10,090 results match your criteria BMJ quality & safety[Journal]


Diabetes in pregnancy in associations with perinatal and postneonatal mortality in First Nations and non-Indigenous populations in Quebec, Canada: population-based linked birth cohort study.

BMJ Open 2019 Apr 15;9(4):e025084. Epub 2019 Apr 15.

Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Objective: Both pregestational and gestational diabetes mellitus (PGDM, GDM) occur more frequently in First Nations (North American Indians) pregnant women than their non-Indigenous counterparts in Canada. We assessed whether the impacts of PGDM and GDM on perinatal and postneonatal mortality may differ in First Nations versus non-Indigenous populations.

Design: A population-based linked birth cohort study. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025084DOI Listing

Persistence with opioids post discharge from hospitalisation for surgery in Australian adults: a retrospective cohort study.

BMJ Open 2019 Apr 16;9(4):e023990. Epub 2019 Apr 16.

Quality Use of Medicines and Pharmacy Research Centre, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia.

Objective: To determine time to opioid cessation post discharge from hospital in persons who had been admitted to hospital for a surgical procedure and were previously naïve to opioids.

Design, Setting And Participants: Retrospective cohort study using administrative health claims database from the Australian Government Department of Veterans' Affairs (DVA). DVA gold card holders aged between 18 and 100 years who were admitted to hospital for a surgical admission between 1 January 2014 and 30 December 2015 and naïve to opioid therapy prior to admission were included in the study. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02399
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http://dx.doi.org/10.1136/bmjopen-2018-023990DOI Listing
April 2019
1 Read

Real-world persistence and adherence with oral bisphosphonates for osteoporosis: a systematic review.

BMJ Open 2019 Apr 14;9(4):e027049. Epub 2019 Apr 14.

Department of Health Professions, Manchester Metropolitan University, Manchester, UK.

Objectives: This study examined patient adherence and persistence to oral bisphosphonates for the treatment of osteoporosis in real-world settings.

Methods: A systematic review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) and National Health Service Economic Evaluation Database NHS EED) databases were searched for studies published in English language up to April 2018. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02704
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http://dx.doi.org/10.1136/bmjopen-2018-027049DOI Listing
April 2019
1 Read

Cost-effectiveness of faecal calprotectin used in primary care in the diagnosis of inflammatory bowel disease.

BMJ Open 2019 Apr 14;9(4):e027043. Epub 2019 Apr 14.

Department of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, Canada.

Objective: Inflammatory bowel disease (IBD) is a chronic, autoimmune, gastrointestinal disorder. Canada has one of the highest prevalence and incidence rates of IBD in the world. Diagnosis is challenging due to the similarity of symptoms to functional gastrointestinal disorders. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027043DOI Listing

Involving the general practitioner during curative cancer treatment: a systematic review of health care interventions.

BMJ Open 2019 Apr 14;9(4):e026383. Epub 2019 Apr 14.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Objective: The role of primary care providers (PCP) in the cancer care continuum is expanding. In the post-treatment phase, this role is increasingly recognised by policy makers and healthcare professionals. During treatment, however, the role of PCP remains largely undefined. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02638
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http://dx.doi.org/10.1136/bmjopen-2018-026383DOI Listing
April 2019
1 Read

Walk, Talk and Listen: a pilot randomised controlled trial targeting functional fitness and loneliness in older adults with hearing loss.

BMJ Open 2019 Apr 14;9(4):e026169. Epub 2019 Apr 14.

Medicine, University of British Columbia, Kelowna, British Columbia, Canada.

Background: Age-related hearing loss (HL) is a prevalent disability associated with loneliness, isolation, declines in cognitive and physical function and premature mortality. Group audiological rehabilitation (GAR) and hearing technologies address communication and cognitive decline. However, the relationship between loneliness, physical function and GAR among older adults with HL has not been studied. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026169DOI Listing

Does exercise impact gut microbiota composition in men receiving androgen deprivation therapy for prostate cancer? A single-blinded, two-armed, randomised controlled trial.

