Introduction: Depression affects many adults in the UK, often resulting in referral to primary care mental health services (e.g. improving access to psychological therapies, IAPT). CBT is the main modality for depression within IAPT, with other approaches offered in a limited capacity. Arts psychotherapies are rarely provided despite their attractiveness to clients. However, the recent dropout rate of 64% within IAPT suggests that clients' needs are not being fully met. Therefore, in order to expand clients' choice we developed a new creative psychological therapy integrating evidencebased approaches with arts psychotherapies. Method: A three-level approach was used: (a) thematic synthesis of client-identified helpful factors in evidence-based approaches for depression and in arts psychotherapies; (b) studio practice exploring Cochrane Review findings on arts psychotherapies for depression; (c) pilot workshops for clients with depression and therapists.Findings and Discussion: Eight key ingredients for positive therapy outcomes were identified: encouraging active engagement, learning skills, developing relationships, expressing emotions, processing at a deeper level, gaining understanding, experimenting with different ways of being and integrating useful material. These ingredients were brought together as Arts for the Blues for clients with depression: a 12-session evidence-based pluralistic group psychotherapy integrating creative methods as well as talking therapy. Conclusion:The evidence-based foundation, creative content and pluralistic nature of this new approach aligned with eight client-identified key ingredients for positive therapy outcomes make it a promising therapy option that can be adapted to individual therapy. Implications include consideration for NICE approval as an additional therapy for depression.

Older female patients were more likely to have a pulmonary embolism. High-risk groups such as heart failure, chronic pulmonary disease, anemia, and malignancy need to be given extra attention to prevent worse outcomes.

A 68-year-old woman with a history of hypothyroidism, hypertension, and obstructive sleep apnea (OSA) not on current treatment was referred to the sleep clinic for treatment of OSA. She was diagnosed with OSA in 2008 and started on continuous positive airway pressure (CPAP). On PAP she slept much better and was well rested. Subsequently she had problems with eye dryness attributed to a mask leak that could not be corrected, so she stopped CPAP. In the clinic, she reports loud snoring, witnessed apneas, difficulty maintaining sleep, and a desire to have her OSA treated. Epworth Sleepiness Scale was 2 of 24. On examination, the Mallampati score was 4, neck circumference was 16 in., and body mass index was 45.52 kg/m 2 . An oral examination was significant for normal dentition, no missing teeth, and orthognathic bite. Medications included lisinopril and levothyroxine.

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