ObjectivesTo assess the prevalence of visual impairment (VI) and blindness (BL) due to cataract and cataract surgical outcomes in remote dispersed and high-altitude Tibetan areas of China. Design and settingA cross-sectional study was conducted among people aged 50 and above in Tibetan Autonomous Prefecture of Kandze (TAPK), China, in 2017. The Rapid Assessment of Avoidable Blindness protocol was followed. ParticipantsOf 5000 eligible participants, 4764 were examined (response rate 95.3%). Primary...
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ObjectivesThe aim of this study was to estimate alcohol and tobacco use prevalence and their correlates among female sex workers (FSW), men who have sex with men (MSM) and drug users (DU) in Togo. Design, setting and participantsA cross-sectional bio-behavioural study was conducted among 2115 MSM, FSW and DU in 2017 using a respondent-driven sampling method, in the eight biggest towns of Togo. Selection criteria for the MSM were being male and having had oral or anal intercourse with a man in the...
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IntroductionResistant Gram-positive organisms, such as methicillin-resistant staphylococci, account for a significant proportion of infections following joint replacement surgery. Current surgical antimicrobial prophylaxis guidelines recommend the use of first-generation or second-generation cephalosporin antibiotics, such as cefazolin. Cefazolin, however, does not prevent infections due to these resistant organisms; therefore, new prevention strategies need to be examined. One proposed strategy...
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ObjectivesTo investigate the relation between mode of birth and women’s long-term sexual health. DesignMaternal follow-up of the Danish National Birth Cohort (1996–2002) in 2013–2014 including questions on sexual health. Logistic regression was used to relate registry-based information about mode of birth and perineal tears with data on sexual problems. SettingDenmark. ParticipantsOf 82 569 eligible mothers in the Danish National Birth Cohort, 43 639 (53%) completed the follow-up. Of these, 37...
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ObjectiveWith the emergence of Zika virus (ZIKV) disease in Central and South America in the mid-2010s and recognition of the teratogenic effects of congenital exposure to ZIKV, there has been a substantial increase in new research published on ZIKV. Our objective is to synthesise the literature on health outcomes associated with ZIKV infection in humans. MethodsWe conducted a systematic review (SR) of SRs following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We...
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ObjectivesGenome sequencing is poised to be incorporated into clinical care for diagnoses of rare diseases and some cancers in many parts of the world. Healthcare professionals are key stakeholders in the clinical delivery of genome sequencing-based services. Our aim was to explore views of healthcare professionals with experience of offering genome sequencing via the 100 000 Genomes Project. DesignInterview study using thematic analysis. SettingFour National Health Service hospitals in London....
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ObjectiveWe sought to investigate the concept and practices of ‘clinician presence’, exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts. DesignIn 2017–2018, we conducted qualitative semistructured interviews with 10 physicians and 30 non-medical professionals from the fields of protective services, business, management, education, art/design/entertainment, social services,...
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IntroductionDifficult airway management during tracheal intubation can lead to severe hypoxic sequelae. Routine intubation practice is to use a strict supine position, whereas a 25° head-up or reverse Trendelenburg position increases efficacy of preoxygenation, seems more comfortable for the anaesthetist and may also provide better intubation conditions in direct laryngoscopy. The 25° head-up position could be used for the whole population rather than only for obese patients, but there is no prospective...
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BackgroundCervical cancer rates are higher in low-resourced countries than high, partly due to lower rates of screening. Incidence in Thailand is nearly three times higher than in the USA (16.2 vs 6.5 age-standardised incidence), even with Thailand’s universal health coverage, which includes screening, suggesting that alternative methods are needed to reduce the burden. We investigated barriers to screening, as well as acceptability of self-collection human papillomavirus (HPV) testing as a primary...
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ObjectivesIndividuals in rural areas face critical health disparities, including limited access to mental healthcare services and elevated burden of chronic illnesses. While disease outcomes are often worse in individuals who have both physical and mental comorbidities, few studies have examined rural, chronically-ill older adults’ experiences accessing mental health services. The aim of the study was to determine barriers to finding, receiving and adhering to mental health treatments in this population...
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IntroductionFever is an integral part of the inflammatory response and has therefore likely a physiological role in fighting infections. Nevertheless, whether fever in itself is beneficial or harmful in adults is unknown. This protocol for a systematic review aims at identifying the beneficial and harmful effects of fever control interventions in adults. Methods and analysisThis protocol for a systematic review was conducted following the recommendations of Cochrane, GRADE and the eight-step assessment...
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BackgroundMigration is a stressful process of resettlement and acculturation that can often negatively impact the mental health of migrants. International migration to Japan, a country with dominant ethnic homogeneity, is growing steadily amid an ageing domestic population and severe labour shortages. ObjectivesTo identify the contemporary barriers to, and facilitators of, mental well-being among the migrant population in Japan. DesignSystematic review Data sourcesPubMed, ProQuest, Web of Science,...