BMJ Open 2019 Apr 14;9(4):e024872. Epub 2019 Apr 14.

Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia.

Introduction: A potential link exists between prostate cancer (PCa) disease and treatment and increased inflammatory levels from gut dysbiosis. This study aims to examine if exercise favourably alters gut microbiota in men receiving androgen deprivation therapy (ADT) for PCa. Specifically, this study will explore whether: (1) exercise improves the composition of gut microbiota and increases the abundance of bacteria associated with health promotion and (2) whether gut health correlates with favourable inflammatory status, bowel function, continence and nausea among patients participating in the exercise intervention. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024872DOI Listing

Psycho-oncology care in breast cancer centres: a nationwide survey.

BMJ Support Palliat Care 2019 Apr 13. Epub 2019 Apr 13.

Center for Integrated Oncology (CIO), Bonn, Germany.

Objective: To describe psycho-oncological care structures and processes in German breast cancer centres from the perspective of the centre administration.

Methods: The findings are based on a postal survey of a representative random sample of surgical sites of certified breast cancer centres in Germany. Data were collected in 2013 and 2014. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001704DOI Listing

Healthcare portraiture and unconscious bias.

BMJ 2019 Apr 12;365:l1668. Epub 2019 Apr 12.

Department of Obstetrics and Gynaecology, Brigham and Women's Hospital, Harvard Medical School, USA.

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http://dx.doi.org/10.1136/bmj.l1668DOI Listing
April 2019
1 Read

Patient activation intervention to facilitate participation in recovery after total knee replacement (MIME): a cluster randomised cross-over trial.

BMJ Qual Saf 2019 Apr 11. Epub 2019 Apr 11.

Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Epworth Partnership, Deakin University, Geelong, Victoria, Australia.

Background: Patient participation in care is a fundamental element of safe and high-quality healthcare with the potential to enhance health outcomes and improve patient satisfaction.

Objectives: To test the efficacy of a clinician-facilitated, bedside multimedia () intervention designed to support patient participation in their recovery after total knee replacement surgery. The primary outcome was patients' reported worst pain intensity on postoperative day 3. Read More

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http://dx.doi.org/10.1136/bmjqs-2018-008975DOI Listing

iValidate: a communication-based clinical intervention in life-limiting illness.

BMJ Support Palliat Care 2019 Apr 11. Epub 2019 Apr 11.

ICU, Barwon Health, Geelong, Victoria, Australia.

Objectives: Report the implementation, user evaluation and key outcome measures of an educational intervention-the iValidate educational programme-designed to improve engagement in shared decision-making by health professionals caring for patients with life-limiting illness (LLI).

Design: Prospective, descriptive, cohort study.

Participants: Health professionals working in acute care settings caring for patients with an LLI. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001669DOI Listing
April 2019
2 Reads

Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: a protocol for a systematic review.

BMJ Open 2019 Apr 11;9(4):e027490. Epub 2019 Apr 11.

Institute for Global Health, University College London, London, UK.

Introduction: Type 2 diabetes mellitus (T2DM) remains one of the most common chronic diseases of adulthood which creates high degrees of morbidity and mortality worldwide. The incidence of T2DM continues to rise and recently, mHealth interventions have been increasingly used in the prevention, monitoring and management of T2DM. The aim of this study is to systematically review the published evidence on cost and cost-effectiveness of mHealth interventions for T2DM, as well as assess the quality of reporting of the evidence. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027490DOI Listing

Patient-centred rehabilitation for non-communicable disease in a low-resource setting: study protocol for a feasibility and proof-of-concept randomised clinical trial.

BMJ Open 2019 Apr 11;9(4):e025732. Epub 2019 Apr 11.

Department of Physiotherapy, Stellenbosch University, Cape Town, South Africa.

