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https://www.readbyqxmd.com/read/30341135/improve-hip-fracture-outcome-in-the-elderly-patient-ihope-a-study-protocol-for-a-pragmatic-multicentre-randomised-controlled-trial-to-test-the-efficacy-of-spinal-versus-general-anaesthesia
#1
Ana Kowark, Christian Adam, Jörg Ahrens, Malek Bajbouj, Cornelius Bollheimer, Matthias Borowski, Richard Dodel, Michael Dolch, Thomas Hachenberg, Dietrich Henzler, Frank Hildebrand, Ralf-Dieter Hilgers, Andreas Hoeft, Susanne Isfort, Peter Kienbaum, Mathias Knobe, Pascal Knuefermann, Peter Kranke, Rita Laufenberg-Feldmann, Carla Nau, Mark D Neuman, Cynthia Olotu, Christopher Rex, Rolf Rossaint, Robert D Sanders, Rene Schmidt, Frank Schneider, Hartmut Siebert, Max Skorning, Claudia Spies, Oliver Vicent, Frank Wappler, Dieter Christian Wirtz, Maria Wittmann, Kai Zacharowski, Alexander Zarbock, Mark Coburn
INTRODUCTION: Hip fracture surgery is associated with high in-hospital and 30-day mortality rates and serious adverse patient outcomes. Evidence from randomised controlled trials regarding effectiveness of spinal versus general anaesthesia on patient-centred outcomes after hip fracture surgery is sparse. METHODS AND ANALYSIS: The iHOPE study is a pragmatic national, multicentre, randomised controlled, open-label clinical trial with a two-arm parallel group design...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30341124/better-outcomes-for-older-people-with-spinal-trouble-boost-trial-a-randomised-controlled-trial-of-a-combined-physical-and-psychological-intervention-for-older-adults-with-neurogenic-claudication-a-protocol
#2
Esther Williamson, Lesley Ward, Karan Vadher, Susan J Dutton, Ben Parker, Stavros Petrou, Charles E Hutchinson, Richard Gagen, Nigel K Arden, Karen Barker, Graham Boniface, Julie Bruce, Gary Collins, Jeremy Fairbank, Judith Fitch, David P French, Angela Garrett, Varsha Gandhi, Frances Griffiths, Zara Hansen, Christian Mallen, Alana Morris, Sarah E Lamb
INTRODUCTION: Neurogenic claudication due to spinal stenosis is common in older adults. The effectiveness of conservative interventions is not known. The aim of the study is to estimate the clinical and cost-effectiveness of a physiotherapist-delivered, combined physical and psychological intervention. METHODS AND ANALYSIS: This is a pragmatic, multicentred, randomised controlled trial. Participants are randomised to a combined physical and psychological intervention (Better Outcomes for Older people with Spinal Trouble (BOOST) programme) or best practice advice (control)...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30341121/comparative-efficacy-and-safety-of-oral-or-transdermal-opioids-in-the-treatment-of-knee-or-hip-osteoarthritis-a-systematic-review-and-bayesian-network-meta-analysis-protocol
#3
Jun Wang, Yin Wang, Hui Zhang, Ming Lu, Weilu Gao, Li Yin, Zongsheng Yin
INTRODUCTION: Osteoarthritis is a common degenerative joint disease that eventually leads to disability and poor quality of life. The main symptoms are joint pain and mobility disorders. If the patient has severe pain or other analgesics are contraindicated, opioids may be a viable treatment option. To evaluate and compare the efficacy and safety of opioids in the treatment of knee or hip osteoarthritis, we will integrate direct and indirect evidence using a Bayesian network meta-analysis to establish hierarchies of these drugs...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30341117/protocol-for-faecal-microbiota-transplantation-in-ulcerative-colitis-fmtuc-a-randomised-feasibility-study
#4
Maki Jitsumura, Andrew Laurence Cunningham, Matthew David Hitchings, Saiful Islam, Angharad P Davies, Paula E Row, Andrew D Riddell, James Kinross, Tom S Wilkinson, G J Jenkins, John G Williams, Dean Anthony Harris
BACKGROUND: The interaction of the gut microbiota with the human host is implicated in the pathogenesis of inflammatory and immunological diseases including ulcerative colitis (UC). Faecal microbiota transplantation (FMT) as a method of restoring gut microbial diversity is of increasing interest as a therapeutic approach in the management of UC. The current literature lacks consensus about the dose of FMT, route of administration and duration of response. METHODS AND ANALYSIS: This single-blinded randomised trial will explore the feasibility of FMT in 30 treatment-naïve patients with histologically confirmed distal UC limited to the recto-sigmoid region (up to 40 cm from the anal verge)...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30341114/brief-intervention-on-smoking-nutrition-alcohol-and-physical-snap-inactivity-for-smoking-relapse-prevention-after-release-from-smoke-free-prisons-a-study-protocol-for-a-multicentre-investigator-blinded-randomised-controlled-trial
