scholarly journals Medical cannabis in the UK: From principle to practice

2020 ◽  
Vol 34 (9) ◽  
pp. 931-937
Author(s):  
Anne Katrin Schlag ◽  
David S Baldwin ◽  
Michael Barnes ◽  
Steve Bazire ◽  
Rachel Coathup ◽  
...  
Keyword(s):  
Medical Profession ◽  
Scientific Evidence ◽  
Evidence Base ◽  
Patient Survey ◽  
Chronic Illnesses ◽  
Medical Cannabis ◽  
Medical Problems ◽  
Patient Reported ◽  
Recent Patient ◽  
The Uk

Background: In the UK, medical cannabis was approved in November 2018, leading many patients to believe that the medicine would now be available on the NHS. Yet, to date, there have been only 12 NHS prescriptions and less than 60 prescriptions in total. In marked contrast, a recent patient survey by the Centre for Medical Cannabis (Couch, 2020) found 1.4 m people are using illicit cannabis for medical problems. Aims: Such a mismatch between demand and supply is rare in medicine. This article outlines some of the current controversies about medical cannabis that underpin this disparity, beginning by contrasting current medical evidence from research studies with patient-reported outcomes. Outcomes: Although definite scientific evidence is scarce for most conditions, there is significant patient demand for access to medical cannabis. This disparity poses a challenge for prescribers, and there are many concerns of physicians when deciding if, and how, to prescribe medical cannabis which still need to be addressed. Potential solutions are outlined as to how the medical profession and regulators could respond to the strong demand from patients and families for access to medical cannabis to treat chronic illnesses when there is often a limited scientific evidence base on whether and how to use it in many of these conditions. Conclusions: There is a need to maximise both clinical research and patient benefit, in a safe, cautious and ethical manner, so that those patients for whom cannabis is shown to be effective can access it. We hope our discussion and outlines for future progress offer a contribution to this process.

scholarly journals So near yet so far: why won’t the UK prescribe medical cannabis?

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038687 ◽  
Author(s):  
David Nutt ◽  
Steve Bazire ◽  
Lawrence D Phillips ◽  
Anne Katrin Schlag
Keyword(s):  
Patient Reported Outcomes ◽  
Scientific Evidence ◽  
Evidence Base ◽  
Decision Makers ◽  
Medical Cannabis ◽  
Medicinal Use ◽  
Patient Reported ◽  
The Uk ◽  
Improve Patient ◽  
Gain Access

Although cannabis-based products for medicinal use are now legal in the UK, it is still challenging for patients to gain access, and only very few National Health Service prescriptions have been written to date. This paper attempts to make sense of why the UK lags behind so many other countries which also have legalised medical cannabis. From consulting with parents and patients, prescribers, pharmacists and decision-makers it seems that there are a series of distinct barriers to prescribing that need to be overcome in order to improve patient access to medical cannabis in the UK. These include concerns about the perceived lack of scientific evidence. To alleviate these concerns, we highlight the importance of patient-centred approaches including patient-reported outcomes, pharmacoepidemiology and n=1 trials, which can contribute to the development of the evidence base for medical cannabis. We hope that this paper will help policymakers and prescribers understand the challenges to prescribing and so help them develop approaches to overcome the current situation which is detrimental to patients.

scholarly journals UK Medical Cannabis Registry palliative care patients cohort: initial experience and outcomes

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Devaki Nimalan ◽  
Michal Kawka ◽  
Simon Erridge ◽  
Mehmet Ergisi ◽  
Michael Harris ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Adverse Events ◽  
Symptom Control ◽  
Case Series ◽  
Nausea And Vomiting ◽  
Medical Cannabis ◽  
Patient Reported ◽  
The Uk