Introduction: Non-communicable diseases (NCDs) are the leading cause of death globally. Even though NCD disproportionally affects low-to-middle income countries, these countries including South Africa, often have limited capacity for the prevention and control of NCDs. The standard evidence-based care for the long-term management of NCDs includes rehabilitation. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02573
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http://dx.doi.org/10.1136/bmjopen-2018-025732DOI Listing
April 2019
6 Reads

Patients' and health professionals' attitudes and perceptions towards the initiation of preventive drugs for primary prevention of cardiovascular disease: protocol for a systematic review of qualitative studies.

BMJ Open 2019 Apr 11;9(4):e025587. Epub 2019 Apr 11.

Institute of Applied Health Research, University of Birmingham, Birmingham, West Midlands, UK.

Introduction: Lipid-lowering drugs and antihypertensive agents can be prescribed for the primary prevention of cardiovascular disease. In some cases, patients eligible for primary prevention of cardiovascular disease according to the European guidelines are not always started on preventive drugs. Existing research explores the attitudes of health professionals and patients towards cardiovascular preventive drugs but does not always differentiate between the attitudes towards drug initiation for primary or secondary prevention. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025587DOI Listing

Gut-directed hypnotherapy versus standard medical treatment for nausea in children with functional nausea or functional dyspepsia: protocol of a multicentre randomised trial.

BMJ Open 2019 Apr 11;9(4):e024903. Epub 2019 Apr 11.

Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands.

Introduction: The treatment of chronic functional nausea or nausea due to functional dyspepsia in children is generally symptomatic. Moreover, these disorders pose a risk for worse psychosocial and health outcomes in children. Hypnotherapy (HT), by its ability to positively influence gastrointestinal and psychosocial functioning, may be an effective treatment for chronic nausea. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02490
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http://dx.doi.org/10.1136/bmjopen-2018-024903DOI Listing
April 2019
1 Read

What factors are associated with resilient outcomes in children exposed to social adversity? A systematic review.

BMJ Open 2019 Apr 11;9(4):e024870. Epub 2019 Apr 11.

Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Objectives: Children exposed to social adversity-hardship as a result of social circumstances such as poverty or intergenerational trauma-are at increased risk of poor outcomes across the life course. Understanding what promotes resilient outcomes is essential for the development of evidence informed intervention strategies. We conducted a systematic review to identify how child resilience is measured and what factors are associated with resilient outcomes. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02487
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http://dx.doi.org/10.1136/bmjopen-2018-024870DOI Listing
April 2019
2 Reads

Improving rates of ferrous sulfate prescription for suspected iron deficiency anaemia in infants.

BMJ Qual Saf 2019 Apr 10. Epub 2019 Apr 10.

Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.

Background: Iron deficiency anaemia (IDA) in infancy is prevalent and associated with impaired neurodevelopment; however, studies suggest that treatment and follow-up rates are poor.

Objectives: To improve the rate of ferrous sulfate prescription for suspected IDA among infants aged 8-13 months to 75% or greater within 24 months.

Methods: We implemented a multidisciplinary process improvement effort aimed at standardising treatment for suspected IDA at two academic paediatric primary care clinics. Read More

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http://dx.doi.org/10.1136/bmjqs-2018-009098DOI Listing
April 2019
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The BMJ Awards 2019: Innovation in Quality Improvement Team of the Year.

Authors:
Jacqui Wise

BMJ 2019 Apr 10;365:l1653. Epub 2019 Apr 10.

London, UK.

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http://www.bmj.com/lookup/doi/10.1136/bmj.l1653
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http://dx.doi.org/10.1136/bmj.l1653DOI Listing
April 2019
2 Reads

A cohort study of functional electrical stimulation in people with multiple sclerosis demonstrating improvements in quality of life and cost-effectiveness.

Clin Rehabil 2019 Apr 10:269215519837326. Epub 2019 Apr 10.

1 The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.

Objective: The objective of this study was to determine the impact on health-related quality of life of functional electrical stimulation used to improve walking in people with multiple sclerosis and to explore cost-effectiveness.

Design: A retrospective analysis of patient records was conducted.

