Ruth, additional, Palmer, Tom, additional, Sterne, Jonathan, additional, Walker, Venexia, additional, Huntley, Lizzie, additional, Fox, Laura, additional, Denholm, Rachel, additional, Knight, Rochelle, additional, Northstone, Kate, additional, Kanagaratnam, Arun, additional, Horne, Elsie, additional, Forbes, Harriet, additional, North, Teri, additional, Taylor, Kurt, additional, Arab, Marwa A.L., additional, Walker, Scott, additional, Coronado, Jose I.C., additional, Karthikeyan, Arun S., additional, Ploubidis, George, additional, Moltrecht, Bettina, additional, Booth, Charlotte, additional, Parsons, Sam, additional, Wielgoszewska, Bozena, additional, Bridger-Staatz, Charis, additional, Steves, Claire, additional, Thompson, Ellen, additional, Garcia, Paz, additional, Cheetham, Nathan, additional, Bowyer, Ruth, additional, Freydin, Maxim, additional, Roberts, Amy, additional, Goldacre, Ben, additional, Walker, Alex, additional, Morley, Jess, additional, Hulme, William, additional, Nab, Linda, additional, Fisher, Louis, additional, Andrews, Colm, additional, Curtis, Helen, additional, Hopcroft, Lisa, additional, Green, Amelia, additional, Patalay, Praveetha, additional, Maddock, Jane, additional, Patel, Kishan, additional, Stafford, Jean, additional, Jacques, Wels, additional, Tilling, Kate, additional, Macleod, John, additional, McElroy, Eoin, additional, Shah, Anoop, additional, Silverwood, Richard, additional, Denaxas, Spiros, additional, Flaig, Robin, additional, McCartney, Daniel, additional, Campbell, Archie, additional, Smeeth, Liam, additional, Cowling, Thomas, additional, Mansfield, Kate, additional, Costello, Ruth E., additional, Wang, Kevin, additional, Mansfield, Kathryn, additional, Mahalingasivam, Viyaasan, additional, Douglas, Ian, additional, Langan, Sinead, additional, Brophy, Sinead, additional, Parker, Michael, additional, Kennedy, Jonathan, additional, McEachan, Rosie, additional, Wright, John, additional, Willan, Kathryn, additional, Badrick, Ellena, additional, Santorelli, Gillian, additional, Yang, Tiffany, additional, Hou, Bo, additional, Steptoe, Andrew, additional, Giorgio, Di Gessa, additional, Zhu, Jingmin, additional, Zaninotto, Paola, additional, Wood, Angela, additional, Cezard, Genevieve, additional, Ip, Samantha, additional, Bolton, Tom, additional, Sampri, Alexia, additional, Rafeti, Elena, additional, Almaghrabi, Fatima, additional, Sheikh, Aziz, additional, Shah, Syed A., additional, Katikireddi, Vittal, additional, Shaw, Richard, additional, Hamilton, Olivia, additional, Green, Michael, additional, Kromydas, Theocharis, additional, Kopasker, Daniel, additional, Greaves, Felix, additional, Willans, Robert, additional, Glen, Fiona, additional, Sharp, Steve, additional, Hughes, Alun, additional, Wong, Andrew, additional, Howes, Lee Hamill, additional, Rapala, Alicja, additional, Nigrelli, Lidia, additional, McArdle, Fintan, additional, Beckford, Chelsea, additional, Raman, Betty, additional, Dobson, Richard, additional, Folarin, Amos, additional, Stewart, Callum, additional, Ranjan, Yatharth, additional, Carpentieri, Jd, additional, Sheard, Laura, additional, Fang, Chao, additional, Baz, Sarah, additional, Gibson, Andy, additional, Kellas, John, additional, Neubauer, Stefan, additional, Piechnik, Stefan, additional, Lukaschuk, Elena, additional, Saunders, Laura C., additional, Wild, James M., additional, Smith, Stephen, additional, Jezzard, Peter, additional, Tunnicliffe, Elizabeth, additional, Sanders, Zeena-Britt, additional, Finnigan, Lucy, additional, Ferreira, Vanessa, additional, Green, Mark, additional, Rhead, Rebecca, additional, Kibble, Milla, additional, Wei, Yinghui, additional, Lemanska, Agnieszka, additional, Perez-Reche, Francisco, additional, Teece, Lucy, additional, Parker, Edward, additional, Walker, Alex J., additional, Inglesby, Peter, additional, Curtis, Helen J., additional, Morton, Caroline E., additional, Morley, Jessica, additional, Bacon, Sebastian C.J., additional, Hickman, George, additional, Croker, Richard, additional, Evans, David, additional, Ward, Tom, additional, DeVito, Nicholas J., additional, Green, Amelia C.A., additional, Massey, Jon, additional, Smith, Rebecca M., additional, Hulme, William J., additional, Davy, Simon, additional, Andrews, Colm D., additional, Hopcroft, Lisa E.M., additional, Drysdale, Henry, additional, Dillingham, Iain, additional, Park, Robin Y., additional, Higgins, Rose, additional, Cunningham, Christine, additional, Wiedemann, Milan, additional, Maude, Steven, additional, Macdonald, Orla, additional, Butler-Cole, Ben F.C., additional, O'Dwyer, Thomas, additional, Stables, Catherine L., additional, Wood, Christopher, additional, Brown, Andrew D., additional, Speed, Victoria, additional, Bridges, Lucy, additional, Schaffer, Andrea L., additional, Walters, Caroline E., additional, Rentsch, Christopher T., additional, Bhaskaran, Krishnan, additional, Schultze, Anna, additional, Williamson, Elizabeth J., additional, McDonald, Helen I., additional, Tomlinson, Laurie A., additional, Wing, Kevin, additional, Grieve, Richard, additional, Grint, Daniel J., additional, Douglas, Ian J., additional, Evans, Stephen J.W., additional, Walker, Jemma L., additional, Cowling, Thomas E., additional, Herrett, Emily L., additional, Bates, Christopher, additional, Cockburn, Jonathan, additional, Parry, John, additional, Hester, Frank, additional, Harper, Sam, additional, O'Hanlon, Shaun, additional, Eavis, Alex, additional, Jarvis, Richard, additional, Avramov, Dima, additional, Griffiths, Paul, additional, Fowles, Aaron, additional, Parkes, Nasreen, additional, Nicholson, Brian, additional, Perera, Rafael, additional, Harrison, David, additional, Khunti, Kamlesh, additional, Sterne, Jonathan AC., additional, and Quint, Jennifer, additional

