223,659 results match your criteria BMJ USA[Journal]


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

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

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
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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

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
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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

Comprehensive scoping review of health research using social media data.

BMJ Open 2018 Dec 14;8(12):e022931. Epub 2018 Dec 14.

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

Introduction: The rising popularity of social media, since their inception around 20 years ago, has been echoed in the growth of health-related research using data derived from them. This has created a demand for literature reviews to synthesise this emerging evidence base and inform future activities. Existing reviews tend to be narrow in scope, with limited consideration of the different types of data, analytical methods and ethical issues involved. Read More

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December 2018

Qualitative exploration of sociocultural determinants of health inequities of Dalit population in Dhaka City, Bangladesh.

BMJ Open 2018 Dec 14;8(12):e022906. Epub 2018 Dec 14.

Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.

Objectives: In recent years, Bangladesh has made remarkable advances in health outcomes; however, the benefits of these gains are unequally shared among citizens and population groups. Dalits ( sweepers), a marginalised traditional working community, have relatively poor access to healthcare services. This study sought to explore the sociopolitical and cultural factors associated with health inequalities among Dalits in an urban setting. Read More

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December 2018

Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis.

BMJ Open 2018 Dec 14;8(12):e022879. Epub 2018 Dec 14.

Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.

Objective: To investigate the efficacy and safety of the pulsed electromagnetic field (PEMF) therapy in treating osteoarthritis (OA).

Design: Meta-analysis.

Data Sources: PubMed, Embase, the Cochrane Library and Web of Science were searched through 13 October 2017. Read More

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December 2018

Development of a tool to assess beliefs about mythical causes of cancer: the Cancer Awareness Measure Mythical Causes Scale.

BMJ Open 2018 Dec 14;8(12):e022825. Epub 2018 Dec 14.

Research Department of Behavioural Science and Health, University College London, London, UK.

Objectives: We aimed to develop a reliable and valid measure to assess public beliefs in mythical causes of cancer: the Cancer Awareness Measure-MYthical Causes Scale (CAM-MYCS).

Design And Setting: Cancer myth items were generated from a literature review, social media and interviews (n=16). The CAM-MYCS was prepared by reducing items using (a) an online sample (n=527) with exploratory factor analysis and (b) cancer experts with Delhpi methodology (n=13). Read More

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December 2018

Relationship between hospital or surgeon volume and outcomes in joint arthroplasty: protocol for a suite of systematic reviews and dose-response meta-analyses.

BMJ Open 2018 Dec 14;8(12):e022797. Epub 2018 Dec 14.

Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Introduction: Joint arthroplasty is a particularly complex orthopaedic surgical procedure performed on joints, including the hip, knee, shoulder, ankle, elbow, wrist and even digit joints. Increasing evidence from volume-outcomes research supports the finding that patients undergoing joint arthroplasty in high-volume hospitals or by high-volume surgeons achieve better outcomes, and minimum case load requirements have been established in some areas. However, the relationships between hospital/surgeon volume and outcomes in patients undergoing arthroplasty are not fully understood. Read More

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December 2018

Cost of oropharyngeal dysphagia after stroke: protocol for a systematic review.

BMJ Open 2018 Dec 14;8(12):e022775. Epub 2018 Dec 14.

Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.

Introduction: Oropharyngeal dysphagia (OD) is a major disorder following stroke. OD can produce alterations in both the efficacy and safety of deglutition and may result in malnutrition, dehydration, frailty, respiratory infections and pneumonia. These complications can be avoided by early detection and treatment of OD in poststroke patients, and hospital stays, medication and mortality rates can be reduced. Read More

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December 2018

Predicting 7-year mortality for use with evidence-based guidelines for Prostate-Specific Antigen (PSA) testing: findings from a large prospective study of 123 697 Australian men.

BMJ Open 2018 Dec 14;8(12):e022613. Epub 2018 Dec 14.