Setting: This study used outpatient therapy service as the study setting. Read More

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http://dx.doi.org/10.1177/0269215519837326DOI Listing
April 2019
3 Reads

Efficacy of pressure ulcer prevention interventions in adult intensive care units: a protocol for a systematic review and network meta-analysis.

BMJ Open 2019 Apr 9;9(4):e026727. Epub 2019 Apr 9.

Heart Center, Beijing Chaoyang Hospital affiliated with Capital Medical University, Beijing, China.

Introduction: Pressure ulcers (PUs) are associated with substantial health burden. Patients in intensive care units (ICUs) are at high risk for developing PU. In the absence of large randomised controlled trials (RCTs) that compare commonly known interventions for preventing PU in ICUs, uncertainty remains around the best practice strategy for PU management in adult ICUs. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02672
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http://dx.doi.org/10.1136/bmjopen-2018-026727DOI Listing
April 2019
5 Reads

What is the impact on the readmission ratio of taking into account readmissions to other hospitals? A cross-sectional study.

BMJ Open 2019 Apr 9;9(4):e025740. Epub 2019 Apr 9.

IQ healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.

Objectives: Readmissions are used widespread as an indicator of the quality of care within hospitals. Including readmissions to other hospitals might have consequences for hospitals. The aim of our study is to determine the impact of taking into account readmissions to other hospitals on the readmission ratio. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025740DOI Listing

A guided and unguided internet- and mobile-based intervention for chronic pain: health economic evaluation alongside a randomised controlled trial.

BMJ Open 2019 Apr 9;9(4):e023390. Epub 2019 Apr 9.

Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany.

Objective: This study aims at evaluating the cost-effectiveness and cost-utility of a guided and unguided internet-based intervention for chronic pain patients (ACTonPain and ACTonPain) compared with a waitlist control group (CG) as well as the comparative cost-effectiveness of the guided and the unguided version.

Design: This is a health economic evaluation alongside a three-arm randomised controlled trial from a societal perspective. Assessments were conducted at baseline, 9 weeks and 6 months after randomisation. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023390DOI Listing

Efficacy and safety of dual SGLT 1/2 inhibitor sotagliflozin in type 1 diabetes: meta-analysis of randomised controlled trials.

BMJ 2019 Apr 9;365:l1328. Epub 2019 Apr 9.

Humanitas University Gradenigo Hospital, 8 Corso Regina Margherita, 10132 Turin, Italy.

Objective: To assess the efficacy and safety of dual sodium glucose cotransporter (SGLT) 1/2 inhibitor sotagliflozin in type 1 diabetes mellitus.

Design: Meta-analysis of randomised controlled trials.

Data Sources: Medline; Cochrane Library; Embase; international meeting abstracts; international and national clinical trial registries; and websites of US, European, and Japanese regulatory authorities, up to 10 January 2019. Read More

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http://www.bmj.com/lookup/doi/10.1136/bmj.l1328
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http://dx.doi.org/10.1136/bmj.l1328DOI Listing
April 2019
3 Reads

SANRA-a scale for the quality assessment of narrative review articles.

Res Integr Peer Rev 2019 26;4. Epub 2019 Mar 26.

Deutsches Ärzteblatt and Deutsches Ärzteblatt International, Dieselstraße 2, D-50859 Cologne, Germany.

Background: Narrative reviews are the commonest type of articles in the medical literature. However, unlike systematic reviews and randomized controlled trials (RCT) articles, for which formal instruments exist to evaluate quality, there is currently no instrument available to assess the quality of narrative reviews. In response to this gap, we developed SANRA, the Scale for the Assessment of Narrative Review Articles. Read More

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http://dx.doi.org/10.1186/s41073-019-0064-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434870PMC

Role of comprehensive geriatric assessment in healthcare of older people in UK care homes: realist review.

BMJ Open 2019 Apr 8;9(4):e026921. Epub 2019 Apr 8.

National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care East Midlands, Nottingham, UK.

Objectives: Comprehensive geriatric assessment (CGA) may be a way to deliver optimal care for care home residents. We used realist review to develop a theory-driven account of how CGA works in care homes.

