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Purpose: Foresight J's journey started in 1999, and in 2022, it marked the conclusion of its 24 years of publication. This paper aims to provide an overall overview of important research trends published in Foresight J between 1999 and 2022 by conducting a quantitative analysis of the journal's literature. The overarching goal is to provide valuable insights into the dynamics of scholarly communication, aiding researchers, institutions and policymakers in assessing the significance and influence of academic work, guiding future research directions and academic evaluation. Design/methodology/approach: The two bibliometrics methodologies that make up the methodology of this article are scientific mapping and performance analysis. Authors have explained the development and composition of the Foresight J using these methods. The SCOPUS database is being used in current research to analyse several dimensions, such as the evolution of publications by year, the most cited papers, core authors and researchers, leading countries and prolific institutions. Moreover, the conceptual structure, scope, burst detection and co-occurrence analysis of the journal are mapped using network visualization software such as VOSviewer, CiteSpace and RStudio. Findings: With a strong track record of output over the years, Foresight J has continued to develop in terms of publications. It is determined that "Saritas" is the author with the greatest overall impact. However, according to SCOPUS bibliometric data, "Blackman" and "Richardson" are the authors with the greatest relevance in terms of the quantity of articles. In addition, it becomes apparent that the USA, Australia and the UK are very productive nations in terms of publications. The most popular fields of the journal have always been forecasting, foresight, scenario planning, strategic planning, decision-making, technology and sustainable development. These are also the author keywords that appear the most frequently. In contrast, new study themes in the Foresight J include digital technologies, innovation, sustainability, blockchain, artificial intelligence and sustainability. Research limitations/implications: Several noteworthy research implications are provided by the bibliometric study of Foresight J. "Saritas" is the author with the most overall impact, indicating that the precise contributions and influence of this researcher in the fields of forecasting, foresight and related fields. Given that "Blackman" and "Richardson" are well-known writers, it is also critical to examine the scope and complexity of their contributions to potentially identify recurring themes or patterns in their writing. The geographic productivity results, which show that the USA, Australia and the UK are the top three countries for Foresight J publications, may encourage more research into regional differences, patterns of collaboration and the worldwide distribution of research endeavours in the context of forecasting and foresight. Popular fields including scenario planning, forecasting, foresight and sustainable development are consistent, indicating persistent research interests. Examining the causes of these subjects' ongoing relevance can reveal information about the consistency and development of scholarly interests over time. Practical implications: Foresight J's bibliometric analysis has real-world applications for many stakeholders. It helps editors and publishers make strategic decisions about outreach and content by providing insights regarding the journal's influence. Assessing organizational and author productivity helps institutions allocate resources more effectively. Policymakers acquire an instrument to evaluate research patterns and distribute funds efficiently. In general, bibliometric study of a journal helps decisionmakers in academic publishing make well-informed choices that maximize the potential of options for authors, editors, institutions and policymakers. Social implications: The societal ramifications of bibliometrically analysing Foresight J from 1999 and 2022 are substantial. This analysis highlights, over the past 24 years, research trends, technological developments and societal priorities have changed by methodically looking through the journal's articles. Gaining knowledge about the academic environment covered by the journal can help raise public awareness of important topics and promote critical thinking. In addition, the analysis can support evidence-based decision-making by alerting decision makers to the influential research that was published in Foresight J. This could have an impact on the course of policies pertaining to innovation, technology and societal development. Originality/value: This study presents a first comprehensive article that provides a general overview of the main trends and patterns of the research over the Foresight J's history since its inception. Also, the paper will help the scientific community to know the value and impact of Foresight J. [ABSTRACT FROM AUTHOR]

This article critically assesses the UK counter-terrorism strategy and determines the extent to which there is international justice within the War on Terror. It investigates why war crimes are investigated and prosecuted differently, as well as how understandings of what terrorism is varied, according to who the perpetrators are. It argues that new legal mechanisms and institutions need to hold all perpetrators of war crimes accountable, both state and non-state actors. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had, and continues to have, a significant effect on individuals worldwide, and it is clear that minority communities including the Sikh community have been particularly affected by the virus. The current study assessed the impact of the pandemic in a sample of 44 British Sikhs across 11 virtual focus groups. Three main themes emerged including making meaningful connections, struggling to adjust and the organisation of gurdware (Sikh places of worship) in coping with the COVID-19 pandemic. Findings highlight that faith may promote collective action for collective healing especially during mass trauma, with specific insight into what this may entail for the Sikh community. [ABSTRACT FROM AUTHOR]

