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BMJ Open

John T Y Soong, Alan J Poots, Derek Bell
OBJECTIVE: We seek to address gaps in knowledge and agreement around optimal frailty assessment in the acute medical care setting. Frailty is a common term describing older persons who are at increased risk of developing multimorbidity, disability, institutionalisation and death. Consensus has not been reached on the practical implementation of this concept to assess clinically and manage older persons in the acute care setting. DESIGN: Modified Delphi, via electronic questionnaire...
October 14, 2016: BMJ Open
Caroline Anne Mitchell, Alice Pitt, Joe Hulin, Rod Lawson, Fleur Ashby, Ivan Appelqvist, Brigitte Delaney
OBJECTIVES: Increased rates of illicit drug inhalation are thought to expose opiate misusers (OMUs) to an enhanced risk of respiratory health problems. This pilot study aimed to determine the feasibility of undertaking respiratory screening of OMUs in a community clinic. SETTING: Single-centre UK community substance misuse clinic. PARTICIPANTS: All clinic attendees receiving treatment for opiate misuse were eligible to participate. 36 participants (mean age=37) were recruited over a 5-week period...
October 14, 2016: BMJ Open
Elif Can, Felicitas Richter, Ralitsa Valchanova, Marc Dewey
OBJECTIVES: To identify underlying causes for failure of medical thesis projects and the constantly high drop-out rate in Germany from the supervisors' perspective and to compare the results with the students' perspective. SETTING: Cross-sectional survey. Online questionnaire for survey of medical thesis supervisors among the staff of Charité-Universitätsmedizin Berlin, Germany. Published, earlier longitudinal survey among students for comparison. PARTICIPANTS: 1069 thesis supervisors participated...
October 14, 2016: BMJ Open
Lian Leng Low, Nan Liu, Sijia Wang, Julian Thumboo, Marcus Eng Hock Ong, Kheng Hock Lee
OBJECTIVES: To evaluate the impact of comorbidities, acute illness burden and social determinants of health on predicting the risk of frequent hospital admissions. DESIGN: Multivariable logistic regression was used to associate the predictive variables extracted from electronic health records and frequent hospital admission risk. The model's performance of our predictive model was evaluated using a 10-fold cross-validation. SETTING: A single tertiary hospital in Singapore...
October 14, 2016: BMJ Open
Lene Hammer-Helmich, Allan Linneberg, Carsten Obel, Simon Francis Thomsen, Line Tang Møllehave, Charlotte Glümer
OBJECTIVE: This study aimed to examine the association of eczema, asthma and hay fever with mental health in a general child population and to assess the influence of parental socioeconomic position on these associations. METHODS: We conducted a cross-sectional health survey of children aged 3, 6, 11 and 15 years in the City of Copenhagen, Denmark. Individual questionnaire data on eczema, asthma, and hay fever and mental health problems assessed using the Strengths and Difficulties Questionnaire (SDQ) was linked to register data on demographics and parental socioeconomic position...
October 14, 2016: BMJ Open
Hamde Nazar, Steven Brice, Nasima Akhter, Adetayo Kasim, Ann Gunning, Sarah P Slight, Neil W Watson
OBJECTIVES: To evaluate an electronic patient referral system from one UK hospital Trust to community pharmacies across the North East of England. SETTING: Two hospital sites in Newcastle-upon-Tyne and 207 community pharmacies. PARTICIPANTS: Inpatients who were considered to benefit from on-going support and continuity of care after leaving hospital. INTERVENTION: Electronic transmission of an information related to patient's medicines to their nominated community pharmacy...
October 14, 2016: BMJ Open
J C Hill, E K Afolabi, M Lewis, K M Dunn, E Roddy, D A van der Windt, N E Foster
OBJECTIVES: The STarT Back Tool has good predictive performance for non-specific low back pain in primary care. We therefore aimed to investigate whether a modified STarT Back Tool predicted outcome with a broader group of musculoskeletal patients, and assessed the consequences of using existing risk-group cut-points across different pain regions. SETTING: Secondary analysis of prospective data from 2 cohorts: (1) outpatient musculoskeletal physiotherapy services (PhysioDirect trial n=1887) and (2) musculoskeletal primary-secondary care interface services (SAMBA study n=1082)...
