223,683 results match your criteria BMJ Quality & Safety [Journal]


Consent and recruitment: the reporting of paediatric trials published in 2012.

BMJ Paediatr Open 2018 26;2(1):e000369. Epub 2018 Nov 26.

Alberta Research Centre for Health Evidence, University of Alberta, Edmonton, Alberta, Canada.

Objectives: We evaluated 300 paediatric trials to determine: the consent and recruitment strategies used, who trial information was targeted to, how incentives were used and if they achieved their recruitment targets.

Methods: For this cross-sectional evaluation, we searched the Cochrane Central Register of Controlled Trials for paediatric trials published in 2012 and randomly selected 300 that reported on outcomes for participants aged ≤21 years. We collected data on consent and recruitment procedures for each trial and undertook descriptive analyses in SPSS statistics V. Read More

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November 2018

Why health information needs to be accessible to all.

BMJ Paediatr Open 2018 10;2(1):e000352. Epub 2018 Oct 10.

HIFA, Oxford, UK.

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October 2018

Can microRNA profiles predict corticosteroid responsiveness in childhood nephrotic syndrome? A study protocol.

BMJ Paediatr Open 2018 17;2(1):e000319. Epub 2018 Nov 17.

Department of Pediatric Nephrology, Armed Forces Medical College, Pune, Maharashtra, India.

Introduction: In last few years, several studies have revealed the remarkable stability of extracellular microRNAs (miRNAs) circulating in the blood or excreted in the urine and underscored their key importance as biomarkers of certain diseases. Since miRNA in urinary sediment is relatively stable and easily quantified, it has the potential to be developed as a biomarker for disease diagnosis and monitoring. Identification of serum and urinary levels of certain miRNAs may assist in the diagnosis and assessment of disease activity in patients with nephrotic syndrome (NS). Read More

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November 2018

Content analysis of 50 clinical negligence claims involving test results management systems in general practice.

BMJ Open Qual 2018 22;7(4):e000463. Epub 2018 Nov 22.

Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.

Background And Aims: Laboratory test results management systems are a complex safety issue in primary care settings worldwide. Related failures lead to avoidable patient harm, medicolegal action, patient complaints and additional workload to problem solve identified issues. We aimed to review and learn from 50 clinical negligence cases involving system failures related to the management of test results. Read More

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November 2018

Importance of safety climate, teamwork climate and demographics: understanding nurses, allied health professionals and clerical staff perceptions of patient safety.

BMJ Open Qual 2018 28;7(4):e000433. Epub 2018 Nov 28.

Interprofessional Collaboration and Education, Southlake Regional Health Centre, Newmarket, Ontario, Canada.

Background: There is growing evidence regarding the importance of contextual factors for patient/staff outcomes and the likelihood of successfully implementing safety improvement interventions such as checklists; however, certain literature gaps still remain-for example, lack of research examining the interactive effects of safety constructs on outcomes. This study has addressed some of these gaps, together with adding to our understanding of how context influences safety.

Purpose: The impact of staff perceptions of safety climate (ie, senior and supervisory leadership support for safety) and teamwork climate on a self-reported safety outcome (ie, overall perceptions of patient safety (PS)) were examined at a hospital in Southern Ontario. Read More

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November 2018

Evaluation of a staff training programme to reimplement a comprehensive health assessment.

BMJ Open Qual 2018 20;7(4):e000353. Epub 2018 Nov 20.

School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.

Background: Health information systems with applications in patient care planning and decision support depend on high-quality data. A postacute care hospital in Ontario, Canada, conducted data quality assessment and focus group interviews to guide the development of a cross-disciplinary training programme to reimplement the Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0 comprehensive health assessment into the hospital's clinical workflows. Read More

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November 2018

Reducing acute kidney injury incidence and progression in a large teaching hospital.

BMJ Open Qual 2018 26;7(4):e000308. Epub 2018 Nov 26.

Emergency Admissions Unit, Royal Preston Hospital, Preston, UK.

Acute kidney injury (AKI) is a common syndrome that is associated with significant mortality and cost. The Quality Improvement AKI Collaborative at Salford Royal Foundation Trust was established to review and improve both the recognition and management of AKI. This was a whole-system intervention to tackle AKI implemented as an alternative to employing separate AKI nurses. Read More

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November 2018

Training: improving antenatal detection and outcomes of congenital heart disease.

