IntroductionDiarrhoea is a frequent concern in the intensive care unit (ICU) and is associated with prolonged mechanical ventilation, increased length of ICU stay, skin breakdown and renal dysfunction. However, its prevalence, aetiology and prognosis in the critically ill have been poorly studied. The primary objectives of this study are to determine the incidence, risk factors and consequences of diarrhoea in critically ill adults. The secondary objectives are to estimate the incidence of Clostridium...
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ObjectivesThe aim of this study was to explore the barriers to accessing cancer services faced by adults with pre-existing physical disabilities. DesignCross-sectional, exploratory qualitative study. Data were collected by semistructured interviews and analysed thematically. SettingParticipants were recruited through statutory and third sector organisations in England and Wales between October 2017 and October 2018. Participants18 people with a diagnosis of cancer and a pre-existing physical disability....
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ObjectiveThis study explored beliefs contributing to Hepatitis B stigma, and the ways in which Hepatitis B stigma manifests, from the perspectives of people with chronic Hepatitis B as well as healthcare providers in Northern and Southern Ghana. DesignWe used an exploratory qualitative design with a purposive sampling technique. Face-to-face interviews and focus group discussions were conducted. Data were processed using QSR Nvivo V.10.0 and analysed using inductive thematic analysis. SettingsParticipants...
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IntroductionEvidence indicates a bidirectional relationship between poor sleep and Alzheimer’s disease (AD). While AD may lead to disruption of normal sleep, poor sleep in itself may play a causal role in the development of AD by influencing the production and/or clearance of the amyloid-beta (Aβ) protein. This led to the hypothesis that extended periods (>10 years) of sleep loss could lead to Aβ accumulation with subsequent cognitive AD-related decline. This manuscript describes the methodology...
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ObjectivesNon-response to questionnaires in a longitudinal study reduces the effective sample size and introduces bias. We identified the characteristics of non-respondent pregnant women, and compared them with respondents in the Japan Environment and Children’s Study (JECS) during the gestational period. DesignThis was a questionnaire-based, longitudinal cohort study. SettingQuestionnaires were provided by research coordinators to mothers at prenatal examinations (at obstetrics clinics) or by...
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ObjectivesIdentifying patients who are at high risk for discharge failure allows for implementation of interventions to improve their care. However, discharge failure is currently defined in literature with great variability, making targeted interventions more difficult. We aim to derive a screening tool based on the existing diverse discharge failure models. Design, setting and participantsThis is a single-centre retrospective cohort study in the USA. Data from all patients discharged from the...
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IntroductionPatients having chronic musculoskeletal pain (CMP) face challenges as mismatches often exist between the complexity of patient’s pain problem and the rehabilitation treatment offered. This can result in less efficient care for the patient and increased medical shopping. The Network Pain Rehabilitation Limburg (NPRL), a transmural integrated healthcare network, will be designed to improve daily care for patients with CMP. NPRL focusses on improving patient’s level of functioning despite...
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Barriers to care for women with low-grade endometrial cancer and morbid obesity: a qualitative study
ObjectiveObesity is a major risk factor for low-grade endometrial cancer. The surgical management of patients with obesity is challenging, and they may face unique barriers to accessing care. We completed a qualitative study to understand the experiences of low-grade endometrial cancer patients with morbid obesity, from symptom onset to diagnosis to surgery. DesignSemi-structured interviews were performed with endometrial cancer patients with morbid obesity (body mass index (BMI) >40 kg/m2) referred...
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ObjectiveTo inform feasibility and design of a future randomised controlled trial (RCT) using brain functional MRI (fMRI) to determine the mechanism of action of gabapentin in managing chronic pelvic pain (CPP) in women. DesignMechanistic study embedded in pilot RCT. SettingUniversity Hospital. ParticipantsTwelve women (18–50 years) with CPP and no pelvic pathology (follow-up completed March 2014). InterventionOral gabapentin (300–2700 mg) or matched placebo. Outcome measuresAfter 12 weeks of...