Published
2023
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41. Data-Driven Identification of Unusual Prescribing Behavior: Analysis and Use of an Interactive Data Tool Using 6 Months of Primary Care Data From 6500 Practices in England

Author

Hopcroft, Lisa EM, primary, Massey, Jon, additional, Curtis, Helen J, additional, Mackenna, Brian, additional, Croker, Richard, additional, Brown, Andrew D, additional, O'Dwyer, Thomas, additional, Macdonald, Orla, additional, Evans, David, additional, Inglesby, Peter, additional, Bacon, Sebastian CJ, additional, Goldacre, Ben, additional, and Walker, Alex J, additional

Published
2023
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43. An Event-Driven Approach to Genotype Imputation on a Custom RISC-V Cluster

Author

Morris, Jordan, Rafiev, Ashur, Bragg, Graeme M., Vousden, Mark L., Thomas, David B., Yakovlev, Alex, and Brown, Andrew D.

Abstract

This article proposes an event-driven solution to genotype imputation, a technique used to statistically infer missing genetic markers in DNA. The work implements the widely accepted Li and Stephens model, primary contributor to the computational complexity of modern x86 solutions, in an attempt to determine whether further investigation of the application is warranted in the event-driven domain. The model is implemented using graph-based Hidden Markov Modeling and executed as a customized forward/backward dynamic programming algorithm. The solution uses an event-driven paradigm to map the algorithm to thousands of concurrent cores, where events are small messages that carry both control and data within the algorithm. The design of a single processing element is discussed. This is then extended across multiple cores and executed on a custom RISC-V NoC cluster called POETS. Results demonstrate how the algorithm scales over increasing hardware resources and a multi-core run demonstrates a 270X reduction in wall-clock processing time when compared to a single-threaded x86 solution. Optimisation of the algorithm via linear interpolation is then introduced and tested, with results demonstrating a wall-clock reduction time of $\mathtt {\sim }$∼5 orders of magnitude when compared to a similarly optimised x86 solution.

Published
2024
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45. Protocol for the measurement of changes in knowledge and engagement in the stepped wedge cluster randomised trial for childhood obesity prevention in Australia: (Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND))

Author

Whelan, Jillian, Strugnell, Claudia, Allender, Steven, Korn, Ariella R., Brown, Andrew D., Orellana, Liliana, Hayward, Josh, Brown, Vicki, Bell, Colin, Moodie, Marj, Peeters, Anna, and Nichols, Melanie

Published
2020
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46. Identity Dialogues

Author

Pratt, Michael G., Foreman, Peter O., Scott, Susanne G., Lane, Vicki R., Gioia, Dennis A., Schultz, Majken, Corley, Kevin G., Brickson, Shelley, Brown, Andrew D., Starkey, Ken, Hogg, Michael A., and Terry, Deborah J.

Published
2000

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