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https://www.readbyqxmd.com/read/28442620/the-implementation-of-cardiac-arrest-treatment-recommendations-in-english-acute-nhs-trusts-a-national-survey
#1
James Carberry, Keith Couper, Joyce Yeung
PURPOSE OF THE STUDY: There are approximately 35 000 in-hospital cardiac arrests in the UK each year. Successful resuscitation requires integration of the medical science, training and education of clinicians and implementation of best practice in the clinical setting. In 2015, the International Liaison Committee on Resuscitation (ILCOR) published its latest resuscitation treatment recommendations. It is currently unknown the extent to which these treatment recommendations have been successfully implemented in practice in English NHS acute hospital trusts...
April 25, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28436977/provision-of-long-term-monitoring-and-late-effects-services-following-adult-allogeneic-haematopoietic-stem-cell-transplant-a-survey-of-uk-nhs-based-programmes
#2
A Hamblin, D M Greenfield, M Gilleece, N Salooja, M Kenyon, E Morris, N Glover, P Miller, H Braund, A Peniket, B E Shaw, J A Snowden
Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years...
April 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28434871/a-brief-psychological-intervention-to-reduce-repetition-of-self-harm-in-patients-admitted-to-hospital-following-a-suicide-attempt-a-randomised-controlled-trial
#3
Rory C O'Connor, Eamonn Ferguson, Fiona Scott, Roger Smyth, David McDaid, A-La Park, Annette Beautrais, Christopher J Armitage
BACKGROUND: We investigated whether a volitional helpsheet (VHS), a brief psychological intervention, could reduce repeat self-harm in the 6 months following a suicide attempt. METHODS: We did a prospective, single-site, randomised controlled trial. Patients admitted to a hospital in Edinburgh, UK, after a suicide attempt were deemed eligible for the study if they were over the age of 16 years, had a self-reported history of self-harm, were fluent in English, were medically fit to interview, and were not participating in other research studies within the hospital...
April 20, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28434634/hypospadias-surgery-in-england-higher-volume-centres-have-lower-complication-rates
#4
David J Wilkinson, Patrick A Green, Shanthi Beglinger, Jessica Myers, Rachel Hudson, David Edgar, Simon E Kenny
INTRODUCTION: Hypospadias surgery has progressed steadily over recent years. There remains considerable variation in the operative management of boys with hypospadias in the UK, and it is therefore difficult to identify acceptable standards with regards to reoperation rates. OBJECTIVE: To determine the frequency of reoperations and complications from all centres performing hypospadias surgery in England and to identify variables that influence outcome. METHODS: All children undergoing NHS hypospadias surgery in England between 1999 and 2009 were identified using the Hospital Episode Statistics database...
February 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28427368/complications-of-miliary-tuberculosis-low-mortality-and-predictive-biomarkers-from-a-uk-cohort
#5
Jonathan Underwood, Fiona Cresswell, Alex P Salam, Alex J Keeley, Charles Cleland, Laurence John, Robert N Davidson
BACKGROUND: Untreated, miliary tuberculosis (TB) has a mortality approaching 100%. As it is uncommon there is little specific data to guide its management. We report detailed data from a UK cohort of patients with miliary tuberculosis and the associations and predictive ability of admission blood tests with clinical outcomes. METHODS: Routinely collected demographic, clinical, blood, imaging, histopathological and microbiological data were assessed for all patients with miliary TB identified from the London TB register from 2008 to 2012 from Northwest London Hospitals NHS Trust...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28424088/research-exploring-physical-activity-in-care-homes-reach-study-protocol-for-a-randomised-controlled-trial
#6
Anne Forster, Jennifer Airlie, Karen Birch, Robert Cicero, Bonnie Cundill, Alison Ellwood, Mary Godfrey, Liz Graham, John Green, Claire Hulme, Rebecca Lawton, Vicki McLellan, Nicola McMaster, Amanda Farrin
BACKGROUND: As life expectancy increases and the number of older people, particularly those aged 85 years and over, expands there is an increase in demand for long-term care. A large proportion of people in a care home setting spend most of their time sedentary, and this is one of the leading preventable causes of death. Encouraging residents to engage in more physical activity could deliver benefits in terms of physical and psychological health, and quality of life. This study is the final stage of a programme of research to develop and preliminarily test an evidence-based intervention designed to enhance opportunities for movement amongst care home residents, thereby increasing levels of physical activity...
