Objectives To describe the characteristics and management of individuals attending hospital with self-harm assess changes in service quality since an earlier study 2001, a period which national guidance has been available. Design Observational study. Setting A stratified random sample 32 hospitals England, UK. Participants: 6442 presenting 7689 episodes during 3-month audit between 2010 2011. Outcome Self-harm episodes, key aspects individual relating to psychosocial assessment follow-up,...

<h3>PURPOSE</h3> Potentially inappropriate prescribing (PIP) is common in older people and can result increased morbidity, adverse drug events, hospitalizations. The OPTI-SCRIPT study (Optimizing Prescribing for Older People Primary Care, a cluster-randomized controlled trial) tested the effectiveness of multifaceted intervention reducing PIP primary care. <h3>METHODS</h3> We conducted trial among 21 general practitioner practices 196 patients with PIP. Intervention participants received...

Official suicide statistics for England are based on deaths given verdicts and most cases an open verdict following a coroner's inquest. Previous research indicates that some accidental considered to be suicides by clinicians. Changes in coroners' use of different may bias trend estimates. We investigated whether trends over- or underestimated when they verdicts. Method Possible assessed 12 English coroners 1990/91, 1998 2005 assigned open, accident/misadventure narrative were rated three...

Background Polypharmacy (≥5 medications) is common in older patients and associated with adverse outcomes. Patients’ beliefs about medication can influence their expectations for medication, adherence, willingness to deprescribe. Few studies have examined prescribed among polypharmacy primary care. Aim To explore medication-related factors that might beliefs. Design setting A mixed methods study utilising data from a randomised controlled trial aiming decrease potentially inappropriate...

Background Self-harm is a common reason for Emergency Department (ED) attendance. We aimed to develop clinical tool help identify patients at higher risk of repeat self-harm, or suicide, within 6 months an ED self-harm presentation. Method The tool, the ReACT Self-Harm Rule, was derived using multicentre data from prospective cohort study. Binary recursive partitioning applied two centres, and separate centre were used test tool. There 29 571 presentations five hospital EDs between January...

Objective To investigate the extent to which risk scales were used for assessment of self-harm by emergency department clinicians and mental health staff, examine association between use a scale measures service quality repeat within 6 months. Design Observational study. Setting A stratified random sample 32 hospitals in England. Participants 6442 individuals presenting with hospital services during 3-month period 2010 2011. Outcomes 21-item measure quality, Results variety different tools...

Potentially inappropriate prescribing (PIP) is common in older people primary care, as evidenced by a significant body of quantitative research. However, relatively few qualitative studies have investigated the phenomenon PIP and its underlying processes from perspective general practitioners (GPs). The aim this paper to explore qualitatively, GP perspectives regarding care patients. Semi-structured interviews were conducted with GPs participating randomised controlled trial (RCT) an...

Little is known about prescribing appropriateness for community-dwelling people with dementia (PWD).To estimate potentially inappropriate (PIP) prevalence among PWD in primary care Northern Ireland, and to investigate associations between PIP, polypharmacy, age, gender.A retrospective cross-sectional study was conducted, using data from the Enhanced Prescribing Database. Patients were eligible if a medicine indicated management dispensed them during 1 January 2013-31 December 2013....

Dementia is a major public health concern but one that continues to be stigmatised. We examine lay knowledge of dementia and attitudes people with as potential precursors anxiety, focusing on the social characteristics associated (a) formation these attitudes, (b) perception need for restriction control dementia.

Background Mortality, including suicide and accidents, is elevated in self-harm populations. Although risk factors for following are often investigated, rarely have those accidents been studied. Our aim was to compare accidents. Method A prospective cohort ( n =30 202) from the Multicentre Study of Self-harm England, 2000–2007, followed up 2010 using national death registers. Risk (intentional undetermined intent) (narcotic poisoning, non-narcotic non-poisoning) last hospital presentation...

Whilst multimorbidity is more prevalent with increasing age, approximately 30% of middle-aged adults (45-64 years) are also affected. Several prescribing criteria have been developed to optimise medication use in older people (≥65 little focus on potentially inappropriate (PIP) adults. We a set explicit called PROMPT (PRescribing Optimally Middle-aged People's Treatments) which may be applied datasets determine the prevalence PIP this age-group. A literature search was conducted identify...

The purpose of this study is to establish the prevalence potentially inappropriate prescribing (PIP) in middle-aged adults (45-64 years) two populations with differing socio-economic profiles, and investigate factors associated PIP, using PROMPT (PRescribing Optimally Middle-aged People's Treatments) criteria.A retrospective cross-sectional was conducted 2012 data from Enhanced Prescribing Database (EPD), covering full population Northern Ireland Health Services Executive Primary Care...

Background The care received by people presenting to hospital following self-harm varies and it is unclear how different types of treatment affect risk further self-harm. Method Observational cohort data from the Manchester Self-Harm Project, UK, included 16 456 individuals an Emergency Department with between 2003 2011. Individuals were followed up for 12 months. We also used a smaller 31 hospitals in England during 3-month period 2010/2011, 6 Propensity score (PS) methods address observed...

Recent observational studies indicate that post-diagnostic use of aspirin in breast cancer patients may protect against progression perhaps by inhibiting cyclooxygenase-2 dependent mechanisms. Evidence also supports a crucial role for interactions between tumour cells and circulating platelets growth dissemination, therefore, low-dose reduce the risk death from patients. A cohort newly diagnosed (1998 to 2006) were identified UK Clinical Practice Research Datalink (and confirmed registry...

The OPTI-SCRIPT cluster randomised controlled trial (RCT) found that a three-phase multifaceted intervention including academic detailing with pharmacist, GP-led medicines reviews, supported by web-based pharmaceutical treatment algorithms, and tailored patient information leaflets, was effective in reducing potentially inappropriate prescribing (PIP) Irish primary care. We report process evaluation exploring the implementation of intervention, experiences those participating study lessons...

Radioiodine ablation of thyroid tissue after subtotal thyroidectomy has been shown to decrease recurrence in certain subsets patients with well-differentiated cancer. In a substantial percentage cases (20-30%), initial the remnant fails, necessitating second treatment. The factors associated failure are not fully understood. particular, it is whether use doses higher than 3.70 GBq would result any additional benefit, or there 'stunning' effect diagnostic dose 131I on subsequent rate. A...

Potentially inappropriate prescribing (PIP) is common in older people primary care and can result increased morbidity, adverse drug events hospitalisations. We previously demonstrated the success of a multifaceted intervention decreasing PIP cluster randomised controlled trial (RCT). sought to determine whether improvement short term was sustained at 1-year follow-up. A RCT conducted with 21 GP practices 196 patients (aged ≥70) Irish care. Intervention participants received complex...

Objective There is limited evidence regarding the quality of prescribing for children in primary care. Several criteria (indicators) have been developed to assess appropriateness older and middle-aged adults but few are relevant children. The objective this study was develop a set indicators that can be applied or dispensing data sets determine prevalence potentially inappropriate (PIPc) care settings. Design Two-round modified Delphi consensus method. Setting Irish UK general practice....