Design: Realist review. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02692
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http://dx.doi.org/10.1136/bmjopen-2018-026921DOI Listing
April 2019
2 Reads
2.063 Impact Factor

How human factors affect escalation of care: a protocol for a qualitative evidence synthesis of studies.

BMJ Open 2019 Apr 8;9(4):e025969. Epub 2019 Apr 8.

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.

Introduction: Failure to rescue is defined as mortality after complications during hospital care. Incidence ranges 10.9%-13. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025969DOI Listing

Healthcare Options for People Experiencing Depression (HOPE*D): the development and pilot testing of an encounter-based decision aid for use in primary care.

BMJ Open 2019 Apr 8;9(4):e025375. Epub 2019 Apr 8.

The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.

Objective: To develop and pilot an encounter-based decision aid (eDA) for people with depression for use in primary care.

Design: We developed an eDA for depression through cognitive interviews and pilot tested it using a one-group pretest, post-test design in primary care. Feasibility, fidelity of eDA use and acceptability were assessed using recruitment rates and semistructured interviews with patients, medical assistants and clinicians. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02537
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http://dx.doi.org/10.1136/bmjopen-2018-025375DOI Listing
April 2019
5 Reads

Goal-directed versus outcome-based financial incentives for weight loss among low-income patients with obesity: rationale and design of the Financial Incentives foR Weight Reduction (FIReWoRk) randomised controlled trial.

BMJ Open 2019 Apr 8;9(4):e025278. Epub 2019 Apr 8.

Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

Introduction: Obesity is a major public health challenge and exacerbates economic disparities through employment discrimination and increased personal health expenditures. Financial incentives for weight management may intensify individuals' utilisation of evidence-based behavioural strategies while addressing obesity-related economic disparities in low-income populations. Trials have focused on testing incentives contingent on achieving weight loss outcomes. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025278DOI Listing
April 2019
1 Read

Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action.

BMJ Open 2019 Apr 8;9(4):e024748. Epub 2019 Apr 8.

Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.

Objectives: Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in life, higher rates of trauma and self-medication with alcohol and other substances. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024748DOI Listing

Patient participation in multidisciplinary tumour conferences in breast cancer care (PINTU): a mixed-methods study protocol.

BMJ Open 2019 Apr 8;9(4):e024621. Epub 2019 Apr 8.

Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.

Introduction: A central instrument of multidisciplinary care is the multidisciplinary tumour conference (MTC). In MTCs, diagnosis and treatment of cancer patients are discussed, and therapy recommendations are worked out. As we found previously, patients participate in MTCs in some breast cancer centres in the state of North Rhine-Westphalia, Germany. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024621DOI Listing

Dental management of patients with haemophilia in the era of recombinant treatments: increased efficacy and decreased clinical risk.

BMJ Case Rep 2019 Apr 8;12(4). Epub 2019 Apr 8.

Universidad Complutense de Madrid, Madrid, Spain.

Haemophilia is a hereditary X-linked recessive disorder caused by a deficiency of either clotting factor VIII (haemophilia A) or IX (haemophilia B). Conventional treatment is currently based on the use of either plasma derived or recombinant coagulation factors. This paper reports on the case of a patient with severe haemophilia who presented with mesial decay and interproximal tartar build-up, for which extraction and scaling to remove tartar deposits were indicated. Read More

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http://dx.doi.org/10.1136/bcr-2018-227974DOI Listing
April 2019
1 Read

Ultrasound imaging versus palpation method for diagnostic lumbar puncture in neonates and infants: a systematic review and meta-analysis.

BMJ Paediatr Open 2019 15;3(1):e000412. Epub 2019 Mar 15.

Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences Stellenbosch University, Tygerberg, Cape Town, South Africa.

Importance: Lumbar puncture (LP) failure rates vary and can be as high as 65%. Ultrasound guidance could increase the success of performing LP.

