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    A randomised controlled trial of an intervention delivered by app instant messaging to increase the acceptability of effective contraception among young people in Tajikistan: study protocol.
    BMJ Open 2017 Sep 21;7(9):e017606. Epub 2017 Sep 21.
    Department of Population Health, The London School of Hygiene and Tropical Medicine, London, UK.
    Introduction: Women in lower income countries experience unintended pregnancies at a higher rate compared with women in higher income countries. Unintended pregnancy is associated with numerous poorer health outcomes for both women and their children. In Tajikistan, an estimated 26% of married individuals aged 15-24 years have an unmet need for contraception. Read More

    Protocol of a randomised controlled trial characterising the immune responses induced by varicella-zoster virus (VZV) vaccination in healthy Kenyan women: setting the stage for a potential VZV-based HIV vaccine.
    BMJ Open 2017 Sep 21;7(9):e017391. Epub 2017 Sep 21.
    Department of Immunology, University of Toronto, Toronto, Ontario, Canada.
    Introduction: A protective HIV vaccine would be expected to induce durable effector immune responses at the mucosa, restricting HIV infection at its portal of entry. We hypothesise that use of varicella-zoster virus (VZV) as an HIV delivery vector could generate sustained and robust tissue-based immunity against HIV antigens to provide long-term protection against HIV. Given that HIV uniquely targets immune-activated T cells, the development of human vaccines against HIV must also involve a specific examination of the safety of the vector. Read More

    Reporting of conflicts of interest in oral presentations at medical conferences: a delegate-based prospective observational study.
    BMJ Open 2017 Sep 21;7(9):e017019. Epub 2017 Sep 21.
    Department of Medicine, University of Auckland, Auckland, New Zealand.
    Objective: To assess the prevalence, location, presentation and consistency of conflict of interest statements in oral presentations at medical conferences DESIGN: Prospective, delegate-based observational study SAMPLE: 201 oral presentations at 5 medical conferences in 2016 MAIN OUTCOME MEASURES: Presence of a conflict of interest statement, its location within the presentation and its duration of display. Concordance between conflict of interest disclosures in oral presentations and written abstracts or meeting speaker information RESULTS: Conflict of interest statements were present in 143/201 (71%) presentations (range for conferences 26%-100%). 118 of the 141 evaluable statements (84%) were reported on a specific slide. Read More

    Help-seeking behaviours, opportunistic treatment and psychological implications of adolescent acne: cross-sectional studies in schools and hospital outpatient departments in the UK.
    BMJ Open 2017 Sep 21;7(9):e016964. Epub 2017 Sep 21.
    Department of Adolescent Endocrinologist, University College London Hospitals NHS Foundation Trust, London, UK.
    Background: Acne vulgaris (acne) is a common adolescent skin condition. It is associated with negative psychological impacts and sufferers do not easily seek help, hence is undertreated.

    Objectives: We investigated the self-reported prevalence, severity and psychological sequelae of acne, together with assessing help-seeking behaviour and its barriers, in separate school and hospital samples. Read More

    Is the Salut Programme an effective and cost-effective universal health promotion intervention for parents and their children? A register-based retrospective observational study.
    BMJ Open 2017 Sep 21;7(9):e016732. Epub 2017 Sep 21.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Objectives: This study investigates the effectiveness and cost-effectiveness of the Salut Programme, a universal health promotion intervention, compared with care-as-usual, over the periods of pregnancy, delivery and the child's first 2 years of life.

    Method: We adopted a register-based retrospective observational design using existing data sources with respect to both exposures and outcomes. Health outcomes and costs were compared between geographical areas that received care-as-usual (non-Salut area) and areas where the programme was implemented (Salut area). Read More

    Usage of purchased self-tests for HIV and sexually transmitted infections in Amsterdam, the Netherlands: results of population-based and serial cross-sectional studies among the general population and sexual risk groups.
    BMJ Open 2017 Sep 21;7(9):e016609. Epub 2017 Sep 21.
    Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam, The Netherlands.
    Objectives: There are limited data on the usage of commercially bought self-tests for HIV and other sexually transmitted infections (STIs). Therefore, we studied HIV/STI self-test usage and its determinants among the general population and sexual risk groups between 2007 and 2015 in Amsterdam, the Netherlands.