#5
Xingzhong Jin, Stuart A Kinner, Robyn Hopkins, Emily Stockings, Ryan J Courtney, Anthony Shakeshaft, Dennis Petrie, Timothy Dobbins, Kate Dolan
INTRODUCTION: Smoking remains the leading risk factor for disease burden and mortality worldwide. Heavy Smoking is often associated with poor Nutrition, Alcohol abuse and Physical inactivity (known as 'SNAP'). Australia's first prison smoking ban was introduced in the Northern Territory in July 2013. However, relapse to smoking after release from prison is normative. Holistic and cost-effective interventions are needed to maintain post-release abstinence to realise the potential public health impact of smoke-free prison policies...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30340779/-children-with-high-potential-and-difficulties-contributions-of-clinical-research
#6
S Tordjman, L Vaivre-Douret, S Chokron, S Kermarrec
We have been sensitized to children with high intellectual potential (HIP) having difficulties given the number of children consulting in our outpatient medico-psychological centres for scholastic problems (possibly leading to school failure), anxiety disorders or behavioral disorders such as attention deficit/hyperactivity disorder (ADHD), and in which a high intellectual potential was discovered during psychological assessments. It is the contrast, and more precisely the paradox, between the high intellectual potential of these children and their scholastic difficulties (including school failure), and the psychic suffering expressed by some of them, which led us to question, challenge and propose therapeutic and educational care adapted to these children...
October 16, 2018: L'Encéphale
https://www.readbyqxmd.com/read/30340624/considerations-for-adaptive-design-in-pediatric-clinical-trials-study-protocol-for-a-systematic-review-mixed-methods-study-and-integrated-knowledge-translation-plan
#7
Lauren E Kelly, Michele P Dyson, Nancy J Butcher, Robert Balshaw, Alex John London, Christine J Neilson, Anne Junker, Salaheddin M Mahmud, S Michelle Driedger, Xikui Wang
BACKGROUND: Although children have historically been excluded from clinical trials (CTs), many require medicines tested and approved in CTs, forcing health care providers to treat their pediatric patients based on extrapolated data. Unfortunately, traditional randomized CTs can be slow and resource-intensive, and they often require multi-center collaboration. However, an adaptive design (AD) framework for CTs could be used to increase the efficiency of pediatric CTs by incorporating prospectively planned modifications to CT methods without undermining the integrity or validity of the study...
October 19, 2018: Trials
https://www.readbyqxmd.com/read/30339094/local-preparedness-for-infectious-disease-outbreaks-a-qualitative-exploration-of-willingness-and-ability-to-respond
#8
Holly A Taylor, Lainie Rutkow, Daniel J Barnett
As ecologic, social, and economic conditions continue to facilitate the emergence and transmission of infectious diseases, local health department workers' willingness to respond will remain vital to the United States' ability to recognize and respond to new and emerging disease threats. As demonstrated by heavy occupational morbidity and mortality associated with the 2014 Ebola outbreak, infectious disease response can pose serious risks to the health workforce and presents many ethical and logistical challenges...
September 2018: Health Security
https://www.readbyqxmd.com/read/30339069/shrinking-poor-white-life-spans-class-race-and-health-justice
#9
Erika Blacksher
An absolute decline in US life expectancy in low education whites has alarmed policy makers and attracted media attention. Depending on which studies are correct, low education white women have lost between 3 and 5 years of lifespan; men, between 6 months and 3 years. Although absolute declines in life expectancy are relatively rare, some commentators see the public alarm as reflecting a racist concern for white lives over black ones. How ought we ethically to evaluate this lifespan contraction in low education whites? Should we care, or is it racist to care? Does it constitute an injustice or reflect justice being done? I argue that the lifespan contraction in low education whites violates key normative criteria used to make determinations of health justice, and that these judgments do not vitiate concerns about racism...