BMJ Open Qual 2018 24;7(4):e000276. Epub 2018 Nov 24.

School of Sport and Exercise Sciences and College of Engineering, Swansea University, Medical Physics and Biomedical Engineering, Swansea, UK.

Objectives: This study describes the design, delivery and efficacy of a regional fetal cardiac ultrasound training programme. This programme aimed to improve the antenatal detection of congenital heart disease (CHD) and its effect on fetal and postnatal outcomes.

Design Setting And Participants: This was a prospective study that compared antenatal CHD detection rates by professionals from 13 hospitals in Wales before and after engaging in our 'skills development programme'. Read More

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November 2018

Evaluation of the McMaster Family Health Team: results and practical implications for quality improvement.

BMJ Open Qual 2018 26;7(4):e000259. Epub 2018 Nov 26.

Department of Family Medicine, McMaster University Health Sciences, Hamilton, Ontario, Canada.

Purpose: To evaluate the McMaster Family Health Team (MFHT) as part of a Continuous Quality Improvement initiative using a set of provincial performance metrics to demonstrate which measures of assessment are actually clinically meaningful in context and where system-level changes might be implemented to improve operational practice.

Methods: Measures were selected from the Primary Care Performance Measurement Framework based on data availability for the MFHT and provincial comparators. The measures explored in this paper are those that were deemed to have actionable properties. Read More

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November 2018

Reducing inappropriate antibiotic prescribing in upper respiratory tract infection in a primary care setting in Kolkata, India.

Authors:
Amy Dehn Lunn

BMJ Open Qual 2018 20;7(4):e000217. Epub 2018 Nov 20.

Calcutta Rescue, Kolkata, India.

Inappropriate antibiotic use is a key factor in the emergence of antibiotic resistance. The majority of antibiotics are prescribed in primary care, where upper respiratory tract infection (URTI) is a common presentation. Inappropriate antibiotic prescribing in URTI is common globally and has increased markedly in developing and transitional countries. Read More

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November 2018

Testing of the 'Always Events' approach to improve the patient experience in the emergency department.

BMJ Open Qual 2018 19;7(4):e000195. Epub 2018 Nov 19.

Medical Directorate, NHS Education for Scotland, Glasgow, UK.

Maintaining quality of care and meeting patient expectations in the face of rising demand within emergency departments (ED) is a significant challenge for clinicians. This study tested the Always Events (AE) approach as a means to identify AE's relevance to patient care in the ED and act on this to address patient concerns. The project team looked to identify aspects of care patients would like to see improved within the minor injuries stream (MIS). Read More

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November 2018

Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes.

BMJ Glob Health 2018 26;3(6):e001068. Epub 2018 Nov 26.

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

This paper reports on the use of reciprocal learning for identifying, adopting and adapting a type 2 diabetes self-management support intervention in a multisite implementation trial conducted in a rural setting in a low-income country (Uganda), a periurban township in a middle-income country (South Africa) and socioeconomically disadvantaged suburbs in a high-income country (Sweden). The learning process was guided by a framework for knowledge translation and structured into three learning cycles, allowing for a balance between evidence, stakeholder interaction and contextual adaptation. Key factors included commitment, common goals, leadership and partnerships. Read More

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November 2018

Use of Service Provision Assessments and Service Availability and Readiness Assessments for monitoring quality of maternal and newborn health services in low-income and middle-income countries.

BMJ Glob Health 2018 26;3(6):e001011. Epub 2018 Nov 26.

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Improving the quality of maternal and newborn health (MNH) services is key to reducing adverse MNH outcomes in low-income and middle-income countries (LMICs). The Service Provision Assessment (SPA) and Service Availability and Readiness Assessment (SARA) are the most widely employed, standardised tools that generate health service delivery data in LMICs. We ascertained the use of SPA/SARA surveys for assessing the quality of MNH services using a two-step approach: a SPA/SARA questionnaire mapping exercise in line with WHO's Quality of Care (QoC) Framework for pregnant women and newborns and the WHO quality standards for care around the time of childbirth; and a scoping literature review, searching for articles that report SPA/SARA data. Read More

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November 2018

Ambulances under siege in Syria.

BMJ Glob Health 2018 27;3(6):e001003. Epub 2018 Nov 27.

Department of Emergency Medicine, Mount Sinai St. Luke's Mount Sinai West Hospitals, New York City, New York, USA.