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ObjectivesMany studies have explored the association between Helicobacter pylori infection and osteoporosis. However, the results remain controversial. Therefore, we performed this systematic review and meta-analysis to evaluate the association between H. pylori infection and osteoporosis. DesignSystematic review and meta-analysis of case–control studies. Data sourcesDatabases, including PubMed, Embase, Web of Science and Chinese Biomedical Literature Database, were screened from inception to 30...
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ObjectiveTo examine the role of dietary intake and physical activity in muscle strength among adolescents. DesignCross-sectional analysis. SettingThe Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. ParticipantsFifteen-year-old secondary school children who have given consent and who participated in the MyHeART study in 2014. Primary outcome measureMuscle strength was measured in relation to dietary intake (energy and macronutrients) and physical activity by using...
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ObjectiveTo assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption. DesignA 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2). ParticipantsStudy 1: South Australians, 15+ years (n=2732); study 2: Australians, 18+ years (n=3430). Primary...
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IntroductionNew Zealand has experienced a rise in HIV diagnoses in recent years and new interventions are required to address this. Methods and analysisNZPrEP (A demonstration project of HIV preexposure prophylaxis in Aotearoa New Zealand) is an open-label, single-arm treatment evaluation study to investigate feasibility, retention, adherence, and clinical and behavioural outcomes of HIV pre-exposure prophylaxis (PrEP) provision to gay and bisexual men (GBM) in a publicly funded secondary sexual...
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ObjectiveTo conduct a systematic review investigating the normal age-related changes in lung function in adults without known lung disease. DesignSystematic review. Data sourcesMEDLINE, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for eligible studies from inception to February 12, 2019, supplemented by manual searches of reference lists and clinical trial registries. Eligibility criteriaWe planned to include prospective cohort studies and randomised...
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ObjectivesThe difference between income quintiles in health is relatively well accepted by the general public as a measure of health inequality. However, the slope index of inequality (SII) in health reflects the patterns of all social groups, including the middle 60%, and it could therefore be considered more academically desirable. If these two measures are closely correlated, the widespread use of the difference between income quintiles in health would be better supported. This study was conducted...
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Chen Y, Armoiry X, Higenbottam C, et al. Magnitude and modifiers of the weekend effect in hospital admissions: a systematic review and meta-analysis. BMJ Open 2019;9:e025764. doi: 10.1136/bmjopen-2018-025764. This article was previously published with an error. The author name ‘Rajna Basra’ should be ‘Ranjna Basra’.
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PurposeThe l’Actuel PrEP Cohort was established to monitor the uptake, effectiveness, safety and changes in sexual risk behaviours among individuals receiving pre-exposure prophylaxis (PrEP) for the prevention of HIV. This prospective dynamic cohort is based at Clinique médicale l’Actuel, a large sexual health clinic located in Montreal, Canada. ParticipantsSince the cohort inception in January of 2013 through June 2018, 2156 individuals consulted for PrEP as participants in the l’Actuel PrEP Cohort....
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IntroductionThe majority of young autistic children display impairing emotional and behavioural difficulties that contribute to family stress. There is some evidence that behavioural parenting interventions are effective for reducing behavioural difficulties in autistic children, with less evidence assessing change in emotional difficulties. Previous trials have tended to use unblinded parent-report measures as primary outcomes and many do not employ an active control, limiting the conclusions that...
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Hower KI, Vennedey V, Hillen HA, et al. Implementation of patient-centred care: which organisational determinants matter from decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations. BMJ Open 2019;9:e027591. doi: 10.1136/bmjopen-2018-027591 Some information regarding last authorship, collaborators and the trial registration number were left out in the previous version of this manuscript. The missing details are as follows: The...
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PurposeThe Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain. ParticipantsIn 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega’s catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999–2000 of 495 phase I participants...
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