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BMJ Open

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https://www.readbyqxmd.com/read/28087556/ahead-study-an-observational-study-of-the-management-of-anticoagulated-patients-who-suffer-head-injury
#1
Suzanne Mason, Maxine Kuczawski, M Dawn Teare, Matt Stevenson, Steve Goodacre, Shammi Ramlakhan, Francis Morris, Joanne Rothwell
OBJECTIVES: Management of anticoagulated patients after head injury is unclear due to lack of robust evidence. This study aimed to determine the adverse outcome rate in these patients and identify risk factors associated with poor outcome. DESIGN: Multicentre, observational study using routine patient records. SETTING: 33 emergency departments in England and Scotland. PARTICIPANTS: 3566 adults (aged ≥16 years) who had suffered blunt head injury and were currently taking warfarin...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087555/associations-of-reallocating-sitting-time-into-standing-or-stepping-with-glucose-insulin-and-insulin-sensitivity-a-cross-sectional-analysis-of-adults-at-risk-of-type-2-diabetes
#2
Charlotte L Edwardson, Joe Henson, Danielle H Bodicoat, Kishan Bakrania, Kamlesh Khunti, Melanie J Davies, Thomas Yates
OBJECTIVE: To quantify associations between sitting time and glucose, insulin and insulin sensitivity by considering reallocation of time into standing or stepping. DESIGN: Cross-sectional. SETTING: Leicestershire, UK, 2013. PARTICIPANTS: Adults aged 30-75 years at high risk of impaired glucose regulation (IGR) or type 2 diabetes. 435 adults (age 66.8±7.4 years; 61.7% male; 89.2% white European) were included. METHODS: Participants wore an activPAL3 monitor 24 hours/day for 7 days to capture time spent sitting, standing and stepping...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087554/how-prepared-are-uk-medical-graduates-for-practice-a-rapid-review-of-the-literature-2009-2014
#3
Lynn V Monrouxe, Lisa Grundy, Mala Mann, Zoe John, Eleni Panagoulas, Alison Bullock, Karen Mattick
OBJECTIVE: To understand how prepared UK medical graduates are for practice and the effectiveness of workplace transition interventions. DESIGN: A rapid review of the literature (registration #CRD42013005305). DATA SOURCES: Nine major databases (and key websites) were searched in two timeframes (July-September 2013; updated May-June 2014): CINAHL, Embase, Educational Resources Information Centre, Health Management Information Consortium, MEDLINE, MEDLINE in Process, PsycINFO, Scopus and Web of Knowledge...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087553/prevalence-of-obesity-and-overweight-in-african-learners-a-protocol-for-systematic-review-and-meta-analysis
#4
Theodosia Adom, Thandi Puoane, Anniza De Villiers, André Pascal Kengne
INTRODUCTION: Obesity and overweight are an emerging problem in Africa. Obese children are at increased risk of developing hypertension, high cholesterol, orthopaedic problems and type 2 diabetes as well as increased risk of adult obesity. Prevention of childhood overweight and obesity therefore needs high priority. The review approach is particularly useful in establishing whether research findings are consistent and can be generalised across populations and settings. This systematic review aims to assess the magnitude and distribution of overweight and obesity among primary school learners within populations in Africa...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087552/screening-for-atrial-fibrillation-using-economical-and-accurate-technology-safety-a-pilot-study
#5
Mark Lown, Arthur Yue, George Lewith, Paul Little, Mike Moore
INTRODUCTION: Atrial fibrillation (AF) is a cause of stroke and a marker of atherosclerosis and of all patients with stroke, around 17% have AF. The screening and treatment of AF could prevent about 12% of all strokes. Several relatively low-cost devices with good accuracy now exist which can detect AF including WatchBP and AliveCor. However, they can only measure the ECG or pulse over short time periods. Inexpensive devices such as heart rate monitors, which are widely available, can measure heart rate for prolonged periods and may have potential in screening for AF...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087551/cost-effectiveness-of-superficial-femoral-artery-endovascular-interventions-in-the-uk-and-germany-a-modelling-study
#6
Benjamin C Kearns, Steven M Thomas
OBJECTIVES: To assess the lifetime costs and cost-effectiveness of 5 endovascular interventions to treat superficial femoral arterial disease. DESIGN: A model-based health economic evaluation. An existing decision analytical model was used, with updated effectiveness data taken from the literature, and updated costs based on purchasing prices. SETTING: UK and German healthcare perspectives were considered. PARTICIPANTS: Patients with intermittent claudication of the femoropopliteal arteries eligible for endovascular treatment...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087550/trends-and-changes-in-paediatric-tonsil-surgery-in-sweden-1987-2013-a-population-based-cohort-study
#7
Anna Borgström, Pia Nerfeldt, Danielle Friberg, Ola Sunnergren, Joacim Stalfors
OBJECTIVES: The objective of this study was to longitudinally describe the history of tonsil surgery in Swedish children and adolescents regarding incidence, indications for surgery, surgical methods and the age and gender distributions. SETTING: A retrospective longitudinal population-based cohort study based on register data from the Swedish National Patient Register (NPR) and population data from Statistics Sweden. PARTICIPANTS: All Swedish children 1-<18 years registered in the NPR with a tonsil surgery procedure 1987-2013...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087549/engaging-stakeholders-and-target-groups-in-prioritising-a-public-health-intervention-the-creating-active-school-environments-case-online-delphi-study