October 14, 2016: BMJ Open
Steve Gregory, Yasmin Iles-Caven, Joseph R Hibbeln, Caroline M Taylor, Jean Golding
OBJECTIVES: There have been conflicting data suggesting that prenatal mercury exposure is associated with adverse cardiovascular measures in children. We therefore analysed a large prospective population study to investigate whether prenatal mercury exposure might influence offspring blood pressure (BP) and heart rate adversely. DESIGN: Prospective birth cohort. SETTING: The Avon Longitudinal Study of Parents and Children (ALSPAC). PARTICIPANTS: Maternal whole blood collected in the first half of pregnancy was assayed for mercury and selenium...
October 14, 2016: BMJ Open
Marco Rimoldi, Oliviero Rossi, Nadia Rota
OBJECTIVE: To assess the clinical status of chronic spontaneous urticaria (CSU) and understand treatment approaches in Italy through specialists who treat CSU (dermatologists and allergy specialists) and CSU patients' experience. DESIGN: Multicentre survey. SETTING: Online structured questionnaires (one for physicians and one for patients). PARTICIPANTS: Physicians and patients with CSU in Italy. INTERVENTIONS: None...
October 14, 2016: BMJ Open
M Riishede, C B Laursen, L S Teglbjærg, A T Lassen, G Baatrup
INTRODUCTION: Patients with acute respiratory problems poses a diagnostic challenge because similar symptoms can be caused by various pathological conditions. Focused ultrasound examination (f-US) of the heart and lungs has proven to increase the diagnostic accuracy in these patients. In this protocol of a randomised multicentre trial, we study the effect of f-US of the heart and lungs in patients with respiratory problems performed by emergency physicians (EP) as soon as the patient arrives to the emergency department (ED)...
October 14, 2016: BMJ Open
H White, L Gillgrass, A Wood, D G Peckham
OBJECTIVES: To identify patient's views on the functionality required for personalised access to the secondary care electronic health record (EHR) and their priorities for development. DESIGN: Quantitative analysis of a cross-sectional self-complete survey of patient views on required EHR functionality from a secondary care EHR, including a patient ranking of functionality. SETTING: Secondary care patients attending a regional cystic fibrosis unit in the north of England...
October 14, 2016: BMJ Open
E Knowles, A O'Cathain, J Turner, J Nicholl
OBJECTIVE: To measure the effect of an urgent care telephone service NHS 111 on population perceptions of urgent care. DESIGN: Controlled before and after population survey, using quota sampling to identify 2000 respondents reflective of the age/sex profile of the general population. SETTING: England. 4 areas where NHS 111 was introduced, and 3 control areas where NHS 111 had yet to be introduced. PARTICIPANTS: 28 071 members of the general population, including 2237 recent users of urgent care...
October 14, 2016: BMJ Open
C van der Veer, M Himschoot, S M Bruisten
OBJECTIVES: In this cross-sectional epidemiological study we aimed to identify molecular profiles for Trichomonas vaginalis and to determine how these molecular profiles were related to patient demographic and clinical characteristics. SETTING: Molecular typing methods previously identified two genetically distinct subpopulations for T. vaginalis; however, few molecular epidemiological studies have been performed. We now increased the sensitivity of a previously described multilocus sequence typing (MLST) tool for T...
October 13, 2016: BMJ Open
Maryam Zamanian, Mohammad Reza Baneshi, AliAkbar Haghdoost, Farzaneh Zolala
OBJECTIVES: Abortion is a sensitive issue; many cultures disapprove of it, which leads to under-reporting. This study sought to estimate the rate of abortion visibility in the city of Kerman, Iran-that is, the percentage of acquaintances who knew about a particular abortion. For estimating the visibility rate, it is crucial to use the network scale-up method, which is a new, indirect method of estimating sensitive behaviours more accurately. MATERIALS AND METHODS: This cross-sectional study was conducted in Kerman, Iran using various methods to ensure the cooperation of clinicians and women...