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ObjectivesThe occurrence and mortality of vasospastic angina pectoris (VAP) is largely unknown in western countries. Our objective was to clarify the occurrence, gender-distribution and mortality of VAP in Finland using a population-based hospital registry. MethodsWe studied consecutive patients aged ≥18 years hospitalized with VAP as the primary cause of admission in Finland during 2004–2014. The data were collected from obligatory nationwide registries. During the study period 1762 admissions...
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ObjectiveTo examine the associations of dietary and supplemental magnesium (Mg) as assessed by a semi-quantitative food frequency questionnaire with cognitive outcomes among ageing women. DesignThis work conducts a prospective cohort study of participants enrolled in the Women’s Health Initiative Memory Study (WHIMS), which was subsequently extended and named WHIMS-Epidemiology of Cognitive Health. SettingForty clinical centres in the USA. ParticipantsPostmenopausal women aged 65–79 years without...
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IntroductionCognitive impairment and reduced well-being are common manifestations of Graves’ disease (GD). These symptoms are not only prevalent during the active phase of the disease but also often prevail for a long time after hyperthyroidism is considered cured. The pathogenic mechanisms involved in these brain-derived symptoms are currently unknown. The overall aim of the CogThy study is to identify the mechanism behind cognitive impairment to be able to recognise GD patients at risk. Methods...
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ObjectiveTo determine the effects of yoga practice on subclinical cardiovascular measures, risk factors and neuro-endocrine pathways in patients undergoing cardiac rehabilitation (CR) following acute coronary events. Design3-month, two-arm (yoga +usual care vs usual care alone) parallel randomised mechanistic study. SettingOne general hospital and two primary care CR centres in London. Assessments were conducted at Imperial College London. Participants80 participants, aged 35–80 years (68% men,...
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IntroductionCancer (and survival) is known to affect the quality of life. Strategies as physical activity and exercise during and after cancer may improve health-related qualify of life (HRQOL) outcomes and are, therefore, of clinical and public health importance. To the best of our knowledge, comparative evidence of the effect of the different types of exercise on improving HRQOL in cancer patients has not been synthesised thus far. We aim to conduct a systematic review and network meta-analysis...
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ObjectivesA midwife-led continuity model of care had been implemented in the Palestinian governmental health system to improve maternal services in several rural areas. This study investigated if the model influenced women’s satisfaction with care, during antenatal, intrapartum and postnatal period. DesignAn observational case-control design was used to compare the midwife-led continuity model of care with regular maternity care. Participants and settingWomen with singleton pregnancies, who had...
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ObjectiveTo examine lessons learnt from the implementation of five Vanguard initiatives in the North East of England. DesignData collection comprised semistructured interviews with key informants at each site. SettingThe study took place across six local authority areas in the North East of England and within six clinical commissioning groups responsible for the delivery of each Vanguard’s aims and objectives. ParticipantsSixty-six interviewees with participants from five Vanguard initiatives...
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ObjectiveObstruction release from urolithiasis can be delayed with a lack of suggested time for preventing the deterioration of renal function. The objective of this study was to investigate the effect of obstruction duration, concomitant acute kidney injury (AKI) or acute pyelonephritis (APN) during the obstruction on the prognosis of renal function. DesignRetrospective cohort study. Setting and participants1607 patients from a urolithiasis-related obstructive uropathy cohort, between January...
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ObjectivesTo use wrist-worn accelerometers (Axivity AX3) to establish normative physical activity (PA) and acceptability data for the high-risk elderly preoperative population, to assess whether PA could be modified by a prehabilitation intervention as part of routine care, to assess any correlation between accelerometer-measured PA and self-reported PA and to assess the acceptability of wearing wrist-worn accelerometers in this population. Study designProspective, observational, pilot study. SettingSingle...
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ObjectivesA consensus study from 2017 developed 15 response-specific quality indicators (QIs) for physician-staffed emergency medical services (P-EMS). The aim of this study was to test these QIs for important characteristics in a real clinical setting. These characteristics were feasibility, rankability, variability, actionability and documentation. We further aimed to propose benchmarks for future quality measurements in P-EMS. DesignIn this prospective observational study, physician-staffed helicopter...
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IntroductionThere is increasing attention on the cancer burden for adults with intellectual and developmental disabilities (IDD). Emerging evidence suggests there are differences in cancer experiences and outcomes for individuals living with IDD, from risk through survivorship. These differences may be attributed to features of the IDD, such as cognitive deficits and communication, as well as social determinants of health-like lower education levels and ableism. However, there is no comprehensive...
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IntroductionMultimorbidity, the co-occurrence of a chronic physical condition and mental disorder, affects a substantial number of children and youth and can lead to compromised quality of life, hardship for families, and an increased burden on the healthcare system. We are conducting a study to document the course of mental disorder in children and youth diagnosed with a chronic physical condition; identify predictors of child and youth multimorbidity; examine whether the effects of these predictors...
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BackgroundAgeing patients are discharged from the hospital ‘quicker and sicker’ than before, and hospital discharge is a critical step in patient care. Older patients form a particularly vulnerable group due to multimorbidity and frailty. Patient participation in healthcare is influenced by government policy and an important part of quality improvement of care. There is need for greater insights into the complexity of patient participation for older patients in discharge processes based on aggregated...
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