Who is accessing community lateral flow device testing and why:Characteristics and motivations of individuals participating in COVID-19 community testing in two English local authority areas

BACKGROUND: Antigen testing using lateral flow devices (LFDs) plays an important role in the management of the novel coronavirus pandemic of 2019 (COVID-19) by rapidly identifying individuals who are asymptomatically carrying high levels of the virus. By January 2021, LFD community testing sites were set up across English local authority areas to support the management and containment of regional COVID-19 cases, initially targeting essential workers unable to work from home during the national lockdown. This study aimed to examine the characteristics and motivations of individuals accessing community LFD testing across two local authority areas (LAAs) in the South West of England. METHODS: Data were collected as part of a service evaluation from December 22(nd) 2020 until March 15(th) 2021 for two LAAs. Demographic and postcode data were collected from an online test appointment booking platform and the National Health Service testing service online system, with data accessed from Public Health England. An online survey was sent to individuals who made a testing appointment at an LAA1 site using the online booking platform, consisting of 12 questions to collect data on individual’s motivations for and experiences of testing. RESULTS: Data were available for individuals who completed 12,516 tests in LAA1 and 12,327 tests in LAA2. Most individuals who engaged with testing were female, working age, white, and worked as early years or education staff, health and social care staff, and supermarket or food production staff. 1249 individuals completed the survey with 60% of respondents reported getting tested for work-related reasons. Individuals first heard about LFD testing through various channels including work, media, and word of mouth, and decided to get tested based on the ease and convenience of testing, workplace communications, and to identify asymptomatic cases to help stop the spread. Most tests were completed by individuals living in less deprived areas based on national deciles of deprivation. CONCLUSIONS: While national and local COVID-19 testing strategies have evolved, community and personal LFD testing remains a crucial pillar of the testing strategy. Future studies should collect quantitative and qualitative data from residents to most effectively shape testing offers based on the needs and preferences of their population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-12986-4

Internet-based interventions for smoking cessation

Background Tobacco use is estimated to kill 7 million people a year. Nicotin e is highly addictive, but surveys indicate that almost 70% of U S and UK smokers would like to stop smoking. Although many smokers attempt to give up on their own, advice from a health professio nal increases the chances of quitting. As of 2016 there were 3.5 bill ion Internet users worldwide, making the Internet a potenti al platform to help people quit smoking. Objectives To determine the effectiveness of Internet-based interventi ons for smoking cessation, whether intervention effectivene ss is altered by tailoring or interactive features, and if there is a differen ce in effectiveness between adolescents, young adults, and adu lts. Search methods We searched the Cochrane Tobacco Addiction Group Specialised Regi ster, which included searches of MEDLINE, Embase and PsycINFO (through OVID). There were no restrictions placed on lan guage, publication status or publication date. The most recent search was conducted in August 2016. Selection criteria We included randomised controlled trials (RCTs). Participants w ere people who smoked, with no exclusions based on age, gender , ethnicity, language or health status. Any type of Internet in tervention was eligible. The comparison condition could be a no -intervention control, a different Internet intervention, or a non-Interne t intervention. To be included, studies must have measured sm oking cessation at four weeks or longer. Data collection and analysis Two review authors independently assessed and extracted dat a. We extracted and, where appropriate, pooled smoking cessat ion outcomes of six-month follow-up or more, reporting short-term outcomes n arratively where longer-term outcomes were not available. We reported study effects as a risk ratio (RR) with a 95% confidence interval (CI )

State anxiety and emotional face recognition in healthy volunteers

High trait anxiety has been associated with detriments in emotional face processing. By contrast, relatively little is known about the effects of state anxiety on emotional face processing. We investigated the effects of state anxiety on recognition of emotional expressions (anger, sadness, surprise, disgust, fear and happiness) experimentally, using the 7.5% carbon dioxide (CO2) model to induce state anxiety, and in a large observational study. The experimental studies indicated reduced global (rather than emotion-specific) emotion recognition accuracy and increased interpretation bias (a tendency to perceive anger over happiness) when state anxiety was heightened. The observational study confirmed that higher state anxiety is associated with poorer emotion recognition, and indicated that negative effects of trait anxiety are negated when controlling for state anxiety, suggesting a mediating effect of state anxiety. These findings may have implications for anxiety disorders, which are characterized by increased frequency, intensity or duration of state anxious episodes