    Setting: Data were collected in four different studies among the general population (S1-2) and sexual risk groups (S3-4). Read More

    Is increasing urbanicity associated with changes in breastfeeding duration in rural India? An analysis of cross-sectional household data from the Andhra Pradesh children and parents study.
    BMJ Open 2017 Sep 21;7(9):e016331. Epub 2017 Sep 21.
    Department of Non-communicable Disease Epidemiology, London School of Hygiene, London, UK.
    Objective: To investigate whether village-level urbanicity and lower level socioeconomic factors are associated with breastfeeding practices in transitioning rural communities in India.

    Setting: 29 villages in Ranga Reddy district, southern India between 2011 and 2014.

    Participants: 7848 children under 6 years identified via a cross-sectional household survey conducted as part of the Andhra Pradesh Children and Parents Study. Read More

    Urine cytology screening of French workers exposed to occupational urinary tract carcinogens: a prospective cohort study over a 20-year period.
    BMJ Open 2017 Sep 21;7(9):e016238. Epub 2017 Sep 21.
    Department of Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, CHU-Clermont-Ferrand, Clermont-Ferrand, France.
    Objectives: To demonstrate that urine cytology screening can provide relevant epidemiological data for earlier detection of urothelial cancer caused by occupational exposure.

    Design: Prospective cohort study.

    Setting: Industries using urothelial carcinogens in France. Read More

    Publication of interventional phase 3 and 4 clinical trials in radiation oncology: an observational study.
    BMJ Open 2017 Sep 21;7(9):e016040. Epub 2017 Sep 21.
    Radioterapia i Oncología, Hospital Plato, Barcelona, Spain.
    Objectives: Clinical trials produce the best data available for decision-making in modern evidence-based medicine. We aimed to determine the rate of non-publication of interventional phase 3 and 4 clinical trials involving patients with cancer undergoing radiotherapy.

    Setting: The ClinicalTrials. Read More

    Understanding barriers and outcomes of unspecified (non-directed altruistic) kidney donation from both professional's and patient's perspectives: research protocol for a national multicentre mixed-methods prospective cohort study.
    BMJ Open 2017 Sep 21;7(9):e015971. Epub 2017 Sep 21.
    Department of Renal Transplantation, Guy's and St. Thomas' NHS Foundation Trust/King's College London, London, UK.
    Introduction: Living donation accounts for over one-third of all kidney transplants taking place in the UK. (1) The concept of anonymously donating a kidney to a stranger (non-directed altruistic or unspecified kidney donation (UKD)) remains uncomfortable for some clinicians, principally due to concerns about the motivations and long-term physical and psychological outcomes in this donor group.

    Aims: The research programme aims to provide a comprehensive assessment of the unspecified donor programme in the UK. Read More

    Determinants of community pharmacists' quality of care: a population-based cohort study using pharmacy administrative claims data.
    BMJ Open 2017 Sep 21;7(9):e015877. Epub 2017 Sep 21.
    Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
    Objective: To determine if a prototype pharmacists' services evaluation programme that uses linked community pharmacy claims and health administrative data to measure pharmacists' performance can be used to identify characteristics of pharmacies providing higher quality of care.

    Design: Population-based cohort study using community pharmacy claims from 1 November 2009 to 30 June 2010.