Background: Healthcare is under attack in Syria with repeated air strikes on hospitals and ambulances and the largest death toll of health workers in any recorded conflict.1 Ambulances in Syria have been bombed, shot at, stolen, looted and obstructed, significantly impeding their ability to safely evacuate the wounded and provide medical aid.

Methods: This article presents the summary of a literature review on attacks against ambulances in Syria from 2011 to 2018, as well as a descriptive secondary data analysis on individual attacks reported by the Syrian Network for Human Rights from January 2016 to December 2017. Read More

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November 2018

The potential impact of taxing sugar drinks on health inequality in Indonesia.

BMJ Glob Health 2018 26;3(6):e000923. Epub 2018 Nov 26.

School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.

Background: Evidence suggests reducing consumption of sugar-sweetened beverages is important to reducing weight gain and chronic disease risk. Indonesia's large population is a growing market for sugar-sweetened beverages. Taxation to reduce consumption is of interest, but considered fiscally regressive. Read More

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November 2018

Longitudinal exploration of in situ mock code events and the performance of cardiac arrest skills.

BMJ Simul Technol Enhanc Learn 2019 Jan 2;5(1):29-33. Epub 2018 Mar 2.

Professor, Emeritus, UC Davis Department of Emergency Medicine.

Introduction: In hospital cardiac arrest (IHCA) affects 200,000 adults in the United States each year, and resuscitative efforts are often suboptimal. The objective of this study was to determine whether a program of "mock codes" improves group-level performance of IHCA skills. Our primary outcome of interest was change in CPR fraction, and the secondary outcomes of interest were time to first dose of epinephrine and time to first defibrillation. Read More

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January 2019

Changes in northern hemisphere male international rugby union players' body mass and height between 1955 and 2015.

BMJ Open Sport Exerc Med 2018 16;4(1):e000459. Epub 2018 Nov 16.

Department of Diabetes & Endocrinology, Imperial College Healthcare NHS Trust, London, UK.

Objectives: We sought to establish the effects of professionalism, which officially began in 1995, on the body mass and height of northern hemisphere male international rugby union (RU) players. We hypothesised that mass would significantly increase following professionalism. We also investigated the changes in size of players according to their playing position, and we compared changes to rugby league (RL) players and the public. Read More

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November 2018

Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic low back pain: protocol of a randomised controlled trial.

BMJ Open Sport Exerc Med 2018 22;4(1):e000452. Epub 2018 Nov 22.

Doctoral and Masters Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Londrina-PR, Brazil.

Background: Chronic low back pain (CLBP) is an important disorder in athletes that may negatively affect their performance in competitions. The literature usually recommends physiotherapy based on exercises for back pain management in athletes. Recent evidence suggests that interventions based on lumbar muscle stabilisation exercises (LMSE) and back endurance-resistance exercises (BERE) may improve back pain and function performance. Read More

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November 2018

Effects of body protection vests and experience levels in prevention of equestrian injuries.

BMJ Open Sport Exerc Med 2018 16;4(1):e000426. Epub 2018 Nov 16.

United States Pony Clubs, Lexington, Kentucky, USA.

Objectives: To investigate the risk reduction and benefit of wearing body protection/safety vests in equestrian sports.

Methods: A comparison of equestrians wearing body protective vests and those not wearing vests was performed using incident report data of 718 participants in the United States Pony Clubs during 2011-2017. Data obtained included age, gender, certification level of member, type of activity, description of incident, description of injuries, what protective equipment was worn and other possible contributing factors. Read More

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November 2018
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Impact of smoking on patient outcomes after arthroscopic rotator cuff repair.

BMJ Open Sport Exerc Med 2018 21;4(1):e000416. Epub 2018 Nov 21.

Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Background: Cigarette smoking may adversely affect rotator cuff tear pathogenesis and healing. However, the impact of cigarette smoking on outcomes after arthroscopic rotator cuff repair is relatively unknown.

Patients And Methods: A cohort of 126 patients who underwent arthroscopic rotator cuff repair with minimum 2 years follow-up were retrospectively identified from our institutional database. Read More

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November 2018

The effects of a single session of lumbar spinal manipulative therapy in terms of physical performance test symmetry in asymptomatic athletes: a single-blinded, randomised controlled study.