April 19, 2017: Trials
https://www.readbyqxmd.com/read/28424061/young-people-mental-health-practitioners-and-researchers-co-produce-a-transition-preparation-programme-to-improve-outcomes-and-experience-for-young-people-leaving-child-and-adolescent-mental-health-services-camhs
#7
Valerie Dunn
BACKGROUND: In the UK young people attending child and adolescent mental health services (CAMHS) are required to move on, either through discharge or referral to an adult service, at age 17/18, a period of increased risk for onset of mental health problems and other complex psychosocial and physical changes. CAMHS transitions are often poorly managed with negative outcomes for young people. Better preparation may improve outcomes and experience. This study aimed to co-produce, with young people who had transitioned or were facing transition from CAMHS, a CAMHS Transition Preparation Programme (TPP), deliverable in routine NHS settings...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28422387/should-we-be-putting-our-scalpel-down-is-hifu-the-answer-to-fertility-sparing-fibroid-treatment
#8
Nicola Tempest, Dharani Hapangama
Despite HIFU being a fertility sparing, outpatient procedure reported to be safe and effective in treating patients with fibroids for 15 years (Wang et al. Zhonghua Chao Sheng Ying Xiang Xue Za Zhi 2002; 11:161-63); approved by the FDA in America in 2004; and seen to have similar cost-effectiveness as all other uterine preserving treatments; it is currently only available in two private treatment centers and on a case by case basis on the NHS in the UK and not consistently covered by any major US insurance company...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28421937/rules-of-attraction
#9
James Buchan
Nottingham University Hospitals NHS Trust is the latest in a small, select band of UK hospitals working to achieve Magnet hospital accreditation. Along with Oxford University Hospitals and the Heart of England NHS Foundation Trust in Birmingham, Nottingham is a key member of the new UK Magnet Alliance, which brings together UK healthcare organisations interested in pursuing Magnet recognition.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28420664/the-uk-cardiac-and-vascular-surgery-interventional-anaemia-response-caviar-study-protocol-for-an-observational-cohort-study-to-determine-the-impact-and-effect-of-preoperative-anaemia-management-in-cardiac-and-vascular-surgical-patients
#10
Marisa Chau, Toby Richards, Caroline Evans, Anna Butcher, Timothy Collier, Andrew Klein
INTRODUCTION: Preoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28409743/pet-neck-a-multicentre-randomised-phase-iii-non-inferiority-trial-comparing-a-positron-emission-tomography-computerised-tomography-guided-watch-and-wait-policy-with-planned-neck-dissection-in-the-management-of-locally-advanced-n2-n3-nodal-metastases-in-patients
#11
Hisham Mehanna, Chris C McConkey, Joy K Rahman, Wai-Lup Wong, Alison F Smith, Chris Nutting, Andrew Gj Hartley, Peter Hall, Claire Hulme, Dharmesh K Patel, Sandra Ventorin von Zeidler, Max Robinson, Bal Sanghera, Lydia Fresco, Janet A Dunn
BACKGROUND: Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28409557/randomised-controlled-trial-of-silk-therapeutic-garments-for-the-management-of-atopic-eczema-in-children-the-clothes-trial
#12
Kim S Thomas, Lucy E Bradshaw, Tracey H Sach, Fiona Cowdell, Jonathan M Batchelor, Sandra Lawton, Eleanor F Harrison, Rachel H Haines, Amina Ahmed, Taraneh Dean, Nigel P Burrows, Ian Pollock, Hannah K Buckley, Hywel C Williams, Joanne Llewellyn, Clare Crang, Jane D Grundy, Juliet Guiness, Andrew Gribbin, Eileen V Wake, Eleanor J Mitchell, Sara J Brown, Alan A Montgomery