    Setting: All community pharmacies in Quebec, Canada. Read More

    Perceptions of parents and paediatricians on pain induced by bone marrow aspiration and lumbar puncture among children with acute leukaemia: a qualitative study in China.
    BMJ Open 2017 Sep 21;7(9):e015727. Epub 2017 Sep 21.
    Department of Pharmacology, College of Pharmacy, Ningxia Medical University, Yinchuan, China.
    Objective: To obtain in-depth insight into the perceptions of parents and paediatricians in China regarding current procedural pain management on bone marrow aspirations and lumbar punctures in paediatric haemato-oncology department.

    Design, Setting And Participants: This qualitative study was conducted in a 4500-bed university hospital in northwest China. To collect data, in-depth semistructured interviews were conducted with parents of children with acute leukaemia (n=12) and haemato-oncology paediatricians (n=11) using purposive sampling. Read More

    Recording a diagnosis of stroke, transient ischaemic attack or myocardial infarction in primary healthcare and the association with dispensation of secondary preventive medication: a registry-based prospective cohort study.
    BMJ Open 2017 Sep 21;7(9):e015723. Epub 2017 Sep 21.
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Objectives: The aim of this study was to explore whether recording in primary care of a previously recorded hospital diagnosis was associated with increased patient utilisation of recommended medications.

    Design: Registry-based prospective cohort study.

    Setting And Participants: 19 072 patients with a hospital discharge diagnosis of transient ischaemic attack (TIA), stroke or acute coronary syndrome from hospitals in Stockholm County 2010-2013 were included in the study. Read More

    Protocol for a realist review of complex interventions to prevent adolescents from engaging in multiple risk behaviours.
    BMJ Open 2017 Sep 21;7(9):e015477. Epub 2017 Sep 21.
    Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
    Objectives: Adolescent risk behaviours are a key health concern. The purpose of this research is to gaina deeper understanding of how, why, for whom, and inwhat circumstances complex adolescent risk behaviourprevention programmes are most successful.

    Methods And Analysis: To understand how adolescent risk behaviour prevention programmes work in a reallife context, a realist synthesis will be undertaken, operationalised in four phases. Read More

    Association between gender and short-term outcome in patients with ST elevation myocardial infraction participating in the international, prospective, randomised Administration of Ticagrelor in the catheterisation Laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery (ATLANTIC) trial: a prespecified analysis.
    BMJ Open 2017 Sep 21;7(9):e015241. Epub 2017 Sep 21.
    Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Objectives: To evaluate gender differences in outcomes in patents with ST-segment elevation myocardial infarction (STEMI) planned for primary percutaneous coronary intervention (PPCI).

    Settings: A prespecified gender analysis of the multicentre, randomised, double-blind Administration of Ticagrelor in the catheterisation Laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery.

    Participants: Between September 2011 and October 2013, 1862 patients with STEMI and symptom duration <6 hours were included. Read More

    Household and familial resemblance in risk factors for type 2 diabetes and related cardiometabolic diseases in rural Uganda: a cross-sectional community sample.
    BMJ Open 2017 Sep 21;7(9):e015214. Epub 2017 Sep 21.
    Danish Diabetes Academy, Odense, Denmark.
    Objectives: Prevention of type 2 diabetes (T2D) has been successfully established in randomised clinical trials. However, the best methods for the translation of this evidence into effective population-wide interventions remain unclear. To assess whether households could be a target for T2D prevention and screening, we investigated the resemblance of T2D risk factors at household level and by type of familial dyadic relationship in a rural Ugandan community. Read More

    Long-term risk of recurrence after discontinuing anticoagulants for a first unprovoked venous thromboembolism: protocol for a systematic review and meta-analysis.
    BMJ Open 2017 Sep 21;7(9):16950. Epub 2017 Sep 21.
    Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
    Introduction: For patients with a first unprovoked venous thromboembolism (VTE), the optimal duration of anticoagulation is a crucial clinical dilemma which has yet to be resolved. The decision to stop anticoagulant therapy (AT) after the initial 3-6 months or to continue AT indefinitely, is primarily governed by the long-term risk of recurrence when treatment is discontinued. This risk however, is not well established, hindering decision making. Read More

    Association between physical activity levels in mid-life with physical activity in old age: a 20-year tracking study in a prospective cohort.
    BMJ Open 2017 Sep 21;7(8):e017378. Epub 2017 Sep 21.
    UCL Department of Primary Care and Population Health, UCL Medical School, London, UK.
    Objectives: This study aims to examine the tracking and predictability of physical activity in old age from overall physical activity and participation in sport, recreational activity and walking in mid-life.