BMJ Open Sport Exerc Med 2018 28;4(1):e000389. Epub 2018 Nov 28.

Biomechanics and Functional Morphology Laboratory, Faculty of Human Kinetics, FMH, University of Lisbon, Lisbon, Portugal.

Background And Aim: Musculoskeletal disorders in athletes, including spinal biomechanical dysfunctions, are believed to negatively influence symmetry. Spinal manipulative therapy (SMT) is recognised as a safe and effective treatment for musculoskeletal disorders, but there is little evidence about whether it can be beneficial in symmetry. Therefore, this study aimed to measure the effects of lumbar SMT in symmetry. Read More

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November 2018

Interference with the lower gut-liver axis induces remission of primary sclerosing cholangitis in a patient with ulcerative colitis.

BMJ Open Gastroenterol 2018 14;5(1):e000239. Epub 2018 Nov 14.

Department of Gastroenterology, Bedford Hospital South Wing, Bedford, UK.

The gut-liver axis describes the complex interactions between gut microbiota, the small and large bowel, the immune system and the liver. Current evidence associates abnormalities within the gut-liver axis with liver disease such as primary sclerosing cholangitis (PSC). PSC is believed to be an immune-mediated disease though the exact mechanism of its pathogenesis remains unknown. Read More

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November 2018

Baseline clinical characteristics, comorbidities and prescribed medication in a real-world population of patients with idiopathic pulmonary fibrosis: the PROOF registry.

BMJ Open Respir Res 2018 21;5(1):e000331. Epub 2018 Nov 21.

Department of Respiratory Medicine, Erasme University Hospital, Brussels, Belgium.

Introduction: PROOF (a Prospective Observational Registry to Describe the Disease Course and Outcomes of Idiopathic Pulmonary Fibrosis) is an ongoing, observational registry initiated in 2013 with the aim of collecting real-world data from patients with idiopathic pulmonary fibrosis (IPF). Here, we present comprehensive baseline data, which were collected from patients on registry inclusion.

Methods: Patients with IPF were enrolled across eight centres in Belgium and Luxembourg. Read More

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November 2018

Visual rating assessment of cerebral atrophy and its relationship with cognitive function in chronic obstructive pulmonary disease.

BMJ Open Respir Res 2018 26;5(1):e000310. Epub 2018 Nov 26.

Academic Respiratory Unit, Clinical Sciences, University of Bristol, Bristol, UK.

Introduction: Widespread white matter damage and cognitive impairment have been demonstrated in chronic obstructive pulmonary disease (COPD). However, it remains unclear if brain atrophy is a global phenomenon or if specific subregions are differentially affected. The aims of this study are, first, to test a simple, validated visual analogue grading technique. Read More

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November 2018

Born to be Wise: a population registry data linkage protocol to assess the impact of modifiable early-life environmental exposures on the health and development of children.

BMJ Open 2018 Dec 14;8(12):e026954. Epub 2018 Dec 14.

Fielding School of Public Health, University of California, Los Angeles, California, USA.

Introduction: Deficiencies in childhood development is a major global issue and inequalities are large. The influence of environmental exposures on childhood development is currently insufficiently explored. This project will analyse the impact of various modifiable early life environmental exposures on different dimensions of childhood development. Read More

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December 2018
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Effectiveness of cognitive-behavioural therapy: a protocol for an overview of systematic reviews and meta-analyses.

BMJ Open 2018 Dec 14;8(12):e025761. Epub 2018 Dec 14.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Introduction: Cognitive-behavioural therapy (CBT) is a psychological therapy that has been used to improve patient well-being across multiple mental and physical health problems. Its effectiveness has been examined in thousands of randomised control trials that have been synthesised into hundreds of systematic reviews. The aim of this overview is to map, synthesise and assess the reliability of evidence generated from these systematic reviews of the effectiveness of CBT across all health conditions, patient groups and settings. Read More

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December 2018

Dexamethasone versus prednisone for children receiving asthma treatment in the paediatric inpatient population: protocol for a feasibility randomised controlled trial.

BMJ Open 2018 Dec 14;8(12):e025630. Epub 2018 Dec 14.

Departments of Pediatrics and Emergency Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.