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Objectives: To develop and validate a prediction model for short-term mortality in Australian men aged ≥45years, using age and self-reported health variables, for use when implementing the Australian Clinical Practice Guidelines for Prostate-Specific Antigen (PSA) Testing and Early Management of Test-Detected Prostate Cancer. Implementation of one of the Guideline recommendations requires an estimate of 7-year mortality.

Design: Prospective cohort study using questionnaire data linked to mortality data. Read More

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December 2018

Costs and outcomes in evaluating management of unhealed surgical wounds in the community in clinical practice in the UK: a cohort study.

BMJ Open 2018 Dec 14;8(12):e022591. Epub 2018 Dec 14.

Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.

Objective: To evaluate the patient pathways and associated health outcomes, resource use and corresponding costs attributable to managing unhealed surgical wounds in clinical practice, from initial presentation in the community in the UK.

Methods: This was a retrospective cohort analysis of the records of 707 patients in The Health Improvement Network (THIN) database whose wound failed to heal within 4 weeks of their surgery. Patients' characteristics, wound-related health outcomes and healthcare resource use were quantified, and the total National Health Service (NHS) cost of patient management was estimated at 2015/2016 prices. Read More

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December 2018

Evaluation of stakeholder views on peer review of NIHR applications for funding: a qualitative study.

BMJ Open 2018 Dec 14;8(12):e022548. Epub 2018 Dec 14.

Wessex Institute, University of Southampton, Southampton, UK.

Objectives: Innovations resulting from research have both national and global impact, so selecting the most promising research studies to fund is crucial. Peer review of research funding applications is part of the selection process, and requires considerable resources. This study aimed to elicit stakeholder opinions about which factors contribute to and influence effective peer review of funding applications to the UK National Institute for Health Research (NIHR), and to identify possible minor improvements to current processes and any major changes or potential innovations to achieve a more efficient peer review process. Read More

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December 2018

Influence of external peer reviewer scores for funding applications on funding board decisions: a retrospective analysis of 1561 reviews.

BMJ Open 2018 Dec 14;8(12):e022547. Epub 2018 Dec 14.

Wessex Institute, Faculty of Medicine, University of Southampton, Southampton, UK.

Objectives: To evaluate the influence of external peer reviewer scores on the National Institute for Health Research (NIHR) research funding board decisions by the number of reviewers and type of reviewer expertise.

Design: Retrospective analysis of external peer review scores for shortlisted full applications for funding (280 funding applications, 1236 individual reviewers, 1561 review scores).

Setting: Four applied health research funding programmes of NIHR, UK. Read More

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December 2018

Ten-year trends in traumatic brain injury: a retrospective cohort study of California emergency department and hospital revisits and readmissions.

BMJ Open 2018 Dec 14;8(12):e022297. Epub 2018 Dec 14.

Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.

Objective: To describe visits and visit rates of adults presenting to emergency departments (EDs) with a diagnosis of traumatic brain injury (TBI). TBI is a major cause of death and disability in the USA; yet, current literature is limited because few studies examine longer-term ED revisits and hospital readmission patterns of TBI patients across a broad spectrum of injury severity, which can help inform potential unmet healthcare needs.

Design: We performed a retrospective cohort study. Read More

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December 2018

study: protocol for a stepped-wedge cluster randomised trial to compare access to care for a mobile app versus a workstation-based store-and-forward teledermatology process.

BMJ Open 2018 Dec 14;8(12):e022218. Epub 2018 Dec 14.

US Department of Veterans Affairs, Center for Access Policy, Evaluation and Research, Boston, Massachusetts, USA.

Introduction: Teledermatology has emerged as an important strategy to enhance access to high-quality skin care. is a provider-facing, web-based mobile app designed to integrate into the existing teledermatology workflow in the US Veterans Health Administration (VHA). In this study, we will conduct a systematic evaluation of on access outcomes in VHA facilities using a pragmatic trial guided by clinical and operational leaders. Read More

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December 2018
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Study protocol for a double-blind randomised controlled trial investigating the impact of 12 weeks supplementation with a extract on cholesterol levels in adults with elevated fasting LDL cholesterol who are overweight or have obesity.