    Design: Prospective population-based cohort study.

    Setting: British Regional Heart Study participants recruited from primary care centres in the UK in 1978-1980. Read More

    Impact of oral self-care on incident functional disability in elderly Japanese: the Ohsaki Cohort 2006 study.
    BMJ Open 2017 Sep 18;7(9):e017946. Epub 2017 Sep 18.
    Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan.
    Objectives: To assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss.

    Design: A 5.7-year prospective cohort study. Read More

    Protocol for a scoping review of skin self-care of people with spinal cord injury.
    BMJ Open 2017 Sep 18;7(9):e017860. Epub 2017 Sep 18.
    Department of Nursing, Center for Health Sciences, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
    Introduction: In recent years, increasing methodological references have been used in scientific research; these are points of support in the search for evidence, formulation and elaboration of instruments, scales, guideline and protocols. However, significant variability currently exists in scoping review conduct and reporting, thus limiting the potential of the methodology to advance research and practice about skin self-care of people with spinal cord injury (SCI). Our objective was to perform a scoping review protocol within the health rehabilitation context of people with SCI, focusing on skin self-care. Read More

    REACH: study protocol of a randomised trial of rehabilitation very early in congenital hemiplegia.
    BMJ Open 2017 Sep 18;7(9):e017204. Epub 2017 Sep 18.
    CSIRO Mathematical and Information Sciences Biomedical Imaging Group, Australian e-Health Research Centre.
    Objectives: Congenital hemiplegia is the most common form of cerebral palsy (CP). Children with unilateral CP show signs of upper limb asymmetry by 8 months corrected age (ca) but are frequently not referred to therapy until after 12 months ca. This study compares the efficacy of infant-friendly modified constraint-induced movement therapy (Baby mCIMT) to infant friendly bimanual therapy (Baby BIM) on upper limb, cognitive and neuroplasticity outcomes in a multisite randomised comparison trial. Read More

    Diagnostic validity of early-onset obsessive-compulsive disorder in the Danish Psychiatric Central Register: findings from a cohort sample.
    BMJ Open 2017 Sep 18;7(9):e017172. Epub 2017 Sep 18.
    Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.
    Objectives: Employing national registers for research purposes depends on a high diagnostic validity. The aim of the present study was to examine the diagnostic validity of recorded diagnoses of early-onset obsessive-compulsive disorder (OCD) in the Danish Psychiatric Central Register (DPCR).

    Design: Review of patient journals selected randomly through the DPCR. Read More

    The course and prognostic factors of cognitive status after central nervous system trauma: a systematic review protocol.
    BMJ Open 2017 Sep 18;7(9):e017165. Epub 2017 Sep 18.
    Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
    Introduction: Traumatic brain injury (TBI) is among the most disabling injuries, resulting in a range of cognitive impairments. Traumatic spinal cord injury (SCI) often occurs in conjunction with TBI; the two are best considered together in the context of trauma to the central nervous system (CNS). Despite strong indications of cognitive dysfunction in CNS trauma, little is known about its natural history or relationship with other factors. Read More

    A pragmatic group sequential, placebo-controlled, randomised trial to determine the effectiveness of glyceryl trinitrate for retained placenta (GOT-IT): a study protocol.
    BMJ Open 2017 Sep 18;7(9):e017134. Epub 2017 Sep 18.
    Tommy's Centre for Maternal and Fetal Health Research, Medical Research Council Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
    Introduction: A retained placenta is diagnosed when the placenta is not delivered following delivery of the baby. It is a major cause of postpartum haemorrhage and treated by the operative procedure of manual removal of placenta (MROP).