Introduction: Asthma exacerbations are a leading cause of paediatric hospitalisations. Corticosteroids are key in the treatment of asthma exacerbations. Most current corticosteroids treatment regimens for children admitted with asthma exacerbation consist of a 5-day course of prednisone or prednisolone. Read More

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December 2018

Understanding cauda equina syndrome: protocol for a UK multicentre prospective observational cohort study.

BMJ Open 2018 Dec 14;8(12):e025230. Epub 2018 Dec 14.

Department for Clinical Neurosciences, Western General Hospital, Edinburgh, UK.

Introduction: Cauda equina syndrome (CES) is a potentially devastating condition caused by compression of the cauda equina nerve roots. This can result in bowel, bladder and sexual dysfunction plus lower limb weakness, numbness and pain. CES occurs infrequently, but has serious potential morbidity and medicolegal consequences. Read More

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December 2018

Role of diffusional kurtosis imaging in grading of brain gliomas: a protocol for systematic review and meta-analysis.

BMJ Open 2018 Dec 14;8(12):e025123. Epub 2018 Dec 14.

Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery UCL Hospitals NHS Trust, London, UK.

Introduction: Central nervous system (CNS) gliomas are the most common primary intra-axial brain tumours and pose variable treatment response according to their grade, therefore, precise staging is mandatory. Histopathological analysis of surgical tumour samples is still deemed as the state-of-the-art staging technique for gliomas due to the moderate specificity of the available non-invasive imaging modalities. A recently evolved analysis of the tissue water diffusion properties, known as diffusional kurtosis imaging (DKI), is a dimensionless metric, which quantifies water molecules' degree of non-Gaussian diffusion, hence reflects tissue microenvironment's complexity by means of non-invasive diffusion-weighted MRI acquisitions. Read More

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December 2018

Behaviour change interventions for the management of Raynaud's phenomenon: a systematic literature review.

BMJ Open 2018 Dec 14;8(12):e024528. Epub 2018 Dec 14.

Centre for Pain Research, University of Bath, Bath, UK.

Objectives: Raynaud's phenomenon (RP) is a significant cause of morbidity. Vasodilator medications cause unwanted adverse effects, with behavioural and lifestyle changes forming the mainstay of self-management; this is difficult to implement successfully. The objectives of this study were to evaluate the efficacy of behaviour change interventions for RP and identify learning points for future treatment development. Read More

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December 2018

Effectiveness of self-testing kits availability on improving HIV testing frequency for chinese men who have sex with men and their sexual partners: a protocol for a multicenter randomised controlled trial.

BMJ Open 2018 Dec 14;8(12):e024423. Epub 2018 Dec 14.

Xiangya Nursing School of Central South University, Changsha, China.

Introduction: HIV epidemic is increasing among men who have sex with men (MSM) in China, yet HIV testing uptake remains low. As an emerging approach, HIV self-testing (HIVST) has the potential to promote HIV testing coverage and frequency in this population. However, evidence of the effectiveness on implementation of HIVST among Chinese MSM and their sexual partners is scarce. Read More

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December 2018

Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study.

BMJ Open 2018 Dec 14;8(12):e024367. Epub 2018 Dec 14.

Spenshult Research and Development Center, Spenshult, Halmstad, Sweden.

Objectives: The aims were to identify patients with rheumatoid arthritis (RA) who had stopped drinking alcohol and compare them with patients drinking alcohol, and to explore reasons for stopping drinking alcohol.

Design: A sequential explanatory mixed methods design was used.

Setting: Six rheumatology clinics in Southern Sweden Better Anti-Rheumatic FarmacOTherapy cohort. Read More

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December 2018

Comparison of the validity of checklist assessment in cardiac arrest simulations with an app in an academic hospital in Taiwan: a retrospective observational study.

BMJ Open 2018 Dec 14;8(12):e024309. Epub 2018 Dec 14.

Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.

Introduction: Robust assessment is a crucial component in Advanced Cardiac Life Support (ACLS) training to determine whether participants have achieved learning objectives with little or no variation in their overall outcomes. This study aimed to evaluate resuscitation performance by real-time logs. We hypothesised that instructors may not be able to evaluate time-sensitive parameters, namely, chest compression fraction, time to initiating chest compression and time to initiating defibrillation accurately in a subjective manner. Read More

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December 2018

Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews.

BMJ Open 2018 Dec 14;8(12):e024262. Epub 2018 Dec 14.

Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.