Primary care-based interventions for secondary prevention of opioid dependence in chronic non-cancer pain patients on pharmaceutical opioids:Systematic review

BackgroundGlobally almost one third of adults with chronic non-cancer pain (CNCP) are prescribed opioids. Prevention of opioid dependence among these patients is a public health priority. AimSynthesize the evidence on the effectiveness of primary care-based interventions for secondary prevention of opioid dependence in CNCP patients on pharmaceutical opioids.Design and SettingSystematic review of randomized controlled trials (RCTs) and comparative non-randomized studies of interventions from high-income countries.MethodsWe searched five databases for studies on non-tapering secondary prevention interventions such as tools for predicting dependence, screening tools for early recognition of dependence, prescribing/medication monitoring, and specialist support. We examined multiple outcomes, including reduction in opioid dosage. Primary analyses were restricted to RCTs with data synthesized using an effect direction plot. Risk of bias was assessed using the Cochrane risk of bias (RoB2) tool.Results Of 7102 identified reports, 18 studies were eligible (8 RCTs). Most used multiple interventions/components. Of the seven RCTs at low risk of bias or ‘some concerns’, five showed a positive intervention effect on at least one relevant outcome, four of which included a nurse care manager and/or other specialist support. The remaining two RCTs showed no positive effect of automated symptom monitoring and optimized analgesic management by a nurse care manager/physician pain specialist team, or of a mobile opioid management app.ConclusionWe identify a clear need for further adequately powered high quality studies. The conclusions that can be drawn on intervention effectiveness are limited by the sparsity and inconsistency of available data. <br/

Prevalence of problematic pharmaceutical opioid use in patients with chronic non-cancer pain:A systematic review and meta-analysis

BACKGROUND AND AIMS: Chronic non-cancer pain (CNCP) is one of the most common causes of disability globally. Opioid prescribing to treat CNCP remains widespread, despite limited evidence of long-term clinical benefit and evidence of harm such as problematic pharmaceutical opioid use (POU) and overdose. The study aimed to measure the prevalence of POU in CNCP patients treated with opioid analgesics.METHOD: A comprehensive systematic literature review and meta-analysis was undertaken using MEDLINE, Embase and PsycINFO databases from inception to 27 January 2021. We included studies from all settings with participants aged ≥ 12 with non-cancer pain of ≥ 3 months duration, treated with opioid analgesics. We excluded case-control studies, as they cannot be used to generate prevalence estimates. POU was defined using four categories: dependence and opioid use disorder (D&amp;OUD), signs and symptoms of D&amp;OUD (S&amp;S), aberrant behaviour (AB) and at risk of D&amp;OUD. We used a random-effects multi-level meta-analytical model. We evaluated inconsistency using the I 2 statistic and explored heterogeneity using subgroup analyses and meta-regressions. RESULTS: A total of 148 studies were included with &gt; 4.3 million participants; 1% of studies were classified as high risk of bias. The pooled prevalence was 9.3% [95% confidence interval (CI) = 5.7-14.8%; I 2 = 99.9%] for D&amp;OUD, 29.6% (95% CI = 22.1-38.3%, I 2 = 99.3%) for S&amp;S and 22% (95% CI = 17.4-27.3%, I 2 = 99.8%) for AB. The prevalence of those at risk of D&amp;OUD was 12.4% (95% CI = 4.3-30.7%, I 2  = 99.6%). Prevalence was affected by study setting, study design and diagnostic tool. Due to the high heterogeneity, the findings should be interpreted with caution. CONCLUSIONS: Problematic pharmaceutical opioid use appears to be common in chronic pain patients treated with opioid analgesics, with nearly one in 10 experiencing dependence and opioid use disorder, one in three showing signs and symptoms of dependence and opioid use disorder and one in five showing aberrant behaviour.</p

Supplementary Table S2 from State anxiety and emotional face recognition in healthy volunteers

Paired-sample t-test results of sensitivity (unbiased hit rate) data from studies one and tw