BMJ Open 2018 Dec 14;8(12):e022195. Epub 2018 Dec 14.

Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia.

Introduction: Hyperlipidaemia, hyperglycaemia and chronic inflammation are risk factors for chronic diseases cardiovascular disease and type 2 diabetes. Polyphenols are bioactive compounds found in marine algae with potential antihyperlipidaemic, antihyperglycaemic and anti-inflammatory effects. The modulation of these risk factors using bioactive polyphenols may represent a useful strategy for disease prevention and management; research in humans, however, remains limited. Read More

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December 2018
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Neighbourhood characteristics and cumulative biological risk: evidence from the Jamaica Health and Lifestyle Survey 2008: a cross-sectional study.

BMJ Open 2018 Dec 14;8(12):e021952. Epub 2018 Dec 14.

Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.

Objective: To examine whether neighbourhood characteristics are associated with cumulative biological risk (CBR) and sex differences in CBR in a nationally representative sample in Jamaica, a small island developing country with increasing prevalence of non-communicable diseases (NCDs).

Design: Cross-sectional study SETTING: A population-based cross-sectional survey, the Jamaica Health and Lifestyle Survey 2008 (JHLS II) recruited persons at their homes over a 4 month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts (EDs).

Participants: 2544 persons aged 15-74 years old from the 2008 Jamaica Health and Lifestyle Survey (JHLS II), who completed interviewer-administered questionnaires and had biomarkers assessed, and whose home addresses could be reliably geocoded. Read More

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December 2018

Impact of workplace incivility in hospitals on the work ability, career expectations and job performance of Chinese nurses: a cross-sectional survey.

BMJ Open 2018 Dec 14;8(12):e021874. Epub 2018 Dec 14.

Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China.

Objectives: The objectives of this study were to investigate new nurses' experiences of workplace incivility; verify the mediating role of work ability in the relationship between workplace incivility and job performance and examine the moderating role of career expectations in the relationship between workplace incivility and job performance.

Design: This cross-sectional survey was conducted in China in May 2016.

Settings: The research settings included 54 cities across 29 provinces of China. Read More

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December 2018

ICF Generic Set as new standard for the system wide assessment of functioning in China: a multicentre prospective study on metric properties and responsiveness applying item response theory.

BMJ Open 2018 Dec 14;8(12):e021696. Epub 2018 Dec 14.

Swiss Paraplegic Research, Nottwil, Switzerland.

Objectives: To examine metric properties and responsiveness of the International Classification of Functioning, Disability and Health (ICF) Generic Set when used in routine clinical practice to assess functioning.

Design: Prospective multicentre study.

Setting: 50 hospitals from 20 provinces of Mainland China. Read More

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December 2018
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Clinical effectiveness of pharmacy-led versus conventionally delivered antiviral treatment for hepatitis C in patients receiving opioid substitution therapy: a study protocol for a pragmatic cluster randomised trial.

BMJ Open 2018 Dec 14;8(12):e021443. Epub 2018 Dec 14.

Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.

Introduction: Hepatitis C virus (HCV) infection affects 0.7% of the general population, and up to 40% of people prescribed opioid substitution therapy (OST) in Scotland. In conventional care, less than 10% of OST users are tested for HCV and less than 25% of these initiate treatment. Read More

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December 2018

Cultural validation of the Addenbrooke's Cognitive Examination Version III Urdu for the British Urdu-speaking population: a qualitative assessment using cognitive interviewing.

BMJ Open 2018 Dec 14;8(12):e021057. Epub 2018 Dec 14.

Centre for Primary Care, The University of Manchester, Manchester, UK.

Objectives: Our research determined whether the Addenbrooke's Cognitive Examination Version III (ACE-III) Urdu eliminated cultural bias through a qualitative assessment of its understanding and acceptability within the British Urdu-speaking population, employing cognitive interviews.