Background: Chronic intestinal pseudo‐obstruction (CIPO) and enteric dysmotility (ED) are small intestinal motility disorders defined by radiological and manometric criteria. In the absence of consensus guidelines, we surveyed opinions on the diagnosis and management of CIPO and ED among experts from different countries. Methods: A survey questionnaire was circulated electronically to members of the European society for Clinical Nutrition and Metabolism, European Society of Neurogastroenterology and Motility, and United European Gastroenterology. Only responses from participants completing all required components were included. Key Results: Of 154 participants, 93% agreed that CIPO and ED should be classified separately. Overall, 73% reported an increasing incidence of CIPO and ED, with hypermobile Ehlers‐Danlos Syndrome the group with the largest increase in referrals (37%), particularly in the UK (P <.0001). The majority (95%) find diagnosing CIPO and ED difficult. Notably, antroduodenal manometry, a test mandated to diagnose ED, is infrequently used (only 21% respondents use in >50% cases) and full thickness biopsies were reported to seldom influence medical treatment, nutritional management, and prognosis. Respondents reported that very few treatments are useful for most patients, with bacterial overgrowth treatment, prucalopride, and psychological therapies felt to be the most useful. While only 23% of clinicians felt that parenteral nutrition (PN) improves gastrointestinal symptoms in >50% of cases, 68% reported PN dependency at 5 years in the majority of cases. Conclusions and Inferences: These data highlight the difficulties with diagnosing and managing CIPO and ED and underscore the urgent need for international, multidisciplinary, clinical practice guidelines. [ABSTRACT FROM AUTHOR]

There is a limited access to liver transplantation, however, many organs are discarded based on subjective assessment only. Here we report the VITTAL clinical trial (ClinicalTrials.gov number NCT02740608) outcomes, using normothermic machine perfusion (NMP) to objectively assess livers discarded by all UK centres meeting specific high-risk criteria. Thirty-one livers were enroled and assessed by viability criteria based on the lactate clearance to levels ≤2.5 mmol/L within 4 h. The viability was achieved by 22 (71%) organs, that were transplanted after a median preservation time of 18 h, with 100% 90-day survival. During the median follow up of 542 days, 4 (18%) patients developed biliary strictures requiring re-transplantation. This trial demonstrates that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia. The shortage of viable donated livers limits patient access to liver transplantation. Here the authors report the use of normothermic machine perfusion to help identify viable organs from livers discarded based on current clinical criteria, which are then transplanted to recipients in a single-arm clinical trial. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to highlight some initial efforts within Her Majesty’s Prison and Probation Service (HMPPS) to develop digitally enabled services supporting the rehabilitation of service users. It is not designed to set out either HMPPS policy on digital rehabilitative services or the position of HMPPS Interventions Services on this subject. Rather, it is a short exposition of the authors’ views on the potential of digitally enabled strategies to enhance interventions in forensic settings. In this context, the authors will also describe the development of the first digitally enabled rehabilitation service accessed via HMPPS in-room computer terminals.Design/methodology/approach The authors have reviewed current literature and outlined how the authors have and are aiming to add to this area of work.Findings This general review outlines the authors’ views on the potential of digitally enabled strategies for improving interventions in forensic settings.Originality/value This paper is a short exposition of the authors’ views on the potential of digitally enabled strategies to enhance interventions in forensic settings. In this context, the authors will also describe the development of the first digitally enabled rehabilitation service accessed via HMPPS in-room computer terminals. [ABSTRACT FROM AUTHOR]

