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Mashup Score: 0Body mass index and all-cause mortality in HUNT and UK biobank studies: revised non-linear Mendelian randomisation analyses - 13 hour(s) ago
Objectives To estimate the shape of the causal relationship between body mass index (BMI) and mortality risk in a Mendelian randomisation framework. Design Mendelian randomisation analyses of two prospective population-based cohorts. Setting Individuals of European ancestries living in Norway or the UK. Participants 56 150 participants from the Trøndelag Health Study (HUNT) in Norway and 366 385 participants from UK Biobank recruited by postal invitation. Outcomes All-cause mortality and cause-specific mortality (cardiovascular, cancer, non-cardiovascular non-cancer). Results A previously published non-linear Mendelian randomisation analysis of these data using the residual stratification method suggested a J-shaped association between genetically predicted BMI and mortality outcomes with the lowest mortality risk at a BMI of around 25 kg/m2. However, the ‘constant genetic effect’ assumption required by this method is violated. The reanalysis of these data using the more reliable doubl
Source: bmjopen.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 3Identification of acute respiratory distress syndrome subphenotypes de novo using routine clinical data: a retrospective analysis of ARDS clinical trials - 17 hour(s) ago
Objectives The acute respiratory distress syndrome (ARDS) is a heterogeneous condition, and identification of subphenotypes may help in better risk stratification. Our study objective is to identify ARDS subphenotypes using new simpler methodology and readily available clinical variables. Setting This is a retrospective Cohort Study of ARDS trials. Data from the US ARDSNet trials and from the international ART trial. Participants 3763 patients from ARDSNet data sets and 1010 patients from the ART data set. Primary and secondary outcome measures The primary outcome was 60-day or 28-day mortality, depending on what was reported in the original trial. K-means cluster analysis was performed to identify subgroups. Sets of candidate variables were tested to assess their ability to produce different probabilities for mortality in each cluster. Clusters were compared with biomarker data, allowing identification of subphenotypes. Results Data from 4773 patients were analysed. Two subphenotypes
Source: bmjopen.bmj.comCategories: General Medicine News, Critical CareTweet
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Mashup Score: 3How prepared are newly qualified allied health professionals for practice in the UK? A systematic review - 17 hour(s) ago
Objectives It is important that allied health professionals (AHPs) are prepared for clinical practice from the very start of their working lives to provide quality care for patients, for their personal well-being and for retention of the workforce. The aim of this study was to understand how well newly qualified AHPs were prepared for practice in the UK. Design Systematic review. Data sources Embase, MEDLINE, CINAHL, ERIC and BEI were searched from 2012 to 2024. Grey literature searching and citation chasing were also conducted. Eligibility criteria We included primary studies reporting the preparedness for practice of UK graduates across 15 professions; all study types; participants included graduates who were up to 2 years postgraduation, their supervisors, trainers, practice educators and employers; and all outcome measures. Data extraction and synthesis A standardised data extraction form was used. Studies were quality assessed using the Quality Appraisal for Diverse Studies tool.