October 13, 2016: BMJ Open
Suzie Mudge, Juliet Rosie, Susan Stott, Denise Taylor, Nada Signal, Kathryn McPherson
OBJECTIVE: To enhance understanding of the experiences of ageing with cerebral palsy (CP) in adulthood with a particular focus on experiences with health services. DESIGN: A qualitative descriptive methodology was applied to capture adults' views of ageing with CP and related interactions with health services. Semistructured interviews were undertaken with data systematically coded and interpreted by grouping information into categories. Themes that encompassed the categories were identified through thematic analysis...
October 13, 2016: BMJ Open
Dimitri Taurino Guedes, Afshin Vafaei, Beatriz Eugenia Alvarado, Carmen Lucia Curcio, Jack M Guralnik, María Victoria Zunzunegui, Ricardo Oliveira Guerra
BACKGROUND: Life course exposure to violence may lead to disability in old age. We examine associations and pathways between life course violence and mobility disability in older participants of the International Mobility in Aging Study (IMIAS). METHODS: A cross-sectional study using IMIAS 2012 baseline. Men and women aged 65-74 years were recruited at 5 cities (n=1995): Kingston and Saint-Hyacinthe (Canada), Tirana (Albania), Manizales (Colombia) and Natal (Brazil)...
October 13, 2016: BMJ Open
Lars T Fadnes, Kathy Ainul Møen, Esperanza Diaz
OBJECTIVES: Health status, disease spectrum and use of healthcare have been reported to vary across groups of migrants and according to the different phases of migration. However, most studies are conducted among adults. This study assesses usage of primary healthcare (PHC) by children with immigrant background compared with non-immigrant children in Norway and describes their relative morbidity burden. DESIGN: Population-based retrospective cohort study. SETTING: This study used 3 linked population-based registers in Norway for children under 18 years of age in 2008...
October 13, 2016: BMJ Open
Anisa Rowhani-Farid, Adrian G Barnett
OBJECTIVE: To quantify data sharing trends and data sharing policy compliance at the British Medical Journal (BMJ) by analysing the rate of data sharing practices, and investigate attitudes and examine barriers towards data sharing. DESIGN: Observational study. SETTING: The BMJ research archive. PARTICIPANTS: 160 randomly sampled BMJ research articles from 2009 to 2015, excluding meta-analysis and systematic reviews...
October 13, 2016: BMJ Open
Rianne A Weersink, Margriet Bouma, David M Burger, Joost P H Drenth, Nicole G M Hunfeld, Minke Kranenborg, Margje H Monster-Simons, Sandra A W van Putten, Herold J Metselaar, Katja Taxis, Sander D Borgsteede
INTRODUCTION: Liver cirrhosis can have a major impact on drug pharmacokinetics and pharmacodynamics. Patients with cirrhosis often suffer from potentially preventable adverse drug reactions. Guidelines on safe prescribing for these patients are lacking. The aim of this study is to develop a systematic method for evaluating the safety and optimal dosage of drugs in patients with liver cirrhosis. METHODS AND ANALYSIS: For each drug, a six-step evaluation process will be followed...
October 12, 2016: BMJ Open
E A Huhn, T Fischer, C S Göbl, M Todesco Bernasconi, M Kreft, M Kunze, A Schoetzau, E Dölzlmüller, W Eppel, P Husslein, N Ochsenbein-Koelble, R Zimmermann, E Bäz, H Prömpeler, E Bruder, S Hahn, I Hoesli
INTRODUCTION: As the accurate diagnosis and treatment of gestational diabetes mellitus (GDM) is of increasing importance; new diagnostic approaches for the assessment of GDM in early pregnancy were recently suggested. We evaluate the diagnostic power of an 'early' oral glucose tolerance test (OGTT) 75 g and glycosylated fibronectin (glyFn) for GDM screening in a normal cohort. METHODS AND ANALYSIS: In a prospective cohort study, 748 singleton pregnancies are recruited in 6 centres in Switzerland, Austria and Germany...
October 12, 2016: BMJ Open
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