BACKGROUND: Atopic eczema (AE) is a chronic, itchy, inflammatory skin condition that affects the quality of life of children and their families. The role of specialist clothing in the management of AE is poorly understood. OBJECTIVES: To assess the effectiveness and cost-effectiveness of silk garments for the management of AE in children with moderate to severe disease. DESIGN: Parallel-group, observer-blind, randomised controlled trial of 6 months' duration, followed by a 2-month observational period...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28406394/a-randomised-controlled-trial-to-compare-the-safety-effectiveness-and-cost-effectiveness-of-doxycycline-200%C3%A2-mg-day-with-that-of-oral-prednisolone-0-5%C3%A2-mg-kg-day-for-initial-treatment-of-bullous-pemphigoid-the-bullous-pemphigoid-steroids-and-tetracyclines-blister
#13
Joanne R Chalmers, Fenella Wojnarowska, Gudula Kirtschig, James Mason, Margaret Childs, Diane Whitham, Karen Harman, Anna Chapman, Shernaz Walton, Enno Schmidt, Thomas R Godec, Andrew J Nunn, Hywel C Williams
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering skin disorder with increased morbidity and mortality in the elderly. OBJECTIVES: To evaluate the effectiveness, safety and cost-effectiveness of a strategy of initiating BP treatment with oral doxycycline or oral prednisolone. We hypothesised that starting treatment with doxycycline gives acceptable short-term blister control while conferring long-term safety advantages over starting treatment with oral prednisolone...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28406053/burden-of-illness-in-systemic-lupus-erythematosus-results-from-a-uk-patient-and-carer-online-survey
#14
T Kent, A Davidson, D Newman, G Buck, D D'Cruz
Objective The objective of this study was to assess the impact of systemic lupus erythematosus (SLE) on patients and carers. Methods Adults with SLE and carers of SLE patients completed a UK-specific online survey covering many aspects of the disease. Surveys were developed in collaboration with an NHS lupus unit and a lupus patient organization. Results A total of 121 patients and 31 carers completed the surveys. Of the 70% of patients initially misdiagnosed with another condition, 59% received treatment for the misdiagnosis...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28400524/women-s-healthcare-consultations-on-operations-a-multidisciplinary-provider-questionnaire
#15
Magdalena Thiel, S Evans, R Sawdy
BACKGROUND: 30% of UK primary care consultations relate to gynaecology. Servicewomen access healthcare in general more frequently than their NHS counterparts, so military medical professionals are thus more likely to be managing significant numbers of gynaecological conditions on deployed military operations. Little is known about their confidence and preparedness in managing female-specific complaints. This study aimed to assess clinicians' views as to their training and confidence in managing gynaecological conditions; to gauge the need for developing treatment guidelines and specific training opportunities and to establish the frequency and scope of female-specific presentations on a military deployment...
April 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28399810/a-programme-to-spread-egfr-graph-surveillance-for-the-early-identification-support-and-treatment-of-people-with-progressive-chronic-kidney-disease-assist-ckd-protocol-for-the-stepped-wedge-implementation-and-evaluation-of-an-intervention-to-reduce-late-presentation
#16
Hugh Gallagher, Shona Methven, Anna Casula, Nicola Thomas, Charles R V Tomson, Fergus J Caskey, Tracey Rose, Stephen J Walters, David Kennedy, Anne Dawnay, Martin Cassidy, Richard Fluck, Hugh C Rayner, Michael Nation
BACKGROUND: Patients who start renal replacement therapy (RRT) for End-Stage Kidney Disease (ESKD) without having had timely access to specialist renal services have poor outcomes. At one NHS Trust in England, a community-wide CKD management system has led to a decline in the incident rate of RRT and the lowest percentage of patients presenting within 90 days of starting RRT in the UK. We describe the protocol for a quality improvement project to scale up and evaluate this innovation...