Objective: To summarise the evidence on the use of ultrasound guidance versus palpation method for LP. Read More

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http://dx.doi.org/10.1136/bmjpo-2018-000412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422243PMC
March 2019
1 Read

What do families want to improve in the management of paediatric febrile neutropenia during anti-cancer treatment? Report of a patient/public involvement group.

BMJ Paediatr Open 2019 1;3(1):e000398. Epub 2019 Mar 1.

Centre for Reviews and Dissemination, University of York, Leeds, UK.

Background: This study reports how parents and young people who had an experience offebrile neutropenia (FN) improved the design of a trial to inform the management of this condition. Five parents, a young person who had completed treatment and three clinician-researchers contributed.

Methods: The group was formed after an invitation on social media and met via video conference. Read More

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http://dx.doi.org/10.1136/bmjpo-2018-000398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422240PMC

First patient-centred set of outcomes for pulmonary sarcoidosis: a multicentre initiative.

BMJ Open Respir Res 2019 18;6(1):e000394. Epub 2019 Feb 18.

Department of Value-Based Healthcare, St. Antonius Hospital, Nieuwegein, The Netherlands.

Introduction: Routine and international comparison of clinical outcomes enabling identification of best practices for patients with pulmonary sarcoidosis is lacking. The aim of this study was to develop a standard set of outcome measures for pulmonary sarcoidosis, using the value-based healthcare principles.

Methods: Six expert clinics for interstitial lung diseases in four countries participated in a consensus-driven RAND-modified Delphi study. Read More

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http://dx.doi.org/10.1136/bmjresp-2018-000394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424298PMC
February 2019
1 Read

Sex and intimacy in people with severe asthma: a qualitative study.

BMJ Open Respir Res 2019 12;6(1):e000382. Epub 2019 Feb 12.

Respiratory Medicine, Beaumont Hospital, Dublin, Ireland.

Introduction: People with severe asthma experience unpredictable daily symptoms requiring an intense treatment regimen impacting on health-related quality of life (QoL). Sexuality contributes to this, yet there is a dearth of research exploring intimacy in people with severe asthma. We aimed to explore the patient's perception of the impact of severe asthma on intimacy, establish their information needs and their perceived role of the healthcare practitioner. Read More

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http://dx.doi.org/10.1136/bmjresp-2018-000382DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424302PMC
February 2019
1 Read

The King's Brief Interstitial Lung Disease (KBILD) questionnaire: an updated minimal clinically important difference.

BMJ Open Respir Res 2019 18;6(1):e000363. Epub 2019 Feb 18.

Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Introduction: The King's Brief Interstitial Lung Disease (KBILD) is a 15-item validated health-related quality of life (HRQOL) questionnaire. The method of scoring the KBILD has recently changed to incorporate a logit-scale transformation from one that used raw item responses, as this is potentially a more linear scale. The aim of this study was to re-evaluate the KBILD minimal clinically important difference (MCID) using the new logit -transformed scoring. Read More

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http://dx.doi.org/10.1136/bmjresp-2018-000363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424243PMC
February 2019
2 Reads

Sarcoidosis in the UK: insights from British Thoracic Society registry data.

BMJ Open Respir Res 2019 18;6(1):e000357. Epub 2019 Feb 18.

Department of Respiratory Medicine, Hammersmith Hospital, London, UK.

Introduction: The British Thoracic Society Sarcoidosis Registry allows physicians to record clinical data after gaining written consent from patients. The registry's aim is to phenotype sarcoidosis in the UK.

Methods: Between February 2013 and July 2017, demographic details for 308 patients (with complete clinical data for 205 patients) presenting to 24 UK hospitals were recorded. Read More

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http://dx.doi.org/10.1136/bmjresp-2018-000357DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424275PMC
February 2019
1 Read

The perspective of physicians on the value of online clinical decision support.

Authors:
Kieran Walsh

Proc (Bayl Univ Med Cent) 2019 Jan 7;32(1):58-60. Epub 2019 Jan 7.

BMJ LearningLondonUK.