#8
Katie L Morton, Andrew J Atkin, Kirsten Corder, Marc Suhrcke, David Turner, Esther M F van Sluijs
OBJECTIVES: Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to facilitate stakeholder engagement-especially during the intervention prioritisation phase. We present the findings of an online 'Delphi' study that engaged stakeholders (including young people) in the process of prioritising secondary school environment-focused interventions that aim to increase physical activity...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087548/early-lens-extraction-with-intraocular-lens-implantation-for-the-treatment-of-primary-angle-closure-glaucoma-an-economic-evaluation-based-on-data-from-the-eagle-trial
#9
Mehdi Javanbakht, Augusto Azuara-Blanco, Jennifer M Burr, Craig Ramsay, David Cooper, Claire Cochran, John Norrie, Graham Scotland
OBJECTIVE: To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. DESIGN: Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087547/risk-of-pneumonia-in-patients-with-isolated-minor-rib-fractures-a-nationwide-cohort-study
#10
Sai-Wai Ho, Ying-Hock Teng, Shun-Fa Yang, Han-Wei Yeh, Yu-Hsun Wang, Ming-Chih Chou, Chao-Bin Yeh
OBJECTIVES: Isolated minor rib fractures (IMRFs) after blunt chest traumas are commonly observed in emergency departments. However, the relationship between IMRFs and subsequent pneumonia remains controversial. This nationwide cohort study investigated the association between IMRFs and the risk of pneumonia in patients with blunt chest traumas. DESIGN: Nationwide population-based cohort study. SETTING: Patients with IMRFs were identified between 2010 and 2011 from the Taiwan National Health Insurance Research Database...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087546/association-between-insomnia-symptoms-job-strain-and-burnout-syndrome-a-cross-sectional-survey-of-1300-financial-workers
#11
Arnaud Metlaine, Fabien Sauvet, Danielle Gomez-Merino, Maxime Elbaz, Jean Yves Delafosse, Damien Leger, Mounir Chennaoui
OBJECTIVES: Professional burnout is closely related to work stress but less frequently associated with disturbed sleep. This study determines whether job strain and sleep disturbances are associated risk factors of burnout among financial workers. DESIGN: Observational study. PARTICIPANTS: 1300 employees (725 female) of a financial company. PRIMARY MEASURES: Self-reported questionnaires (Maslach Burnout Inventory, Job Content Questionnaire, Sleep questionnaire based on ICSD-3 classification), the Epworth sleepiness scale and the Hospital Anxiety and Depression Scale (HADS)...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087545/predictors-of-public-support-for-nutrition-focused-policy-systems-and-environmental-change-strategies-in-los-angeles-county-2013
#12
Brenda Robles, Tony Kuo
BACKGROUND: Since 2010, federal and local agencies have invested broadly in a variety of nutrition-focused policy, systems and environmental change (PSE) initiatives in Los Angeles County (LAC). To date, little is known about whether the public supports such efforts. We address this gap in the literature by examining predictors of support for a variety of PSEs. METHODS: Voters residing in LAC (n=1007) were randomly selected to participate in a cross-sectional telephone survey commissioned by the LAC Department of Public Health...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087544/children-s-experiences-of-chronic-fatigue-syndrome-myalgic-encephalomyelitis-cfs-me-a-systematic-review-and-meta-ethnography-of-qualitative-studies
#13
Roxanne M Parslow, Sarah Harris, Jessica Broughton, Adla Alattas, Esther Crawley, Kirstie Haywood, Alison Shaw
OBJECTIVE: To synthesis the qualitative studies of children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). DESIGN: Systematic review and meta-ethnography. BACKGROUND: CFS/ME is an important disabling illness, with uncertain cause and prognosis. As a result, children with CFS/ME can find themselves living with greater uncertainty and stigma, exacerbating the impact of the condition. There is a growing body of qualitative research in CFS/ME, yet there has been no attempt to systematically synthesis the studies involving children...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087543/leisure-time-sport-and-overuse-injuries-of-extremities-in-children-age-6-13-a-2-5%C3%A2-years-prospective-cohort-study-the-champs-study-dk
#14
Charlène Chéron, Charlotte Leboeuf-Yde, Christine Le Scanff, Eva Jespersen, Christina Trifonov Rexen, Claudia Franz, Niels Wedderkopp
OBJECTIVES: It is not known which sports are most likely to cause overuse injuries of the extremities in children. In this study, we report on the incidence of overuse injuries of the upper and lower extremities in children who participate in various leisure-time sports and relate this to the frequency of sport sessions. DESIGN: Natural experiment including a prospective cohort study. SETTING: 10 state schools in 1 Danish municipality: Svendborg...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28082368/efficacy-of-combined-conservative-therapies-on-clinical-outcomes-in-patients-with-thumb-base-osteoarthritis-protocol-for-a-randomised-controlled-trial-combo
#15
Leticia A Deveza, David J Hunter, Anne Wajon, Kim L Bennell, Bill Vicenzino, Paul Hodges, Jillian P Eyles, Ray Jongs, Edward A Riordan, Vicky Duong, Win Min Oo, Rachel O'Connell, Sarah R F Meneses
INTRODUCTION: Management of thumb base osteoarthritis (OA) using a combination of therapies is common in clinical practice; however, evidence for the efficacy of this approach is lacking. The aim of this study is to determine the effect of a combination of conservative therapies for the treatment of thumb base OA compared with an education control group. METHODS AND ANALYSIS: This is a randomised, controlled, single-centre, two-arm superiority trial with 1:1 allocation ratio; with assessor and statistician blinded...