Source: bmjopen.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 18Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance - 20 hour(s) ago
Objective The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals. Design/setting An international research priority-setting partnership. Participants People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb. Methods A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021–October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second internati
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Mashup Score: 15Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance - 4 day(s) ago
Objective The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals. Design/setting An international research priority-setting partnership. Participants People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb. Methods A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021–October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second internati
Source: bmjopen.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 0
Objectives Long-term benzodiazepine use is common despite known risks. In the original Eliminating Medications Through Patient Ownership of End Results (EMPOWER) Study set in Canada, patient education led to increased rates of benzodiazepine cessation. We aimed to determine the effectiveness of implementing an adapted EMPOWER quality improvement (QI) initiative in a US-based healthcare system. Design We used a pre–post design with a non-randomised control group. Setting A network of primary care clinics. Participants Patients with ≥60 days’ supply of benzodiazepines in 6 months and ≥1 risk factor (≥65 years of age, a concurrent high-risk medication prescribed or a diazepam equivalent daily dose ≥10) were eligible. Intervention In March 2022, we engaged 22 primary care physicians (PCPs), and 308 of their patients were mailed an educational brochure, physician letter and flyer detailing benzodiazepine risks; the control group included 4 PCPs and 291 of their patients. Primary and seconda
Source: bmjopen.bmj.comCategories: General Medicine News, Hem/OncsTweet
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Mashup Score: 1Paediatric off-label use of drugs in Gansu, China: a multicentre cross-sectional study - 4 day(s) ago
Objective To examine the current prevalence and cost of paediatric off-label drug prescriptions in Gansu, China, and the potential influencing factors. Design The prevalence of off-label prescriptions in paediatrics was evaluated according to the National Medical Products Administration drug instructions in the China Pharmaceutical Reference (China Pharmaceutical Reference, MCDEX) database. The evidence of the prescription was determined by existing clinical practice guidelines and the Thomson Grade in the Micromedex 2021 compendium. We used logistic regression to investigate the characteristics that influence paediatric off-label drug use after single-factor regression analysis. Setting A multicentre cross-sectional study of outpatient paediatric prescriptions in 196 secondary and tertiary hospitals in Gansu Province, China, in March and September 2020. Results We retrieved 104 029 paediatric prescriptions, of which 39 480 (38.0%) contained off-label use. The most common diseases trea
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Mashup Score: 0Assessing the impact of obesity interventions in the early years: a systematic review of UK-based studies - 4 day(s) ago
Objectives Childhood obesity rates in the UK are high. The early years of childhood are critical for establishing healthy behaviours and offer interventional opportunities. We aimed to identify studies evaluating the impact of UK-based obesity interventions in early childhood. Design Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources Nine databases were searched in March 2023. Eligibility criteria: We included UK-based obesity intervention studies delivered to children aged 6 months to 5 years that had diet and/or physical activity components and reported anthropometric outcomes. The primary outcome of interest was z-score Body Mass Index (zBMI) change (within and between subjects). Studies evaluating the effects of breastfeeding interventions were not included as obesity prevention interventions, given that best-practice formula feeding is also likely to encourage healthy growth. The publication date for studies was
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Mashup Score: 27What is current care for people with Long COVID in England? A qualitative interview study - 4 day(s) ago
Objective To investigate current care for people with Long COVID in England. Design In-depth, semistructured interviews with people living with Long COVID and Long COVID healthcare professionals; data analysed using thematic analysis. Setting National Health Service England post-COVID-19 services in six clinics from November 2022 to July 2023. Participants 15 healthcare professionals and 21 people living with Long COVID currently attending or discharged (18 female; 3 male). Results Health professionals and people with lived experience highlighted the multifaceted nature of Long COVID, including its varied symptoms, its impact on people’s lives and the complexity involved in managing this condition. These impacts encompass physical, social, mental and environmental dimensions. People with Long COVID reported barriers in accessing primary care, as well as negative general practitioner consultations where they felt unheard or invalidated, though some positive interactions were also noted.
Source: bmjopen.bmj.comCategories: General Medicine News, CardiologistsTweet
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Mashup Score: 2Understanding the impact of a residential housing program for people living with HIV/AIDS: results from a realist evaluation - 5 day(s) ago
Background In Canada, the Public Health Agency surveillance of new HIV cases has demonstrated annual increasing rates since 2020. The rates of new HIV cases are highest in the province of Saskatchewan. Objectives The aim of the project was to conduct a resident-oriented realist evaluation of an innovative supportive housing programme, Sanctum, for people living with HIV/AIDS who also face social care issues, such as homelessness. This project took place in Saskatchewan, a province that is seeking innovative approaches to improve quality of life and HIV/AIDS management for its citizens. Our evaluation addressed how and why participants were successful (or not) within the Sanctum programme. Design and setting Sanctum is a housing programme located in an inner-city location within the province of Saskatchewan. A unique component of this evaluation was the inclusion of an individual with lived experience, a resident partner, as a member of the research team. Participants 11 recent Sanctum
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Body mass index and all-cause mortality in HUNT and UK biobank studies: revised non-linear Mendelian randomisation analyses. https://t.co/admoUS7dZE