Background Whilst many countries have introduced legislation prohibiting tobacco advertising and sponsorship, references to tobacco continue to appear in the media. This study quantified and characterized tobacco smoking content in popular women's magazines. Methods The 10 top weekly and 5 monthly women's magazines most popular among 15-34 year olds in Britain published over a 3-month period were included. A content analysis was conducted for both written and visual content. Results In 146 magazines, there were 310 instances of tobacco content, the majority of which were positive towards smoking. Instances of celebrities smoking were most common (171, 55%), often in holiday or party settings that could be perceived to be luxurious, glamorous or fun. In all, 55 (18%) tobacco references related to fashion, which generally created an impression of smoking as a norm within the industry; and 34 (11%) text and image references to tobacco in TV and film. There were 50 (16%) reader-initiated mentions of smoking, typically in real-life stories or readers writing in to seek advice about smoking. Anti-smoking references including the hazards of smoking were infrequent (49; 16%). Conclusions Although tobacco advertising is prohibited in Britain, women's magazines still appear to be promoting positive messages about tobacco and smoking. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study is to describe the portrayal of alcohol content in popular YouTube music videos. Method: We used inductive thematic analysis to explore the lyrics and visual imagery in 49 UK Top 40 songs and music videos previously found to contain alcohol content and watched by many British adolescents aged between 11 and 18 years and to examine if branded content contravened alcohol industry advertising codes of practice. Results: The analysis generated three themes. First, alcohol content was associated with sexualised imagery or lyrics and the objectification of women. Second, alcohol was associated with image, lifestyle and sociability. Finally, some videos showed alcohol overtly encouraging excessive drinking and drunkenness, including those containing branding, with no negative consequences to the drinker. Conclusion: Our results suggest that YouTube music videos promote positive associations with alcohol use. Further, several alcohol companies adopt marketing strategies in the video medium that are entirely inconsistent with their own or others agreed advertising codes of practice. We conclude that, as a harm reduction measure, policies should change to prevent adolescent exposure to the positive promotion of alcohol and alcohol branding in music videos. [ABSTRACT FROM AUTHOR]

Background: Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods: Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results: Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions: Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services. [ABSTRACT FROM AUTHOR]

Background Hospital admission provides a powerful opportunity to promote smoking cessation. We explored patients' and healthcare professionals' (HCP) views of a specialist smoking cessation service comprising systematic smoking ascertainment, default provision of pharmacotherapy and behavioural counselling at the bedside, and post-discharge follow-up, in a clinical trial in a United Kingdom teaching hospital. Methods Semi-structured interviews with 30 patients who were offered the intervention, and 27 HCPs working on intervention wards, were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results The shock of being admitted, and awareness that smoking may have contributed to the need for hospital admission, caused many patients to reassess their quit intentions. Most patients felt the service was too good an opportunity to pass up, because having long-term support and progress monitored was more likely to result in abstinence than trying alone. Had they not been approached, many patients reported that they would have attempted to quit alone, though some would have been discouraged from doing so by pharmacotherapy costs. Service delivery by a specialist advisor was favoured by patients and HCPs, largely because HCPs lacked time and expertise to intervene. HCPs reported that in usual practice, discussions about smoking were usually limited to ascertainment of smoking status. Timing of service delivery and improved co-ordination between service staff and inpatient ward staff were matters to address. Conclusions A hospital-based specialist smoking cessation service designed to identify smokers and initiate cessation support at the bedside was deemed appropriate by patients and HCPs. [ABSTRACT FROM AUTHOR]