January 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28082367/antidepressant-use-during-pregnancy-and-the-risk-of-major-congenital-malformations-in-a-cohort-of-depressed-pregnant-women-an-updated-analysis-of-the-quebec-pregnancy-cohort
#16
Anick Bérard, Jin-Ping Zhao, Odile Sheehy
OBJECTIVE: Antidepressant use during gestation has been associated with risk of major congenital malformations but estimates can lack statistical power or be confounded by maternal depression. We aimed to determine the association between first-trimester exposure to antidepressants and the risk of major congenital malformations in a cohort of depressed/anxious women. SETTING AND PARTICIPANTS: Data were obtained from the Quebec Pregnancy Cohort (QPC). All pregnancies with a diagnosis of depression or anxiety, or exposed to antidepressants in the 12 months before pregnancy, and ending with a live-born singleton were included...
January 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28082366/psychosocial-well-being-and-health-related-quality-of-life-in-a-uk-population-with-usher-syndrome
#17
Gavin Dean, Amy Orford, Roy Staines, Anna McGee, Kimberley J Smith
OBJECTIVES: To determine whether psychosocial well-being is associated with the health-related quality of life (HRQOL) of people with Usher syndrome. SETTING: The survey was advertised online and through deafblind-related charities, support groups and social groups throughout the UK. PARTICIPANTS: 90 people with Usher syndrome took part in the survey. Inclusion criteria are having a diagnosis of Usher syndrome, being 18 or older and being a UK resident...
January 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28082365/effectiveness-of-diagnostic-screening-tests-in-mass-screening-for-copd-using-a-cooperative-regional-system-in-a-region-with-heavy-air-pollution-a-cross-sectional-study
#18
Kenji Kotaki, Hisao Ikeda, Takeshi Fukuda, Fumiko Yuki, Kanehiro Hasuo, Yuhei Kawano, Masayuki Kawasaki
OBJECTIVES: This study aimed to evaluate the effectiveness of a cooperative healthcare model for early detection and diagnosis of chronic obstructive pulmonary disease (COPD). METHODS: This was a cross-sectional observational study. We performed diagnosis of COPD at 4 public health centres in Ōmuta, Japan from March 2015 to March 2016, by adding screening for COPD at the time of routine medical evaluations. All patients aged over 40 years were eligible to participate...
January 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28082364/rethinking-clinical-governance-healthcare-professionals-views-a-delphi-study
#19
Gepke L Veenstra, Kees Ahaus, Gera A Welker, Erik Heineman, Maarten J van der Laan, Friso L H Muntinghe
OBJECTIVE: Although the guiding principle of clinical governance states that healthcare professionals are the leading contributors to quality and safety in healthcare, little is known about what healthcare professionals perceive as important for clinical governance. The aim of this study is to clarify this by exploring healthcare professionals' views on clinical governance. DESIGN: Based on a literature search, a list of 99 elements related to clinical governance was constructed...
January 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28082363/direct-to-consumer-advertising-of-success-rates-for-medically-assisted-reproduction-a-review-of-national-clinic-websites
#20
Jack Wilkinson, Andy Vail, Stephen A Roberts
OBJECTIVES: To establish how medically assisted reproduction (MAR) clinics report success rates on their websites. SETTING: Websites of private and NHS clinics offering in vitro fertilisation (IVF) in the UK. PARTICIPANTS: We identified clinics offering IVF using the Choose a Fertility Clinic facility on the website of the Human Fertilisation and Embryology Authority (HFEA). Of 81 clinics identified, a website could not be found for 2, leaving 79 for inclusion in the analysis...
January 12, 2017: BMJ Open
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