    Methods And Analysis: The aim of this pragmatic, randomised, placebo-controlled, double-blind UK-wide trial, with an internal pilot and nested qualitative research to adjust strategies to refine delivery of the main trial, is to determine whether sublingual glyceryl trinitrate (GTN) is (or is not) clinically and cost-effective for (medical) management of retained placenta. Read More

    Economic volatility in childhood and subsequent adolescent mental health problems: a longitudinal population-based study of adolescents.
    BMJ Open 2017 Sep 18;7(9):e017030. Epub 2017 Sep 18.
    Norwegian Center for Child Behavioral Development, University of Oslo, Oslo, Norway.
    Objective: The aim of the current paper was to investigate the association between the patterns of duration, timing and sequencing of exposure to low family income during childhood, and symptoms of mental health problems in adolescence.

    Setting: Survey administered to a large population-based sample of Norwegian adolescents.

    Participants: Survey data from 9154 participants of 16-19 years age (53% participation rate; 52. Read More

    Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care: study protocol for a cluster randomised controlled trial.
    BMJ Open 2017 Sep 18;7(9):e016985. Epub 2017 Sep 18.
    Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia.
    Introduction: Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings. Read More

    Disability acquisition and mental health: effect modification by demographic and socioeconomic characteristics using data from an Australian longitudinal study.
    BMJ Open 2017 Sep 18;7(9):e016953. Epub 2017 Sep 18.
    Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.
    Objectives: There is evidence of a causal relationship between disability acquisition and poor mental health, but the substantial heterogeneity in the magnitude of the effect is poorly understood and may be aetiologically informative. This study aimed to identify demographic and socioeconomic factors that modify the effect of disability acquisition on mental health.

    Design And Setting: The Household, Income and Labour Dynamics in Australia Survey is a nationally representative longitudinal survey of Australian households that has been conducted annually since 2001. Read More

    Measuring the preference towards patient-centred communication with the Chinese-revised Patient-Practitioner Orientation Scale: a cross-sectional study among physicians and patients in clinical settings in Shanghai, China.
    BMJ Open 2017 Sep 18;7(9):e016902. Epub 2017 Sep 18.
    Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
    Objectives: To adapt the Patient-Practitioner Orientation Scale (PPOS), to a Chinese context, and explore the preference towards patient-centred communication among physicians and patients with the Chinese-revised Patient-Practitioner Orientation Scale (CR-PPOS).

    Design: A cross-sectional questionnaire-based study.

    Setting: Clinical settings from eight medical units, including four community hospitals and four general hospitals, in Shanghai, China. Read More

    Does improving sleep lead to better mental health? A protocol for a meta-analytic review of randomised controlled trials.
    BMJ Open 2017 Sep 18;7(9):e016873. Epub 2017 Sep 18.
    Clinical Psychology Unit, Sheffield University, Sheffield, UK.
    Introduction: Sleep and mental health go hand-in-hand, with many, if not all, mental health problems being associated with problems sleeping. Although sleep has been traditionally conceptualised as a secondary consequence of mental health problems, contemporary views prescribe a more influential, causal role of sleep in the formation and maintenance of mental health problems. One way to evaluate this assertion is to examine the extent to which interventions that improve sleep also improve mental health. Read More

    Recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) versus alteplase (rt-PA) as fibrinolytic therapy for acute ST-segment elevation myocardial infarction (China TNK STEMI): protocol for a randomised, controlled, non-inferiority trial.
    BMJ Open 2017 Sep 18;7(9):e016838. Epub 2017 Sep 18.
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
    Aim: To evaluate the efficacy and safety of recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) in lowering major adverse cardiovascular and cerebrovascular events (MACCEs) in Chinese acute ST-segment elevation myocardial infarction (STEMI) patients.