OBJECTIVE Please also see BJUI letters on page 586 To assess the cost-effectiveness of solifenacin vs other antimuscarinic strategies commonly used in UK clinical practice, based on the results of a recent published review. METHODS Overactive bladder (OAB) syndrome is characterized by symptoms of urgency, frequency, incontinence and nocturia. Pharmacological treatment comprises oral antimuscarinic agents, which are divided into older-generation treatments, including oxybutynin, and new-generation treatments, comprising solifenacin, tolterodine, darifenacin and fesoterodine. The latter have reduced central nervous system penetration and have better selectivity for the M3 subclass of acetylcholine receptors, resulting in improved tolerability. A recent systematic review and meta-analysis of the efficacy and safety of antimuscarinics provided an opportunity for an economic evaluation of these agents using a rigorous assessment of efficacy. A cost-utility analysis was undertaken using a 1-year decision-tree model. Treatment success was defined separately for urgency, frequency and incontinence, with efficacy data taken from the recent review. Treatment persistence rates were taken from the Information Management System database. Utility values for the calculation of quality-adjusted life-years (QALYs) were taken from published sources. The analysis included costs directly associated with treatment for OAB, i.e. antimuscarinic therapy, consultations with general practitioners, and outpatient contacts. Resource use was based on expert opinion. Costs were reported at 2007/2008 prices. Extensive deterministic and probabilistic analyses were conducted to test the robustness of the base-case results. RESULTS Solifenacin was associated with the highest QALY gains (per 1000 patients) for all three outcomes of interest, i.e. urgency (712.3), frequency (723.1) and incontinence (695.0). Solifenacin was dominant relative to fesoterodine, tolterodine extended-release (ER) and tolterodine immediate-release (IR), and cost-effective relative to propiverine ER for urgency, frequency and incontinence. Solifenacin was not found to be cost-effective relative to oxybutynin IR for the frequency and incontinence outcomes, with an incremental cost-effectiveness ratio of >£30 000/QALY threshold. CONCLUSIONS Solifenacin provided the greatest clinical benefit and associated QALYs for all three outcomes of interest across all therapies considered, and to be either dominant or cost-effective relative to all other new-generation agents, but not cost-effective relative to oxybutynin for frequency and incontinence. [ABSTRACT FROM AUTHOR]

Smoking remains a leading cause of morbidity and mortality. Exercise improves physical health and reduces cigarette cravings and nicotine withdrawal symptoms, but has required attendance at multiple sessions using specialised equipment that limits delivery in a service. The purpose of this study was to test the feasibility of delivering a simple and brief home-based exercise intervention with existing smoking cessation support in a stop-smoking service. We used a mixed-methods approach in a UK stop-smoking service operating from general practitioner surgeries and libraries near the most deprived areas in Surrey. Smokers recruited through the service gave written consent and received a 12-week exercise programme that included 5 min of home-based jumping activities and an activity diary with educational instructions 1 week before their quit date. Feasibility was assessed by recruitment, retention, adherence to the exercise programme, and follow-up and completion of assessments. Semi-structured interviews with trial participants (n=16), people who declined to take part (n=21), and smoking cessation advisors (n=10) assessed views and attitudes to participation and delivery of the intervention. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis (NVivo, version 12.0). 30 eligible trial participants consented, with 14 (47%) lost to follow-up, 16 participants (eight females, eight males; mean age 48 years [SD 11]) completed a mean of 47 (SD 18) of 74 prescribed exercise sessions over the 12-week period, resulting in 63% adherence. The exercise programme was received positively by most who engaged with it; fitting into their daily routine was an important outcome for completion. Of the participants who declined to take part (15 females, six males; mean age 48 years [SD 12]), many were positively disposed to the idea of participation, especially if the programme could be offered later in their treatment. All smoking cessation advisors (six females, four males; mean age 48 years [SD 20]) were supportive of the exercise programme, but several favoured the delivery by someone independent of the service. A simple and brief exercise intervention may be feasible for smokers receiving smoking cessation treatment in a UK stop-smoking service. However, substantial attrition and non-compliance, along with some delivery components, need to be addressed before to a definitive trial. Medical Research Council Public Health Intervention Development Scheme (MR/P017142/1). [ABSTRACT FROM AUTHOR]