Online clinical decision support has been shown to help physicians improve the quality of care that they provide. However, there is little evidence as to how individual physicians perceive the utility of clinical decision support considering its cost. This article evaluates the perceptions of physicians who are part of a user group at BMJ about the cost and utility of an online clinical decision support resource, BMJ Best Practice. Read More

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http://dx.doi.org/10.1080/08998280.2018.1521189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442882PMC
January 2019
1 Read

Effect on secondary care of providing enhanced support to residential and nursing home residents: a subgroup analysis of a retrospective matched cohort study.

BMJ Qual Saf 2019 Apr 7. Epub 2019 Apr 7.

Data Analytics, The Health Foundation, London, UK.

Background: Thirteen residential care homes and 10 nursing homes specialising in older people in Rushcliffe, England, participated in an improvement programme. The enhanced support provided included regular visits from named general practitioners and additional training for care home staff. We assessed and compared the effect on hospital use for residents in residential and nursing homes, respectively. Read More

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http://dx.doi.org/10.1136/bmjqs-2018-009130DOI Listing

Efficacy of low-dose and/or adjuvant methadone in palliative medicine.

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Saint Francis Hospice Blanchardstown, Dublin, Ireland.

Objectives: To summarise the current body of published evidence on the use of low-dose and/or adjuvant methadone in the palliative care setting.

Methods: The authors searched multiple databases (PubMED, SCORPUS, EMBASE and the Cochrane library) for relevant articles using the terms 'methadone', 'palliative', 'low dose' and 'adjuvant'. The review was restricted to articles published between 2003 and 2018. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001695DOI Listing
April 2019
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Comparative long-term effectiveness and safety of primary bariatric surgeries in treating type 2 diabetes mellitus in adults: a protocol for systematic review and network meta-analysis of randomised controlled trials.

BMJ Open 2019 Apr 4;9(4):e028430. Epub 2019 Apr 4.

Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.

Introduction: Bariatric surgeries are effective in treating obesity related comorbidities, including type 2 diabetes mellitus. More robust evidence is needed to facilitate choice of procedure. In this systemic review, we aim to investigate the comparative long-term effectiveness in inducing remission of type 2 diabetes, halting diabetic complications, reducing mortality and the safety of conventional and emerging bariatric surgeries. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02843
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http://dx.doi.org/10.1136/bmjopen-2018-028430DOI Listing
April 2019
1 Read

Suffering measurement instruments in palliative care: protocol for a systematic psychometric review.

BMJ Open 2019 Apr 3;9(4):e027524. Epub 2019 Apr 3.

Instituto de Investigación Biomédica de Málaga(IBIMA), Málaga, Spain.

Introduction: The prevention and relief of suffering are regarded as a goal at the end of life; therefore, suffering assessment at the end of life is essential. In this regard, we need instruments that allow us to evaluate this construct for gathering more evidence, as the assessment of suffering is increasingly used in research and the clinical setting. Many measures have been designed to assess this construct, and the selection of the most appropriate instrument is crucial. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027524DOI Listing

Study protocol for a non-inferiority randomised controlled trial of SKY breathing meditation versus cognitive processing therapy for PTSD among veterans.

BMJ Open 2019 Apr 3;9(4):e027150. Epub 2019 Apr 3.

War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.

Introduction: Post-traumatic stress disorder (PTSD) is a debilitating, highly prevalent condition. Current clinical practice guidelines recommend trauma-focused psychotherapy (eg, cognitive processing therapy; CPT) as the first-line treatment for PTSD. However, while these treatments show clinically meaningful symptom improvement, the majority of those who begin treatment retain a diagnosis of PTSD post-treatment. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027150DOI Listing

What are the positive drivers and potential barriers to implementation of hospital at home selected by low-risk DECAF score in the UK: a qualitative study embedded within a randomised controlled trial.

BMJ Open 2019 Apr 4;9(4):e026609. Epub 2019 Apr 4.

Respiratory Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.