Objectives: Self-management support aims to give people with chronic disease confidence to actively manage their disease, in partnership with their healthcare provider. A meta-review can inform policy-makers and healthcare managers about the effectiveness of self-management support strategies for people with type 2 diabetes, and which interventions work best and for whom.

Design: A meta-review of systematic reviews of randomised controlled trials (RCTs) was performed adapting Cochrane methodology. Read More

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December 2018
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Prognostic value of Modified Early Warning Score generated in a Chinese emergency department: a prospective cohort study.

BMJ Open 2018 Dec 14;8(12):e024120. Epub 2018 Dec 14.

Research Institute of Gynecology and Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Objectives: This study aimed to validate the performance of the Modified Early Warning Score (MEWS) in a Chinese emergency department and to determine the best cut-off value for in-hospital mortality prediction.

Design: A prospective, single-centred observational cohort study.

Setting: This study was conducted at a tertiary hospital in South China. Read More

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December 2018
2.063 Impact Factor

Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial.

BMJ Open 2018 Dec 14;8(12):e024095. Epub 2018 Dec 14.

Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain.

Introduction: The intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women.

Methods And Analysis: Here we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of ​​at least 12 consecutive months. Read More

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December 2018

Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses.

BMJ Open 2018 Dec 14;8(12):e024086. Epub 2018 Dec 14.

Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Objective: This systematic review and meta-analysis aim to evaluate the risk factors associated with postoperative opioid-induced respiratory depression (OIRD).

Design: Systematic review and meta-analysis.

Data Sources: PubMed-MEDLINE, MEDLINE in-process, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed and Clinicaltrials. Read More

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December 2018
1 Read
2.063 Impact Factor

Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers.

BMJ Open 2018 Dec 14;8(12):e024068. Epub 2018 Dec 14.

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

Objective: Home healthcare is the fastest growing arena in the healthcare system but patient safety research in this context is limited. The aim was to explore how patient safety in Swedish specialised home healthcare is described and adressed from multidisciplinary teams' and clinical managers' perspectives.

Design: An explorative qualitative study. Read More

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December 2018

Informed shared decision-making programme for patients with type 2 diabetes in primary care: cluster randomised controlled trial.

BMJ Open 2018 Dec 14;8(12):e024004. Epub 2018 Dec 14.

Health Sciences and Education, University of Hamburg, Hamburg, Germany.

Objective: To translate an informed shared decision-making programme (ISDM-P) for patients with type 2 diabetes from a specialised diabetes centre to the primary care setting.

Design: Patient-blinded, two-arm multicentre, cluster randomised controlled trial of 6 months follow-up; concealed randomisation of practices after patient recruitment and acquisition of baseline data.

Setting: 22 general practices providing care according to the German Disease Management Programme (DMP) for type 2 diabetes. Read More

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December 2018

Survival and new-onset morbidity after critical care admission for acute pancreatitis in Scotland: a national electronic healthcare record linkage cohort study.

BMJ Open 2018 Dec 14;8(12):e023853. Epub 2018 Dec 14.

Surgery, School of Medicine, University of Edinburgh, Edinburgh, UK.

Introduction: Severe acute pancreatitis (AP) requiring critical care admission (ccAP) impacts negatively on long-term survival.

Objective: To document organ-specific new morbidity and identify risk factors associated with premature mortality after an episode of ccAP.

Design: Cohort study. Read More

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December 2018
1 Read

Disability and morbidity among older patients in the emergency department: a Danish population-based cohort study.

BMJ Open 2018 Dec 14;8(12):e023803. Epub 2018 Dec 14.

Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.

Objectives: The objective was to describe the prevalence of geriatric conditions among older medical patients in the emergency department (ED) and the association with admission, mortality, reattendance and loss of independency.

Design: Population-based prospective cohort study.

Setting: ED of a large university hospital. Read More

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December 2018

Definition of whole person care in general practice in the English language literature: a systematic review.

BMJ Open 2018 Dec 14;8(12):e023758. Epub 2018 Dec 14.

Psycho-Oncology Co-operative Research Group, Sydney Health Ethics, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.

Objectives: The importance of 'whole person' or 'holistic' care is widely recognised, particularly with an increasing prevalence of chronic multimorbidity internationally. This approach to care is a defining feature of general practice. However, its precise meaning remains ambiguous. Read More

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December 2018

Is the decline in neonatal mortality in northern Ghana, 1996-2012, associated with the decline in the age of BCG vaccination? An ecological study.