Background: Frailty is a state of increased vulnerability from physical, social, and cognitive factors resulting in greater risk of negative health-related outcomes and increased healthcare expenditure. A 36-factor electronic frailty index (eFI) developed in the United Kingdom calculates frailty scores using electronic medical record data. There is currently no standardization of frailty screening in Canadian primary care. In order to implement the eFI in a Canadian context, adaptation of the tool is necessary because frailty is represented by different clinical terminologies in the UK and Canada. In considering the promise of implementing an eFI in British Columbia, Canada, we first looked at the content validation of the 36-factor eFI. Our research question was: Does the eFI represent frailty from the perspectives of primary care clinicians and older adults in British Columbia?, Methods: A modified Delphi using three rounds of questionnaires with a panel of 23 experts (five family physicians, five nurse practitioners, five nurses, four allied health professionals, four older adults) reviewed and provided feedback on the 36-factor eFI. These professional groups were chosen because they closely work as interprofessional teams within primary care settings with older adults. Older adults provide real life context and experiences. Questionnaires involved rating the importance of each frailty factor on a 0-10 scale and providing rationale for ratings. Panelists were also given the opportunity to suggest additional factors that ought to be included in the screening tool. Suggested factors were similarly rated in two Delphi rounds., Results: Thirty-three of the 36 eFI factors achieved consensus (> 80% of panelists provided a rating of ≥ 8). Factors that did not achieve consensus were hypertension, thyroid disorder and peptic ulcer. These factors were perceived as easily treatable or manageable and/or not considered reflective of frailty on their own. Additional factors suggested by panelists that achieved consensus included: cancer, challenges to healthcare access, chronic pain, communication challenges, fecal incontinence, food insecurity, liver failure/cirrhosis, mental health challenges, medication noncompliance, poverty/financial difficulties, race/ethnic disparity, sedentary/low activity levels, and substance use/misuse. There was a 100% retention rate in each of the three Delphi rounds., Conclusions and Next Steps: Three key findings emerged from this study: the conceptualization of frailty varied across participants, identification of frailty in community/primary care remains challenging, and social determinants of health affect clinicians' assessments and perceptions of frailty status. This study will inform the next phase of a broader mixed-method sequential study to build a frailty screening tool that could ultimately become a standard of practice for frailty screening in Canadian primary care. Early detection of frailty can help tailor decision making, frame discussions about goals of care, prevent advancement on the frailty trajectory, and ultimately decrease health expenditures, leading to improved patient and system level outcomes., (© 2023. The Author(s).)