October 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/30338129/coproduction-for-feasibility-and-pilot-randomised-controlled-trials-learning-outcomes-for-community-partners-service-users-and-the-research-team
#10
Tracey McConnell, Paul Best, Gavin Davidson, Tom McEneaney, Cherry Cantrell, Mark Tully
Plain English summary: Co-producing research with members of the public is increasingly recognised as a valuable process. Yet, despite these good intentions, the literature on coproduction has struggled to keep pace with the coproduction 'movement'. There is a lack of clarity regarding acceptable levels of involvement and attempts at standardising approaches appear generic and lack detail. Moreover, relatively little research has captured the views of all the parties involved (academics, service providers and service users)...
2018: Research Involvement and Engagement
https://www.readbyqxmd.com/read/30337317/public-medical-professionals-and-patients-preferences-for-the-allocation-of-donor-organs-for-transplantation-study-protocol-for-discrete-choice-experiments
#11
Carina Oedingen, Tim Bartling, Christian Krauth
INTRODUCTION: Organ transplantation is the treatment of choice for patients with severe organ failure. Nevertheless, donor organs are a scarce resource resulting in a large mismatch between supply and demand. Therefore, priority-setting leads to the dilemma of how these scarce organs should be allocated and who should be considered eligible to receive a suitable organ. In order to improve the supply-demand mismatch in transplantation medicine, this study explores preferences of different stakeholders (general public, medical professionals and patients) for the allocation of donor organs for transplantation in Germany...
October 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/30337315/protocol-for-a-gender-sensitised-weight-loss-and-healthy-living-programme-for-overweight-and-obese-men-delivered-in-australian-football-league-settings-aussie-fit-a-feasibility-and-pilot-randomised-controlled-trial
#12
Eleanor Quested, Dominika Kwasnicka, Cecilie Thøgersen-Ntoumani, Daniel F Gucciardi, Deborah A Kerr, Kate Hunt, Suzanne Robinson, Philip J Morgan, Robert U Newton, Cindy Gray, Sally Wyke, Joanne McVeigh, Eva Malacova, Nikos Ntoumanis
INTRODUCTION: Overweight and obesity are highly prevalent among Australian men. Professional sports settings can act as a powerful 'hook' to engage men in weight loss programmes; the Football Fans in Training programme delivered in professional UK soccer clubs was successful and cost-effective in helping men lose weight. The Australian Football League (AFL) is a potentially attractive setting to engage men in a weight loss programme. We aim to develop, pilot and evaluate the feasibility of a weight loss intervention for overweight/obese middle-aged men, delivered in AFL settings, to promote weight loss and healthier lifestyles and determine its suitability for a future randomised control trial...
October 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/30337312/cross-sectional-analysis-of-uk-research-studies-in-2015-results-from-a-scoping-project-with-the-uk-health-research-authority
#13
Tim Clark, Richard H Wicentowski, Matthew R Sydes
OBJECTIVES: To determine whether data on research studies held by the UK Health Research Authority (HRA) could be summarised automatically with minimal manual intervention. There are numerous initiatives to reduce research waste by improving the design, conduct, analysis and reporting of clinical studies. However, quantitative data on the characteristics of clinical studies and the impact of the various initiatives are limited. DESIGN: Feasibility study, using 1 year of data...
October 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/30337310/patient-engagement-treatment-preferences-and-shared-decision-making-in-the-treatment-of-opioid-use-disorder-in-adults-a-scoping-review-protocol
#14
Tyler Marshall, Elizabeth N Kinnard, Myles Hancock, Susanne King-Jones, Karin Olson, Adam Abba-Aji, Katherine Rittenbach, Sunita Vohra
INTRODUCTION: Opioid use disorder (OUD) is characterised by the fifth Edition of the Diagnostic and Statistics Manual as a problematic pattern of opioid use (eg, fentanyl, heroin, oxycodone) that leads to clinically significant impairment. OUD diagnoses have risen substantially over the last decade, and treatment services have struggled to meet the demand. Evidence suggests when patients with chronic illnesses are matched with their treatment preferences and engaged in shared decision-making (SDM), health outcomes may improve...