Objective: Hospital at home (HAH) for chronic obstructive pulmonary disease exacerbation selected by low-risk Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF) score is clinical and cost-effective; DECAF is a prognostic score indicating risk of mortality. Up to 50% of admitted patients are suitable, a much larger proportion than earlier services. Introduction of new models of care is challenging, but may be facilitated by informed engagement with stakeholders. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026609DOI Listing
April 2019
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Postoperative wound dehiscence after laparotomy: a useful healthcare quality indicator? A cohort study based on Norwegian hospital administrative data.

BMJ Open 2019 Apr 3;9(4):e026422. Epub 2019 Apr 3.

Division of Surgery, Akershus University Hospital Trust, Lørenskog, Norway.

Objectives: Postoperative wound dehiscence (PWD) is a serious complication to laparotomy, leading to higher mortality, readmissions and cost. The aims of the present study are to investigate whether risk adjusted PWD rates could reliably differentiate between Norwegian hospitals, and whether PWD rates were associated with hospital characteristics such as hospital type and laparotomy volume.

Design: Observational study using patient administrative data from all Norwegian hospitals, obtained from the Norwegian Patient Registry, for the period 2011-2015, and linked using the unique person identification number. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026422DOI Listing
April 2019
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Carotid endarterectomy with primary closure versus patch angioplasty in patients with symptomatic and significant stenosis: protocol for a systematic review with meta-analyses and trial sequential analysis of randomised clinical trials.

BMJ Open 2019 Apr 4;9(4):e026419. Epub 2019 Apr 4.

Department of Vascular Surgery, HFG, Medical Center Leeuwarden, Leeuwarden, Netherlands.

Introduction: Use of patch angioplasty in carotid endarterectomy (CEA) is suggested to reduce the risk of restenosis and recurrent ipsilateral stroke. The objective is to conduct a systematic review with meta-analysis and trial sequential analysis as well as Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessments comparing the benefits and harms of CEA with primary closure of the arterial wall versus CEA with patch angioplasty in patients with a symptomatic and significant carotid stenosis.

Methods And Analysis: The review shall be conducted according to this published protocol following the recommendations of the 'Cochrane' and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026419DOI Listing
April 2019
2.063 Impact Factor

Antibiotic prescription among outpatients in a prefecture of Japan, 2012-2013: a retrospective claims database study.

BMJ Open 2019 Apr 3;9(4):e026251. Epub 2019 Apr 3.

Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.

Objectives: To investigate oral antibiotic prescribing patterns and identify factors associated with antibiotic prescriptions, with the aim of guiding future interventions to reduce inappropriate prescribing.

Design: Retrospective cohort study.

Setting: Database of public health insurance claims in Kumamoto prefecture (Japan). Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026251DOI Listing
April 2019
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Electroacupuncture versus manual acupuncture in the treatment of plantar heel pain syndrome: study protocol for an upcoming randomised controlled trial.

BMJ Open 2019 Apr 3;9(4):e026147. Epub 2019 Apr 3.

Acupuncture and Moxibustion Department, Guang'anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China.

Introduction: Plantar heel pain syndrome(PHPS) is a common cause of heel pain. It may worsen a patient's quality of life, and potentially lead to knee, hip or lower back problems. Previous studies have shown that electroacupuncture (EA) and manual acupuncture (MA) are effective treatments for relieving pain in patients with PHPS. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026147DOI Listing

Effects of dexmedetomidine on delirium and mortality during sedation in ICU patients: a systematic review and meta-analysis protocol.

BMJ Open 2019 Apr 3;9(4):e025850. Epub 2019 Apr 3.

Department of Anesthesiology, Tongji Medical College, Huazhong University of Science and Technology, Tongji Hospital, Wuhan, China.

Introduction: Delirium is very common in patients admitted to intensive care unit (ICU), and may worsen survival in these patients. Several meta-analyses have evaluated the antidelirium effects of dexmedetomidine in ICU patients, but their findings were inconsistent. Recently, several large multicentre randomised clinical trials (RCTs) were published, but they have not yet to be included in any meta-analysis. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025850DOI Listing
April 2019
3 Reads