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Mashup Score: 7Nurse and doctor turnover and patient outcomes in NHS acute trusts in England: retrospective longitudinal study - 2 hour(s) ago
Objective To investigate the association between monthly turnover rates of hospital nurses and senior doctors and patient health outcomes (mortality and unplanned hospital readmissions). Design Retrospective longitudinal study. Setting All 148 NHS acute trusts in England (1 April 2010 to 30 March 2019), excluding specialist and community NHS hospital trusts. Participants Yearly records on 236 000 nurses, 41 800 senior doctors (specialist, associate specialist and specialty doctors, and consultants), and 8.1 million patients admitted to hospital. Main outcome measures The panel data regression analysis used nine years of monthly observations from administrative datasets at healthcare worker and patient levels. Associations using linear and unconditional quantile regressions were estimated, including controls for seasonality and NHS hospital trust. Four hospital quality indicators (risk adjusted by patient age, sex, and Charlson index comorbidities) were used and measured at a monthly fr
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Mashup Score: 3Endometriosis and uterine fibroids and risk of premature mortality: prospective cohort study - 2 hour(s) ago
Objective To prospectively assess the effect of endometriosis and uterine fibroids on the long term risk of premature mortality (younger than 70 years). Design Prospective cohort study Setting The Nurses’ Health Study II, United States (1989-2019). Participants 110 091 women aged 25-42 years in 1989 without a history of hysterectomy before endometriosis or fibroids diagnosis, cardiovascular diseases, or cancer. Main outcome measures Hazard ratios (estimated by Cox proportional hazards models) for total and cause specific premature mortality according to laparoscopically confirmed endometriosis or ultrasound or hysterectomy confirmed uterine fibroids reported in biennial questionnaires. Results 4356 premature deaths were recorded during 2 994 354 person years of follow-up (27.2 years per person), including 1459 from cancer, 304 from cardiovascular diseases, and 90 from respiratory diseases. The crude incidence of all cause premature mortality for women with and without laparoscopically
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Mashup Score: 1Road safety in Africa: a preventable public health crisis - 3 hour(s) ago
Health, economic, and social progress will stall without urgent global collaborative action Road traffic injuries are the leading killer of children and adults aged 5-29 years globally.1 Low and middle income countries are disproportionately represented in this statistic; Africa has the highest road crash mortality of all global regions. Increasing urbanisation and motorisation in many African countries are not yet matched by safer road infrastructure, safer vehicles, and public education on safer road use. Road traffic injuries rob these nations of their workforce and their future. The World Health Organization status report on road safety in the African region for 2023 highlights the urgent need for concerted global action.1 Whereas recorded road deaths have decreased by 5% globally in the past decade, in Africa they have increased by 17%. The demographics of deaths also differ. In high income countries road deaths are mostly among vehicle drivers and passengers; in Africa, half of t
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Mashup Score: 3What’s it like to be a patient as a doctor? - 4 hour(s) ago
Being a patient can feel alien to many doctors and can bring unique challenges. Jo Best reports For many doctors who start their medical careers as young, fit, healthy people, it can feel as though there’s an abyss between them and their patients. Doctors are the well; patients are the unwell. For most doctors, however, there will come a moment of crossing the Rubicon, from being a medical professional to being a patient. But the nature of doctors’ work can make them reluctant patients—medical knowledge can predispose doctors to self-treat, for example—while long hours make it hard for them to attend medical appointments, and understaffing of health services can put pressure on doctors not to call in sick.1 “Doctors often delay seeking treatment. They will try to diagnose themselves, and they treat themselves,” says Robert Klitzman, psychiatrist and author of When Doctors Become Patients .2 As doctors progress through their careers there’s a change in their attitude towards seeking hea
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Mashup Score: 5Nurse and doctor turnover and patient outcomes in NHS acute trusts in England: retrospective longitudinal study - 5 hour(s) ago
Objective To investigate the association between monthly turnover rates of hospital nurses and senior doctors and patient health outcomes (mortality and unplanned hospital readmissions). Design Retrospective longitudinal study. Setting All 148 NHS acute trusts in England (1 April 2010 to 30 March 2019), excluding specialist and community NHS hospital trusts. Participants Yearly records on 236 000 nurses, 41 800 senior doctors (specialist, associate specialist and specialty doctors, and consultants), and 8.1 million patients admitted to hospital. Main outcome measures The panel data regression analysis used nine years of monthly observations from administrative datasets at healthcare worker and patient levels. Associations using linear and unconditional quantile regressions were estimated, including controls for seasonality and NHS hospital trust. Four hospital quality indicators (risk adjusted by patient age, sex, and Charlson index comorbidities) were used and measured at a monthly fr