October 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/30334497/ethics-in-humanitarian-efforts-when-should-resources-be-allocated-to-paediatric-heart-surgery
#15
Kathleen N Fenton, Marcelo Cardarelli, Frank Molloy, William M Novick
BACKGROUND: In countries with ample resources, no debate exists as to whether heart surgery should be provided. However, where funding is limited, what responsibility exists to care for children with congenital heart defects? If children have a "right" to surgical treatment, to whom is the "duty" to provide it assigned? These questions are subjected to ethical analysis. METHODS: Examination is initially based on the four principles of medical ethics: autonomy, beneficence, non-maleficence, and justice...
October 18, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/30328988/planning-and-understanding-the-intensive-care-network-in-the-state-of-rio-de-janeiro-rj-brazil-a-complex-societal-problem
#16
Rosane Sonia Goldwasser, Maria Stella de Castro Lobo, Edilson Fernandes de Arruda, Simone Audrey Angelo, Eliana Claudia de Othero Ribeiro, José Roberto Lapa E Silva
OBJECTIVES: To determine the optimal number of adult intensive care unit beds to reduce patient's queue waiting time and to propose policy strategies. METHODS: Multimethodological approach: (a) quantitative time series and queueing theory were used to predict the demand and estimate intensive care unit beds in different scenarios; (b) qualitative focus group and content analysis were used to explore physicians' attitudes and provide insights into their behaviors and belief-driven healthcare delivery changes...
July 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/30328980/family-burden-social-support-and-community-health-in-caregivers-of-people-with-serious-mental-disorder
#17
José Javier Navarro Pérez, Ángela Carbonell Marqués
OBJECTIVE: To identify caregivers' level of burden and analyze the factors associated with family care in mental health. METHOD: A cross-sectional descriptive study was conducted between January and July 2016. A sample of caregivers from seven public institutions and an association of relatives and patients was evaluated by identifying their burden and the contributing factors for reduction of these levels through the Zarit Burden Inventory instrument. The study was conducted according to recommendations of the ethics committees of the participating institutions...
October 11, 2018: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/30328554/relational-ethics-for-public-health-interpreting-solidarity-and-care
#18
Bruce Jennings
This article defends 'relational theorizing' in bioethics and public health ethics and describes its importance. It then offers an interpretation of solidarity and care understood as normatively patterned and psychologically and socially structured modes of relationality; in a word, solidarity and care understood as 'practices.' Solidarity is characterized as affirming the moral standing of others and their membership in a community of equal dignity and respect. Care is characterized as paying attention to the moral (and mortal) being of others and their needs, suffering, and vulnerability...
October 17, 2018: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/30327406/protocol-for-a-multicentre-dual-prospective-and-retrospective-cohort-study-investigating-timing-of-ileostomy-closure-after-anterior-resection-for-rectal-cancer-the-closure-of-ileostomy-timing-close-it-study
#19
Peter G Vaughan-Shaw, Katherine Gash, Katie Adams, Abigail E Vallance, Sophie A Pilkington, Jared Torkington, Julie A Cornish
INTRODUCTION: A defunctioning ileostomy is often formed during rectal cancer surgery to reduce the potentially fatal sequelae of anastomotic leak. Once the ileostomy is closed and bowel continuity restored, many patients can suffer poor bowel function, that is, low anterior resection syndrome (LARS). It has been suggested that delay to closure can increase incidence of LARS which is known to significantly reduce quality of life. Despite this, within the UK, time to closure of ileostomy is not subject to national targets within the National Health Service and delay to closure exceeds 18 months in one-third of patients...
October 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/30327400/study-protocol-for-evaluating-the-effectiveness-of-depression-management-on-gylcaemic-control-in-non-communicable-diseases-clinics-in-malawi
#20
Michael Mphatso Udedi, Brian W Pence, Felix Kauye, Adamson S Muula
INTRODUCTION: Depression is associated with negative patient outcomes for chronic diseases and likely affects consistent physical non-communicable diseases (NCDs) care management in relation to clinic attendance and medication adherence. We found no published studies on the integration of depression management in physical NCD clinics in Malawi and assessing its effects on patient and service outcomes. Therefore, the aim of this study is to evaluate the effectiveness of integrating depression screening and management in physical NCD routine care on patient and service outcomes in Malawi...
October 15, 2018: BMJ Open
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