Background: Existing evidence suggests that while the coronavirus disease 2019 (COVID-19) pandemic triggered quit attempts among many smokers, it led some to smoke more and others to relapse back to smoking. These diverse effects have the potential to have a long-term impact on individuals' smoking and vaping behaviors., Aims and Methods: This study explored the effect of COVID-19 on smokers and vapers, vape shops (VS), and stop smoking services (SSS). A total of 39 semi-structured interviews were conducted with stop-smoking practitioners, tobacco control leads, smokers and/or vapers, and vape shop owners. Interviews were transcribed verbatim and analyzed thematically., Results: Four themes were identified: Lockdown as a barrier to becoming or remaining smoke-free; COVID as a catalyst for quitting and remaining smoke-free; changes in vaping and challenges for vapers and VS; and changes and challenges for stop smoking support. Fear of COVID resulting in severe health implications for smokers facilitated behavior change; however, the boredom and monotony of lockdown and associated stress created difficulties in remaining a smoke free. Results showed that the enforced switch from face-to-face to the remote provision of SSS was beneficial for improving engagement, particularly for vulnerable groups such as pregnant women. Stop smoking professionals and vapers disagreed with the forced closure of VS because it created unnecessary difficulties for vapers to access supplies., Conclusions: COVID-19 was both a barrier and facilitator for smoking cessation. Remote provision of SSS implemented due to lockdown was beneficial for hard-to-reach groups; services should look to incorporate these changes into day-to-day practice., Implications: This study is one of the first to explore how the COVID-19 pandemic directly affected smokers, vapers, SSS, tobacco control leads, and VS. It provides evidence for the continued use of the remote provision of smoking cessation services to increase engagement among hard-to-reach groups and provides information on how pandemics can be a catalyst for health behavior change. This study is unique in that it incorporates the views of different stakeholders., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: The increasing incidence of chronic liver disease (CLD) in the UK may be attributed to a rise in preventable risk factors, including hazardous alcohol use and type 2 diabetes. Transient elastography (TE) can rapidly stratify risk of CLD in primary care populations and provide an opportunity to raise patient awareness of risk factors.This study explores patients' experiences of TE screening in a primary care setting. In addition, patient awareness of CLD risk is explored., Study Design and Setting: This study used a qualitative process evaluation of a community screening pathway for CLD (Nottingham, UK). Participants completed semistructured interviews, which were audio-recorded, transcribed verbatim and analysed thematically., Participants: Twenty adults were purposively recruited 6 months to 2 years after TE screening. Inclusion criteria included (1) hazardous alcohol use, (2) type 2 diabetes and/or (3) persistently elevated liver enzymes without known cause., Results: Undergoing TE in primary care was seen as acceptable to most participants. Hazardous alcohol use was identified as the primary cause of CLD; no participants were aware of metabolic risk factors. TE improved understanding of personal risk factors and prompted contemplation of lifestyle changes across all TE stratifications. However, participants' perceptions of risk were altered by the healthcare providers' communication of TE scores., Conclusions: High acceptability of TE, regardless of the risk factor, provides strong support for inclusion of TE stratification in primary care. Findings highlight the positive impact of receiving TE on risk awareness. Future clinical iterations should improve the structure and communication of TE results to patients., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: Management of Candida auris infection is difficult as this yeast exhibits resistance to different classes of antifungals, necessitating the development of new antifungals. The aim of this study was to investigate the susceptibility of C. auris to a novel antifungal triazole, PC945, optimized for topical delivery., Methods: A collection of 50 clinical isolates was obtained from a tertiary care hospital in North India. Nine isolates from the UK, 10 from a CDC panel (USA) and 3 from the CBS-KNAW culture collection (Japanese and South Korean isolates) were also obtained. MICs (azole endpoint) of PC945 and other triazoles were determined in accordance with CLSI M27 (third edition). Quality control strains were included [Candida parapsilosis (ATCC 22019) and Candida krusei (ATCC 6258)]., Results: Seventy-four percent of isolates tested showed reduced susceptibility to fluconazole (≥64 mg/L). PC945 (geometric mean MIC = 0.058 mg/L) was 7.4-fold and 1.5-fold more potent than voriconazole and posaconazole, respectively (both P < 0.01). PC945 MIC values correlated with those of voriconazole or posaconazole, and only three isolates were found to be cross-resistant between PC945 and other azoles. ERG11 sequence analysis revealed several mutations, but no correlation could be established with the MIC of PC945. Tentative epidemiological cut-off values (ECOFFs) evaluated by CLSI's ECOFF Finder (at 99%) with 24 h reading of MICs were 1, 4 and 1 mg/L for PC945, voriconazole and posaconazole, respectively. MIC values for quality control strains of all triazoles were in the normal ranges., Conclusions: PC945 was found to be a more potent inhibitor than posaconazole, voriconazole and fluconazole of C. auris isolates collected globally, warranting further laboratory and clinical evaluations., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.)

Background: 'Vape shops' are a popular source for buying electronic cigarettes (e-cigarettes) and related products. The products that vape shops sell, their marketing techniques and the extent to which they provide information or encouragement to smokers to quit tobacco use, as well as the patterns of tobacco and e-cigarette use of their customers are not well understood., Methods: We conducted cross-sectional surveys in vape shops in the East Midlands region of the United Kingdom, one with shop staff (n = 41), and one with customers (n = 197)., Results: The majority of customers (84%) currently used e-cigarettes. Among current vapers, 19% were dual users and 78% had quit smoking. Over half of vapers reported using a lower level of nicotine in their current e-liquid than when they started using e-cigarettes. There was a wide variety in products and price ranges between the shops. Many staff reported that customers ask for information about quitting smoking (90%). Less than half reported providing smoking cessation advice, although 76% of staff reported feeling confident about delivering cessation advice to customers who ask for it. Just under half of customers and shop staff said they thought it was appropriate to deliver formal in-store smoking cessation support., Conclusions: The majority of vape shop customers are vapers who have quit smoking. Shop staff play a central role in providing customers with product information, and many provide smoking cessation advice. Further research is needed to investigate the potential for smoking cessation interventions in vape shops, including the extent to which these would appeal to non-vapers.