April 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28396301/timely-digital-patient-clinician-communication-in-specialist-clinical-services-for-young-people-a-mixed-methods-study-the-lync-study
#17
Frances Griffiths, Carol Bryce, Jonathan Cave, Melina Dritsaki, Joseph Fraser, Kathryn Hamilton, Caroline Huxley, Agnieszka Ignatowicz, Sung Wook Kim, Peter K Kimani, Jason Madan, Anne-Marie Slowther, Mark Sujan, Jackie Sturt
BACKGROUND: Young people (aged 16-24 years) with long-term health conditions can disengage from health services, resulting in poor health outcomes, but clinicians in the UK National Health Service (NHS) are using digital communication to try to improve engagement. Evidence of effectiveness of this digital communication is equivocal. There are gaps in evidence as to how it might work, its cost, and ethical and safety issues. OBJECTIVE: Our objective was to understand how the use of digital communication between young people with long-term conditions and their NHS specialist clinicians changes engagement of the young people with their health care; and to identify costs and necessary safeguards...
April 10, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28395058/diagnostic-utility-of-lymphoid-enhancer-binding-factor-1-immunohistochemistry-in-small-b-cell-lymphomas
#18
Thomas Menter, Pritesh Trivedi, Raida Ahmad, Rashpal Flora, Stephan Dirnhofer, Alexandar Tzankov, Kikkeri N Naresh
Objectives: Recent studies have shown that lymphoid enhancer binding factor 1 (LEF1) is a useful marker for chronic lymphocytic B-cell leukemia (CLL)/small lymphocytic lymphoma. Yet, it is not still being widely used in a diagnostic setting. In this study, we document the experience with LEF1 immunohistochemistry during routine diagnostics. Methods: In total, 191 B-cell lymphoma cases from Hammersmith Hospital, Imperial College NHS Healthcare Trust (London, UK) were investigated by immunohistochemistry for LEF1 during routine diagnostic workup...
March 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28394249/cognitive-behavioural-therapy-and-short-term-psychoanalytic-psychotherapy-versus-brief-psychosocial-intervention-in-adolescents-with-unipolar-major-depression-impact-a-multicentre-pragmatic-observer-blind-randomised-controlled-trial
#19
Ian M Goodyer, Shirley Reynolds, Barbara Barrett, Sarah Byford, Bernadka Dubicka, Jonathan Hill, Fiona Holland, Raphael Kelvin, Nick Midgley, Chris Roberts, Rob Senior, Mary Target, Barry Widmer, Paul Wilkinson, Peter Fonagy
BACKGROUND: Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. OBJECTIVE: To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28392826/nepa-a-new-fixed-combination-of-netupitant-and-palonosetron-is-a-cost-effective-intervention-for-the-prevention-of-chemotherapy-induced-nausea-and-vomiting-in-the-uk
#20
REVIEW
Helene Cawston, Francois Bourhis, Jennifer Eriksson, Pierfrancesco Ruffo, Paolo D'Agostino, Marco Turini, Lee Schwartzberg, Alistair McGuire
BACKGROUND: The objective was to evaluate the cost-effectiveness of NEPA, an oral fixed combination netupitant (NETU, 300 mg) and palonosetron (PA, 0.5 mg) compared with aprepitant and palonosetron (APPA) or palonosetron (PA) alone, to prevent chemotherapy-induced nausea and vomiting (CINV) in patients undergoing treatment with highly or moderately emetogenic chemotherapy (HEC or MEC) in the UK. SCOPE: A systematic literature review and meta-analysis were undertaken to compare NEPA with currently recommended anti-emetics...
2017: Drugs in Context
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