Abstract Introduction Palliative care aims to improve quality of life through optimal symptom control and pain management. Cannabis-based medicinal products (CBMPs) have a proven role in the treatment of chemotherapy-induced nausea and vomiting. However, there is a paucity of high-quality evidence with regards to the optimal therapeutic regimen, safety, and effectiveness of CBMPs in palliative care, as existing clinical trials are limited by methodological heterogeneity. The aim of this study is to summarise the outcomes of the initial subgroup of patients from the UK Medical Cannabis Registry who were prescribed CBMPs for a primary indication of palliative care, cancer pain and chemotherapy-induced nausea and vomiting, including effects on health-related quality of life and clinical safety. Methods A case series from the UK Medical Cannabis Registry of patients, who were receiving CBMPs for the indication of palliative care was undertaken. The primary outcome consisted of changes in patient-reported outcome measures including EQ-5D-5L, General Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), Pain Visual Analog Scale (VAS) and the Australia-Modified Karnofsky Performance Scale at 1 and 3 months compared to baseline. Secondary outcomes included the incidence and characteristics of adverse events. Statistical significance was defined by p-value< 0.050. Results Sixteen patients were included in the analysis, with a mean age of 63.25 years. Patients were predominantly prescribed CBMPs for cancer-related palliative care (n = 15, 94%). The median initial CBD and THC daily doses were 32.0 mg (Range: 20.0–384.0 mg) and 1.3 mg (Range: 1.0–16.0 mg) respectively. Improvements in patient reported health outcomes were observed according to SQS, EQ-5D-5L mobility, pain and discomfort, and anxiety and depression subdomains, EQ-5D-5L index, EQ-VAS and Pain VAS validated scales at both 1-month and 3-months, however, the changes were not statistically significant. Three adverse events (18.75%) were reported, all of which were either mild or moderate in severity. Conclusion This small study provides an exploratory analysis of the role of CBMPs in palliative care in the first cohort of patients since CBMPs legalisation in the UK. CBMPs were tolerated with few adverse events, all of which were mild or moderate and resolved spontaneously. Further long-term safety and efficacy studies involving larger cohorts are needed to establish CBMPs role in palliative care, including comparisons with standard treatments.

scholarly journals Citizen Science and Food: A Review

2021 ◽  
Author(s):  
Christian Reynolds ◽  
Libby Oakden ◽  
Sarah West ◽  
Rachel Pateman ◽  
Chris Elliott
Keyword(s):  
Data Collection ◽  
Citizen Science ◽  
Scientific Evidence ◽  
Research Priorities ◽  
Evidence Base ◽  
Learning Opportunities ◽  
Research Community ◽  
Geographic Spread ◽  
Chemical Contaminant ◽  
The Uk

Citizen science and food is part of a new programme of work to explore how we can involve the communities we serve when building the evidence-base on which policy decisions are made. Citizen science is an approach that can provide high volumes of data with a wide geographic spread. It is relatively quick to deploy and allows access to evidence we would ordinarily have difficulty collating. This methodology has been endorsed by the European Commission for Research, Science and Innovation. There is no one size fits all definition, but citizen science projects involves engaging with communities and asking them to be part of the project, either through engaging them in data collection or through other ways of co-creation. For participants, citizen science offers learning opportunities, the satisfaction of contributing to scientific evidence and the potential to influence policy. It can also give us data which is high in volume, has wide geographical spread, is relatively quick to deploy and that we couldn’t access any other way. Projects using these methods often involve engaging with communities and asking them to be part of the project. This can be either through working with them in data collection, or through co-creation. This report demonstrates that the research community are already undertaking numerous pieces of research that align with FSA’s evidence needs. This includes examples from the UK and other global communities. Participants in such research have collected data on topics ranging from food preparation in the home to levels of chemical contaminant in foods. The findings of this report outline that citizen science could allow the FSA to target and facilitate more systematic engagement with UK and global research communities, to help address key research priorities of the FSA.

The UK Government agrees to create the world's largest marine reserve around the Pitcairn Islands, a UK Overseas Territory in the South Pacific

2015 ◽  
Vol 21 (2) ◽  
pp. 108 ◽  
Author(s):  
Terence P. Dawson
Keyword(s):  
Scientific Evidence ◽  
Marine Reserve ◽  
Evidence Base ◽  
Concerted Effort ◽  
Members Of Parliament ◽  
The Pacific ◽  
Advocacy Campaigns ◽  
The Pacific Ocean ◽  
Uk Government ◽  
The Uk

In March 2015, the UK Government announced their intention to create the World’s largest marine reserve in the territorial waters of the Pitcairn Islands in the Pacific Ocean. This achievement followed a concerted effort by a consortium of scientists, environmental campaigners and Members of Parliament, who engaged cooperatively in the building of the scientific evidence base and advocacy campaigns.

scholarly journals What Will Happen to This Dog? A Qualitative Analysis of Rehoming Organisations' Pre-adoption Dog Behaviour Screening Policies and Procedures