    Methods And Analysis: The study is designed as a multicentre, randomised, controlled non-inferiority phase IV trial with balanced randomisation (1:1) in patients with STEMI. The planned sample size is 6200 participants (or 3100 per arm). Read More

    Comparative effectiveness of injectable penicillin versus a combination of penicillin and gentamicin in children with pneumonia characterised by indrawing in Kenya: protocol for an observational study.
    BMJ Open 2017 Sep 18;7(9):e016784. Epub 2017 Sep 18.
    Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
    Introduction: WHO treatment guidelines are widely recommended for guiding treatment for millions of children with pneumonia every year across multiple low-income and middle-income countries. Guidelines are based on synthesis of available evidence that provides moderate certainty in evidence of effects for forms of pneumonia that can result in hospitalisation. However, trials have included fewer children from Africa than other settings, and it is suggested that African children with pneumonia have higher mortality. Read More

    How novice, skilled and advanced clinical researchers include variables in a case report form for clinical research: a qualitative study.
    BMJ Open 2017 Sep 18;7(9):e016760. Epub 2017 Sep 18.
    Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
    Objectives: Despite varying degrees in research training, most academic clinicians are expected to conduct clinical research. The objective of this research was to understand how clinical researchers of different skill levels include variables in a case report form for their clinical research.

    Setting: The setting for this research was a major academic institution in Beijing, China. Read More

    Assessing the extent of drug interactions among patients with multimorbidity in primary and secondary care in the West Midlands (UK): a study protocol for the Mixed Methods Multimorbidity Study (MiMMS).
    BMJ Open 2017 Sep 18;7(9):e016713. Epub 2017 Sep 18.
    Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
    Introduction: The numbers of patients with three or more chronic conditions (multimorbidity) are increasing, and will rise to 2.9 million by 2018 in the UK alone. Currently in the UK, conditions are mainly managed using over 250 sets of single-condition guidance, which has the potential to generate conflicting recommendations for lifestyle and concurrent medication for individual patients with more than one condition. Read More

    Gender differences in longevity in free-living older adults who eat-with-others: a prospective study in Taiwan.
    BMJ Open 2017 Sep 18;7(9):e016575. Epub 2017 Sep 18.
    Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
    Objectives: Social activities such as 'eating-with-others' can positively affect the ageing process. We investigated the gender-specific association between eating arrangements and risk of all-cause mortality among free-living older adults.

    Setting: A representative sample from the Elderly Nutrition and Health Survey in Taiwan during 1999-2000. Read More

    Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): study protocol.
    BMJ Open 2017 Sep 18;7(9):e016371. Epub 2017 Sep 18.
    Department of Anaesthetics, Watford General Hospital, Watford, UK.
    Introduction: Delirium is a common, serious and potentially preventable condition with devastating impact on the quality of life prompting a proliferation of interventional trials. Core outcome sets aim to standardise outcome reporting by identifying outcomes perceived fundamental for measurement in trials of a specific interest area. Our aim is to develop international consensus on two core outcome sets for trials of interventions to prevent and/or treat delirium, irrespective of study population. Read More

    A cross-sectional study in a tertiary care hospital in China: noise or silence in the operating room.
    BMJ Open 2017 Sep 18;7(9):e016316. Epub 2017 Sep 18.
    Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
    Objectives: This study aims to provide a comprehensive description of noise levels in operating rooms (ORs) in a tertiary care hospital in China. Additionally, the study aims to examine the deviation in noise levels from international and internal standards as well as the differences in noise levels by category of surgery and day of the week.

    Methods: We monitored noise levels in 23 ORs in a tertiary care hospital in China between August 2015 and March 2016. Read More

    Comparison of anthropometric indices for predicting the risk of metabolic syndrome and its components in Chinese adults: a prospective, longitudinal study.
    BMJ Open 2017 Sep 18;7(9):e016062. Epub 2017 Sep 18.
    Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China.
    Objectives: Our study aimed to distinguish the ability of anthropometric indices to assess the risk of metabolic syndrome (MetS).