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Mashup Score: 16Nurse and doctor turnover and patient outcomes in NHS acute trusts in England: retrospective longitudinal study - 5 hour(s) ago
Objective To investigate the association between monthly turnover rates of hospital nurses and senior doctors and patient health outcomes (mortality and unplanned hospital readmissions). Design Retrospective longitudinal study. Setting All 148 NHS acute trusts in England (1 April 2010 to 30 March 2019), excluding specialist and community NHS hospital trusts. Participants Yearly records on 236 000 nurses, 41 800 senior doctors (specialist, associate specialist and specialty doctors, and consultants), and 8.1 million patients admitted to hospital. Main outcome measures The panel data regression analysis used nine years of monthly observations from administrative datasets at healthcare worker and patient levels. Associations using linear and unconditional quantile regressions were estimated, including controls for seasonality and NHS hospital trust. Four hospital quality indicators (risk adjusted by patient age, sex, and Charlson index comorbidities) were used and measured at a monthly fr
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Mashup Score: 8Extension of the PRISMA 2020 statement for living systematic reviews (PRISMA-LSR): checklist and explanation - 15 hour(s) ago
Publications of living systematic reviews (LSRs) are increasing rapidly. Guidance facilitating transparent, complete, and accurate reporting of LSRs is needed. This paper reports the development of an extension of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement for LSRs (PRISMA-LSR). The PRISMA-LSR extension includes the PRISMA-LSR checklist, the PRISMA-LSR flow diagram, reporting recommendations for the LSR status, and an explanation and elaboration document. This extension has been developed as an “add-on” to the PRISMA 2020 statement, meaning it should be used in addition to the PRISMA 2020 statement. The PRISMA-LSR extension is expected to benefit authors, editors, peer reviewers, and users of LSRs through transparent, complete, and accurate reporting of LSRs. Living systematic reviews (LSRs) are attracting attention from researchers and medical journals.12 Between 2014 (when the LSR approach first emerged3) and 2019, the rate of publi
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Mashup Score: 7Coroner questions policy of waiving reporting requirements for certain medicines after deaths of three babies - 16 hour(s) ago
A UK coroner has warned of possible future deaths unless providers of unlicensed medicines face stricter requirements to report problems.1 Julian Morris, senior coroner for London inner south, delivered the warning after an inquest into the deaths of three babies who died in hospital after consuming contaminated feed. Each baby was one of a set of twins. In each case the babies were receiving total parenteral nutrition (TPN), and Bacillus cereus was recorded as one of the causes of death. Aviva Otte died aged 2 months in January 2014. She had received TPN compounded by the St Thomas’ Hospital pharmacy under an exemption from licensing requirements in section 10 of the Medicines Act 1968. Under the exemption a pharmacist may prepare a limited quantity …
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Mashup Score: 14Fragile promise of psychedelics in psychiatry - 17 hour(s) ago
Cédric Lemarchand and colleagues highlight weaknesses in the evidence on efficacy and safety of hallucinogens and question the use of expedited regulatory pathways The US clinical market for ketamine, estimated at $3.1bn in 2022 and expected to expand at 10.6% a year until 2030,1 is just one of many signs of renewed interest in the use of psychedelics to treat psychiatric conditions.2 Various mind altering drugs have already entered the market, including esketamine nasal spray, which the US Food and Drug Administration approved in 2019. And in 2022 the Australian Therapeutic Goods Administration (TGA) allowed psilocybin and 3,4-methylenedioxymethamphetamine (MDMA) to be prescribed by authorised physicians for psychiatric conditions such as depression and post-traumatic stress disorder. The decision was taken despite an independent scientific report commissioned by the TGA advising against authorisation because the certainty of evidence for benefits was low or very low.3 Psychedelics, t
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Mashup Score: 15How patients are using AI - 19 hour(s) ago
Artificial intelligence (AI) tools such as ChatGPT have hundreds of millions of users—but are they medically safe and reliable? Chris Stokel-Walker asks patients and physicians about the benefits and risks in an AI world In August this year Hayley Brackley lost a large part of her vision, completely out of the blue. She’d gone to her local chemist with eye pain, and a prescribing pharmacist diagnosed sinusitis. She took the recommended medicine to try to resolve the pain, but it began affecting her ability to see. Her first thought was to turn to ChatGPT for advice on what to do next. The chatbot advised her to go back and get the problem checked out more, which she did. Further examination by an optician found that she had significant inflammation and a haemorrhage in her optic nerve, which is currently being treated. It’s not surprising that Brackley’s first port of call was ChatGPT. She prefers ChatGPT to a search engine such as Google because it can hold a conversation and more qui
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High monthly turnover rates of nurses and senior doctors are associated with higher deaths for emergency patients admitted to NHS hospitals in England, finds a study published by @bmj_latest. Link to research: https://t.co/RelYnXEki1 Link to editorial: https://t.co/WIu2liymBv https://t.co/6iF3e3qIMq