Objectives: Evidence from the US Truth campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing youth smoking uptake. We developed, piloted and evaluated a school-based intervention based on this premise., Methods: Exploratory study students in years 7-8 (aged 11-13) in two UK schools received Operation Smoke Storm , comprising three 50 min classroom-based sessions in year 7, an accompanying family booklet and a 1-hour classroom-based booster session in year 8. We compared the risk and odds of ever smoking and susceptibility to smoking in year 8 students in study schools postintervention with students in control schools. Focus groups and interviews with students, teachers and parents evaluated the acceptability of the intervention., Results: In intervention schools, the combined prevalence of ever smoking and susceptibility increased from 18.2% in year 7 to 33.8% in year 8. There was no significant difference in the odds of a year 8 student in an intervention school being an ever smoker or susceptible never smoker compared with controls (adjusted OR (aOR) 1.28, 95% CI 0.83 to 1.97, p=0.263) and no significant difference in the odds of ever smoking (aOR 0.82, 95% CI 0.42 to 1.58, p=0.549). Teachers highlighted differences by academic ability in how well the messages presented were understood. Use of the family component was low but was received positively by parents who engaged with it., Conclusions: Operation Smoke Storm is an acceptable resource for delivering smoking-prevention education, but it does not appear to have reduced smoking and susceptibility., Competing Interests: Competing interests: LLJ receives personal fees from the National Centre for Smoking Cessation and Training, outside the submitted work., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Evidence from the US Truth campaign suggests that interventions focusing on tobacco industry tactics can be effective in preventing smoking uptake by children. Operation Smoke Storm is the first school-based intervention based on this premise and comprises three classroom sessions in which students act as secret agents uncovering tobacco industry tactics through videos, quizzes, discussions, and presentations. We report a qualitative evaluation of its acceptability., Methods: We conducted eight focus groups with 79 students aged 11-12 who participated in Operation Smoke Storm at two UK schools in Autumn 2013, and 20 interviews with teachers who delivered the intervention. These were digitally audio-recorded, transcribed verbatim and analysed using the framework method., Results: Students enjoyed the secret agent scenario and reported acquiring new knowledge about smoking and the tobacco industry, which seemed to strengthen their aversion to smoking. Teachers felt confident delivering the 'off the shelf' resource, although they would have welcomed more background information about the topic and guidance on steering discussions. Teachers highlighted a need for the resource to be flexible and not dependent on lesson length, teacher confidence, or expertise. Students and teachers endorsed the idea of developing a booster component for older students and supported the development of printed information complementing the resource to encourage parents to support their child not to smoke., Conclusions: These findings demonstrate that Operation Smoke Storm can be delivered by teachers to raise awareness about smoking-related issues. The ideas and issues raised are now being used to improve and extend the resource for further evaluation.

Purpose of the Study: Out-of-hospital cardiac arrest (OHCA) has a poor prognosis despite bystander resuscitation and rapid transfer to hospital. Optimal management of patients after arrival to hospital continues to be contentious, especially the timing of emergency coronary angiography±revascularisation. Robust predictors of inhospital outcome would be of clinical value for initial decision-making., Study Design: A retrospective analysis of consecutive patients who presented to a university hospital following OHCA over a 70-month period (2008-2013). Patients were identified from the emergency department electronic patient registration and coding system. For those patients who underwent emergency percutaneous coronary intervention, details were crosschecked with national databases., Results: We identified 350 consecutive patients who were brought to our hospital following OHCA. Return of spontaneous circulation (ROSC) for >20 min was achieved either before arrival or inhospital in 196 individuals. From the 350 subjects, 114 (32.6%) survived to hospital discharge. When sustained ROSC was achieved, either before or inhospital, survival to discharge was 58.2% (114 of 196). Non-shockable rhythm, absence of bystander cardiopulmonary resuscitation, 'downtime' >15 min and initial pH ≤7.11 were predictors of inhospital death. 12% patients who underwent angiography in the presence of ST elevation had no acute coronary occlusion. 21% patients with acute coronary occlusion at angiography did not have ST elevation., Conclusions: In our cohort of patients with OHCA, those who achieve ROSC had a survival-to-discharge rate of 58.2%. We identified four predictors of inhospital death, which are readily available at the time of patient presentation. Reliance on ST elevation to decide about coronary angiography and revascularisation may be flawed. More data are required., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)