2022 ◽  
Vol 8 ◽  
Author(s):  
Karen E. Griffin ◽  
Elizabeth John ◽  
Tom Pike ◽  
Daniel S. Mills
Keyword(s):  
Qualitative Analysis ◽  
Scientific Evidence ◽  
Evidence Base ◽  
Activity Level ◽  
Validity And Reliability ◽  
Safety Risk ◽  
Human Safety ◽  
Increased Risk ◽  
Types Of Information ◽  
The Uk

Rehoming organisations often undertake some type of behaviour evaluation to determine dogs' suitability for rehoming and/or the type of suitable home. Assessments can carry considerable weight in determining dogs' fates. Although evaluation of the validity and reliability of any test is important, a more fundamental consideration is if the nature of the information sought and the weight given to this in organisations' decision making is of more than anecdotal value. Therefore, this study's aim was to conduct a qualitative analysis of organisations' pre-adoption dog behaviour screenings and potential justifications, comparing this with the available scientific evidence. A written enquiry was sent electronically to rehoming organisations in the UK and US from February 2016-July 2017. Of 73 respondents, the majority conducted assessments for all dogs. Using a thematic analysis, nine themes and 71 sub-themes emerged concerning the types of information respondents aim to gather from assessments. The majority of respondents used, at least partially, pass/fail scoring, i.e., certain outcomes would lead to dogs being deemed unadoptable. Forty-one sub-themes and one theme were identified as potentially leading to a dog being deemed unadoptable. The evidence base for these factors was identified from the scientific literature relating to: increased risk for relinquishment, impact on a dog's quality of life, and human safety risk. Evidence supported 10 factors: “aggression towards people”, “aggression towards cats or other animals”, “aggression towards dogs”, “biting or snapping”, “resource guarding”, “activity level or exercise needs”, “destructiveness”, “housetrained”, “fearfulness”, and “knowledge of basic commands and/or general training”. Of those, seven were associated only with relinquishment risk, two (“resource guarding”, “knowledge of basic commands”) with human safety risk, and one (“fearfulness”) with both. Thus, for &gt;85% of characteristics organisations deemed important for dogs' adoptability, scientific evidence to support this is lacking. More research is needed to investigate the value of behaviour assessments, especially concerning the assessment of factors that could pose a public safety risk. However, given the current lack of scientific support for many decisions regarding dogs' rehoming suitability and recognised pressure on resources, it is suggested that organisations should focus on pre-adoption adopter education and post-adoption support.

scholarly journals AMR Consumer Perceptions Survey

2021 ◽  
Author(s):  
Rebecca Gillespie ◽  
Maya King
Keyword(s):  
Action Plan ◽  
Scientific Evidence ◽  
Evidence Base ◽  
Consumer Perceptions ◽  
Consumer Survey ◽  
National Action Plan ◽  
Food Standards ◽  
The Uk ◽  
Changes Over Time ◽  
Over Time

As part of the UK national action plan on antimicrobial resistance (AMR), the Food Standards Agency (FSA) is working to improve the scientific evidence base around consumer perceptions and understanding. A consumer survey was carried out in 2016 and 2019, and replicated in 2021, to understand current views and awareness, and to identify any changes over time.

Mine water heat and heat storage research opportunities at the UK Geoenergy Observatory in Glasgow, UK

2021 ◽  
Author(s):  
Alison Monaghan ◽  
Vanessa Starcher ◽  
Hugh Barron ◽  
Fiona Fordyce ◽  
Helen Taylor-Curran ◽  
...  
Keyword(s):  
Mine Water ◽  
Scientific Evidence ◽  
Open Data ◽  
Evidence Base ◽  
Geothermal Heat ◽  
Resource Potential ◽  
Resource Sustainability ◽  
Heating And Cooling ◽  
The Uk ◽  
And Storage

&lt;p&gt;Mine water geothermal heat production and storage can provide a decarbonised source of energy for space heating and cooling, however the large resource potential has yet to be exploited widely. Besides economic, regulatory and licensing barriers, geoscientific uncertainties such as detailed understanding of thermal and hydrogeological subsurface processes, resource sustainability and potential environmental impacts remain.&lt;/p&gt;&lt;p&gt;The UK Geoenergy Observatory in Glasgow is a research infrastructure for investigating shallow, low-temperature coal mine water heat energy resources available in abandoned and flooded mine workings at depths of around 50-90 m. It is an at-scale &amp;#8216;underground laboratory&amp;#8217; of 12 boreholes, surface monitoring equipment and open data. The Glasgow Observatory is accepting requests for researchers and innovators to undertake their own experiments, test sensors and methods to increase the scientific evidence base and reduce uncertainty for this shallow geothermal technology.&lt;/p&gt;