Method: We aimed to recruit 25 participants fluent in speaking and writing Urdu, over the age of 60 years, able to give informed consent and who did not have a history of cognitive impairment. Participants were administered the ACE-III Urdu, and cognitive interviews were conducted, which involve obtaining verbal data on the individual's perception of the assessment overall, their understanding of the mental processes behind how they interpreted questions within the assessment and how they produced appropriate responses. Read More

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December 2018

Effect of a combined programme of dietary restriction and physical activity on the physical function and body composition of obese middle-aged and older adults with knee OA (DRPA): protocol for a feasibility study.

BMJ Open 2018 Dec 14;8(12):e021051. Epub 2018 Dec 14.

School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.

Introduction: Knee osteoarthritis (OA) is the most common chronic illness among older adults. Up to the submission date of this protocol, there are no published UK studies reporting the efficacy of a combined intervention programme of physical activity and dietary restriction on the musculoskeletal function of obese older adults with knee OA in spite of the clinical recommendation for exercise and diet for people with knee OA. The aim of this study is to assess the feasibility and acceptability of a combined dietary restriction and physical activity intervention programme and collect preliminary data. Read More

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December 2018

Policy environment impacting the societal harm caused by alcohol in India: protocol for a scoping review.

BMJ Open 2018 Dec 14;8(12):e020854. Epub 2018 Dec 14.

Addictions Research Group, Sangath, Porvorim, Goa, India.

Introduction: The aim of this review is to provide the first consolidation of the policy environment surrounding alcohol-related societal harm in India giving researchers and policy-makers a clearer base for future reforms. This review is also an important adaptation on the scoping review method for policy reviews in low-resource settings that may serve as an example for other policy reviews in similar settings.

Methods And Analysis: We will undertake a scoping review with policy relevant adaptations in order to map the alcohol-related policy environment in India. Read More

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December 2018

Clinical and genetic associations of renal function and diabetic kidney disease in the United Arab Emirates: a cross-sectional study.

BMJ Open 2018 Dec 14;8(12):e020759. Epub 2018 Dec 14.

Center of Biotechnology, Khalifa University, Abu Dhabi, United Arab Emirates.

Objectives: Within the Emirati population, risk factors and genetic predisposition to diabetic kidney disease (DKD) have not yet been investigated. The aim of this research was to determine potential clinical, laboratory and reported genetic loci as risk factors for DKD.

Research Design And Methods: Four hundred and ninety unrelated Emirati nationals with type 2 diabetes mellitus (T2DM) were recruited with and without DKD, and clinical and laboratory data were obtained. Read More

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December 2018

Indigenous health worker support for patients with poorly controlled type 2 diabetes: study protocol for a cluster randomised controlled trial of the Mana Tū programme.

BMJ Open 2018 Dec 14;8(12):e019572. Epub 2018 Dec 14.

Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand.

Introduction: Type 2 diabetes mellitus (T2DM) and its complications are more common among Māori and Pacific people compared with other ethnic groups in New Zealand. Comprehensive and sustained approaches that address social determinants of health are required to address this condition, including culturally specific interventions. Currently, New Zealand has no comprehensive T2DM management programme for Māori or Pacific people. Read More

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December 2018

Emergency Room Safer Transfer of Patients (ER-STOP): a quality improvement initiative at a community-based hospital to improve the safety of emergency room patient handovers.

BMJ Open 2018 Dec 14;8(12):e019553. Epub 2018 Dec 14.

Department of Medicine, Division of Respirology, University of Toronto and Michael Garron Hospital, Michael Garron Hospital, Toronto, Ontario, Canada.

Objectives: Ensure early identification and timely management of patient deterioration as essential components of safe effective healthcare. Prompted by analyses of incident reports and deterioration events, a multicomponent organisational rescue from danger system was redesigned to decrease unexpected inpatient deterioration.

Design: Quality improvement before-after unblinded trial. Read More

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December 2018

Impact of the new medical examiner role on patient safety.

BMJ 2018 Dec 14;363:k5166. Epub 2018 Dec 14.

School of Health and Related Research, University of Sheffield, Regent Street, Sheffield S1 4DA, UK

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December 2018