BMJ Open 2018 Dec 14;8(12):e023752. Epub 2018 Dec 14.

Navrongo Health Research Centre, Navrongo, Ghana.

Objective: To examine the association between early Bacille Calmette-Guerin (BCG) vaccination and neonatal mortality in northern Ghana.

Methods: This ecological study used vaccination and mortality data from the Navrongo Health and Demographic Surveillance System. First, we assessed and compared changes in neonatal mortality rates (NMRs) and median BCG vaccination age from 1996 to 2012. Read More

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December 2018

How is the audit of therapy intensity influencing rehabilitation in inpatient stroke units in the UK? An ethnographic study.

BMJ Open 2018 Dec 14;8(12):e023676. Epub 2018 Dec 14.

School of Population Health and Environmental Sciences, King's College London, London, UK.

Objectives: Occupational therapy, physiotherapy and speech and language therapy are central to rehabilitation after a stroke. The UK has introduced an audited performance target: that 45 min of each therapy should be provided to patients deemed appropriate. We sought to understand how this has influenced delivery of stroke unit therapy. Read More

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December 2018

Motor imagery ability assessments in four disciplines: protocol for a systematic review.

BMJ Open 2018 Dec 14;8(12):e023439. Epub 2018 Dec 14.

Research Department, Reha Rheinfelden, Rheinfelden, Switzerland.

Introduction: Motor imagery (MI) is a very popular and well-accepted technique in different disciplines. Originating from sport and psychology, MI is now also used in the field of medicine and education. Several studies confirmed the benefits of MI to facilitate motor learning and skill acquisition. Read More

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December 2018

Study protocol for a randomised controlled trial of humanoid robot-based distraction for venipuncture pain in children.

BMJ Open 2018 Dec 14;8(12):e023366. Epub 2018 Dec 14.

Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Introduction: Intravenous insertion (IVI) is a very common procedure in the emergency department (ED). IVI is often painful and stressful for both children and their families. Currently, distraction therapy is not used as a standard of care for IVI in North America. Read More

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December 2018
2 Reads

Rationale and design of a single-blind, randomised controlled trial of exercise training for managing learning and memory impairment in persons with multiple sclerosis.

BMJ Open 2018 Dec 14;8(12):e023231. Epub 2018 Dec 14.

Kessler Foundation, Neuropsychology and Neuroscience Research, West Orange, New Jersey, USA.

Introduction: This randomised controlled trial (RCT) examines treadmill walking exercise training effects on learning and memory performance, hippocampal volume, and hippocampal resting-state functional connectivity in persons with multiple sclerosis (MS) who have objective impairments in learning new information.

Methods And Analysis: Forty fully ambulatory persons with MS who demonstrate objective learning and memory impairments will be randomly assigned into either the intervention or active control study conditions. The intervention condition involves supervised, progressive treadmill walking exercise training three times per week for a 3-month period. Read More

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December 2018

Association of postlunch napping duration and night-time sleep duration with cognitive impairment in Chinese elderly: a cross-sectional study.

BMJ Open 2018 Dec 14;8(12):e023188. Epub 2018 Dec 14.

Director Office, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.

Objective: To analyse the independent and combined associations of postlunch napping duration and night-time sleep duration with risk of cognitive impairment among Chinese elderly.

Design: A cross-sectional study.

Setting: We analysed the data from Zhejiang Ageing and Health Cohort, a population-based survey of seven counties located in Zhejiang province in eastern China. Read More

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December 2018

Selective carious tissue removal using subjective criteria or polymer bur: study protocol for a randomised controlled trial (SelecCT).

BMJ Open 2018 Dec 14;8(12):e022952. Epub 2018 Dec 14.

Department of Dentistry, School of Health Sciences, University of Brasília, Brasilia, Brazil.

Introduction: Selective (incomplete/partial) carious tissue removal is suitable for treating deep carious lesions in teeth with vital, asymptomatic pulps. In the periphery of a cavity, removal to hard dentin is performed, while in pulpo-proximal areas, leathery or soft dentin is left to avoid pulp exposure. As the decision of what contains 'soft' or 'leathery' dentin is subjective, using self-limiting burs which help to standardise the hardness of the remaining dentin, has been suggested to increase the reliability of carious tissue removal. Read More

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December 2018