The Integration of Acupuncture within Medicine in the UK – the British Medical Acupuncture Society—s 25Th Anniversary

2005 ◽  
Vol 23 (1) ◽  
pp. 2-12 ◽  
Author(s):  
Peter Baldry
Keyword(s):  
Trigger Point ◽  
Medical Profession ◽  
Scientific Journal ◽  
Evidence Base ◽  
25Th Anniversary ◽  
Medical Practitioners ◽  
Medical Acupuncture ◽  
Scientific Meetings ◽  
The Uk ◽  
And Function

Acupuncture was first used in China, probable about 2000 years ago. When acupuncture first arrived in the West in the 17th century, the principles which the Chinese had used to explain its actions were at variance with current scientific knowledge of the body's structure and function. This led to the rejection of acupuncture by the medical profession in the UK, although individual practitioners adopted it with enthusiasm, usually needling the point of maximal tenderness to treat musculoskeletal pain. Acupuncture was more generally accepted in France and Germany, where the pioneering British physician Felix Mann encountered it in the 1950s. He then taught acupuncture to other medical practitioners and organised regular meetings in London, from which the British Medical Acupuncture Society, BMAS, emerged in 1980. The tradition of biannual scientific meetings has continued since then. The Society has many connections with prominent acupuncturists internationally and is a founder member of the International Council of Medical Acupuncture and Related Techniques (ICMART), and has hosted two world congresses. The Society was involved in standardisation of the meridian nomenclature published in 1990. The Society's scientific journal, Acupuncture in Medicine, was founded in 1981 and has gained international recognition, being indexed on several databases. The Society has established regular teaching courses at different levels, which lead to professional qualifications of Certificate and Diploma. The membership is now open to different health professionals, has grown steadily and now stands at nearly 2500. The Society is administered from offices in Cheshire and London. Many individual members have contributed to the Society's characteristic Western ‘medical’ approach to acupuncture in which needling is seen as a form of neuromuscular stimulation that owes little to traditional meridians or points. The Society has shown a particular interest in acupuncture for myofascial trigger point pain. Members of the Society have contributed to the evidence base of acupuncture with several books, clinical trials and reviews. The Society is optimistic that it will have an increasingly important role in promoting the use and scientific evaluation of acupuncture for the public benefit.

Study the Anatomy and Physiology of Body's Urinary System and Fibromyalgia Syndrome (FMS) for the Design an Intelligent Alarm System for Monitoring of FMS

2019 ◽  
Vol 1 (1) ◽  
pp. 72-81
Author(s):  
Hamidreza Shirzadfar ◽  
Narsis Gordoghli
Keyword(s):  
Chronic Pain ◽  
International Association ◽  
Continuous Process ◽  
Well Being ◽  
Chronic Illnesses ◽  
World Health ◽  
Definitive Treatment ◽  
Psychological Consequences ◽  
Medical Problems ◽  
Health Organization

In recent years, chronic medical problems have become increasingly prevalent. Chronic ‎illnesses challenge the view of life as a regular and continuous process, a challenge that has ‎important psychological consequences. The long duration of people suffering from these ‎diseases, the long process of treatment and the fact that there is no proper and definitive ‎treatment for most of these diseases and their associated complications have made chronic ‎diseases a detrimental factor in public health. According to the World Health Organization ‎‎(2006), the prevalence of chronic and non-communicable diseases is increasing in all countries, ‎especially developing countries, so that the major challenge for the health system in the present ‎century, is not living people, but better adapted to chronic illnesses and maintaining their ‎mental and social health and well-being Ed's life-threatening chronic physical illness.‎ Chronic pain is a pain that lasts longer than usual, and according to the criteria of the ‎International Association of Pain, this time is defined as at least 3 months to 6 months. Chronic ‎pain is such that not only faced the sick person whit the pressure of the pain but also with many ‎other pressure that affect different parts of her life. Fibromyalgia is one of the most rheumatologic disorders and one of the most resistant chronic ‎pain syndromes. Fibromyalgia is one of the most common musculoskeletal disorders in adults ‎and chronic pain is one of the most common complaints in this group of patients.

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