Stimulants like lisdexamfetamine can be titrated over a period of several weeks to determine effectiveness and tolerance of the dose, which are unknown until tested - that doesn't seem quick to me and indicates that clinicians can't expect a binary response from a one-off dose.

I know what it's like to see or experience something at the patient end of things and feel the urge to do something about it. It's difficult to find obvious ways forward with that in the NHS system, and the common ways for patients to raise complex and niche issues - MPs or the NHS' public-facing channels - can produce dispiriting responses.

I get the impression you're in England, so my assumptions here are about NHS England. There's been a push (and requirement) in recent years for Patient and Public Voice (PPV) - closer public involvement in the design, production and governance of NHS services - so there should be increasing opportunities for the public to act on their experiences. In practice, there doesn't seem to be much of an open invitation to public involvement in digital at the national level yet.

As you didn't mention it, you might be interested to know that, as well as the breast screening report you mentioned, there has also been a recent review of adults screening services [1]. That's led to NHSX's Digital Transformation of Screening programme [2], with objectives directly relevant to your issue. There's a contact email address that might reach someone more likely to grok it and/or explain the programme's routes for PPV input.

There's also some information about the current digital screening services, including named heads and leads [3]. Maybe a direct approach to one or some of them about how you can influence the issue (and highlight the shortcomings of the approaches you've tried)?

[1] https://www.england.nhs.uk/wp-content/uploads/2019/02/report...

[2] https://www.nhsx.nhs.uk/key-tools-and-info/digital-transform...

[3] https://digital.nhs.uk/about-nhs-digital/our-organisation/ou...

https://www.europarl.europa.eu/RegData/etudes/STUD/2020/6487...

For the general lay reader, is there a more accessible equivalent you can recommend?

Another established and well-regarded institution is the University of London International Programme (https://london.ac.uk). The courses are relatively low cost, but rely a lot on self-discipline.

At the time, I thought it wasn't particularly hard - I had it in my head that bricks and mortar universities were somehow more challenging and rigorous. Having recently completed a master's at a campus university, my feelings about the OU at the time were without basis. By comparison, the master's was easier, less challenging and less valuable.

Looking back on my OU experience, I can appreciate how enriching it was. The course materials and syllabi are fantastic and are often used by other universities. Associate lecturers can be hit and miss. Fellow students tend to be engaged - because they _want_ to do the courses - and often make for a supportive and thoughtful community; I actually found it to be far less isolating than the campus experience of my master's.

I was fortunate to have undertaken my degree prior to tuition fees increases, but I would still recommend them. Compared to other UK universities, the fees were still relatively low, last time I looked.

I haven't heard of nasal irrigation using soap; hypertonic saline solution is usually recommended.

http://www.elvisstudy.com/

What does 'protective' mean in this context? I wondered if it was somehow a typo of 'predictive', but that's a bit of a leap for a typo.

In the UK they seem to have taken store design up a notch, to the point that there's a discernible difference with the Lidl experience (along with now being a tad more expensive on equivalent products). I suspect it's an incremental differentiator in retaining the more affluent customers they captured over the past decade. Lidl, on the other hand, offers a more mixed experience: for the most part, they're still quite dowdy and utilitarian, although they have what seem like experimental stores that appear to be competing in affluent areas with an Aldi presence (larger, open layouts; brighter lighting; polished, natural floor tiles etc.). The kinds of customers I usually find at Lidl are notably absent.