    Design: Prospective cohort study.

    Setting: Shenyang, China. Read More

    Trend analysis of mortality rates and causes of death in children under 5 years old in Beijing, China from 1992 to 2015 and forecast of mortality into the future: an entire population-based epidemiological study.
    BMJ Open 2017 Sep 18;7(9):e015941. Epub 2017 Sep 18.
    Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
    Objectives: To analyse trends in mortality and causes of death among children aged under 5 years in Beijing, China between 1992 and 2015 and to forecast under-5 mortality rates (U5MRs) for the period 2016-2020.

    Methods: An entire population-based epidemiological study was conducted. Data collection was based on the Child Death Reporting Card of the Beijing Under-5 Mortality Rate Surveillance Network. Read More

    Adherence and dosing interval of subcutaneous antitumour necrosis factor biologics among patients with inflammatory arthritis: analysis from a Canadian administrative database.
    BMJ Open 2017 Sep 18;7(9):e015872. Epub 2017 Sep 18.
    Medical Affairs, Janssen Inc, Toronto, Ontario, Canada.
    Objectives: Subcutaneous tumour necrosis factor alpha TNFαinhibitors (SC-TNFis) such as golimumab (GLM), adalimumab (ADA), etanercept (ETA) and certolizumab pegol (CZP) have been used for many years for the treatment of inflammatory arthritis. Non-adherence to therapy is an important modifiable factor that may compromise patient outcomes. The aim of this analysis was to compare adherence and dosing interval of SC-TNFis in the treatment of people with inflammatory arthritis. Read More

    Controlling Nutritional Status (CONUT) score as a predictor of all-cause mortality in elderly hypertensive patients: a prospective follow-up study.
    BMJ Open 2017 Sep 18;7(9):e015649. Epub 2017 Sep 18.
    Department of Geriatric Cardiolog, Chinese People's Liberation Army General Hospital, Beijing, China.
    Objectives: The aim of this study was to elucidate the impact of nutritional status on survival per Controlling Nutritional Status (CONUT) score and Geriatric Nutritional Risk Index (GNRI) in patients with hypertension over 80 years of age.

    Design: Prospective follow-up study.

    Participants: A total of 336 hypertensive patients over 80 years old were included in this study. Read More

    Integrated management of atrial fibrillation including tailoring of anticoagulation in primary care: study design of the ALL-IN cluster randomised trial.
    BMJ Open 2017 Sep 18;7(9):e015510. Epub 2017 Sep 18.
    Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.
    Introduction: In our ageing society, we are at the merge of an expected epidemic of atrial fibrillation (AF). AF management requires an integrated approach, including rate or rhythm control, stroke prevention with anticoagulation and treatment of comorbidities such as heart failure or type 2 diabetes. As such, primary care seems to be the logical healthcare setting for the chronic management of patients with AF. Read More

    Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis.
    BMJ Open 2017 Sep 18;7(9):e014820. Epub 2017 Sep 18.
    Faculty of Health Sciences, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.
    Objectives: To assess the benefits and harms of exercise in patients with depression.

    Design: Systematic review DATA SOURCES: Bibliographical databases were searched until 20 June 2017.

    Eligibility Criteria And Outcomes: Eligible trials were randomised clinical trials assessing the effect of exercise in participants diagnosed with depression. Read More

    Cohort profile of a study on outcomes related to tuberculosis and antiretroviral drug concentrations in Uganda: design, methods and patient characteristics of the SOUTH study.
    BMJ Open 2017 Sep 18;7(9):e014679. Epub 2017 Sep 18.
    Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
    Purpose: Tuberculosis (TB) is a leading cause of death among people living with HIV in sub-Saharan Africa. Several factors influence the efficacy of TB treatment by leading to suboptimal drug concentrations and subsequently affecting treatment outcome. The aim of this cohort is to determine the association between anti-TB drug concentrations and TB treatment outcomes. Read More

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