IntroductionPalliative care is a clinically and cost-effective component of cancer services in sub-Saharan Africa (SSA). Despite the significant need for palliative cancer care in SSA, coverage remains inadequate. The exploration of digital health approaches could support increases in the quality and reach of palliative cancer care services in SSA. However, there is currently a lack of any theoretical underpinning or data to understand stakeholder drivers for digital health components in this context....
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ObjectivesThe aim of this study was to identify the prevalence of peripherally inserted central catheter (PICC) malposition and the influence of guide wire removal on tip location in PICCs and determine whether related factors, including age, sex, side of insertion and brand of catheter, influence the PICC tip location. SettingSingle-centre research institute in China recruiting patients from the hospital. ParticipantsA total of 837 adult patients with inserted PICCs were recruited from October...
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IntroductionIn addition to the well-documented factors that contribute to weaning failure, increased energy demands of the respiratory muscles during spontaneous breathing trials (SBTs) might not be met by sufficient increases in energy supplies. This discrepancy may deprive blood and oxygen of other tissues. In this context, restrictions in perfusion of splanchnic organs and non-working muscles during SBT have been associated with weaning failure. However, alterations in perfusion of the brain during...
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ObjectiveTo generate estimates of comparative clinical effectiveness for interventions used in the treatment of anogenital warts (AGWs) through the systematic review, appraisal and synthesis of data from randomised controlled trials (RCTs). DesignSystematic review and network meta-analysis of RCTs. Search strategies were developed for MEDLINE, Embase, the Cochrane Library and the Web of Science. For electronic databases, searches were run from inception to March 2018. The systematic review was carried...
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IntroductionApproximately one-fourth of patients with clinical stage I testicular germ cell cancer will relapse within 5 years of follow-up. Certain histopathological features in the primary tumour have been associated with an increased risk of relapse. The available evidence on the prognostic value of the risk factors, however, is hampered by heterogeneity of the study populations included and variable reporting of the histopathological features. The aim of this study is to identify pathological...
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ObjectivesStakeholder co-production in design of public health programmes may reduce the ‘implementation gap’ but can be time-consuming and costly. Prototyping, iterative refining relevant to delivery context, offers a potential solution. This evaluation explored implementation and lessons learnt for a 12-week referral-based weight-management programme, ‘Momenta’, along with feasibility of an iterative prototyping evaluation framework. DesignMixed methods evaluation: Qualitative implementation exploration...
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IntroductionPain is a frequent clinical symptom with significant impact on the patient’s well-being. Therefore, adequate pain management is of utmost importance. While cannabinoids have become a more popular alternative to traditional types of pain medication among patients, the quality of evidence supporting the use of cannabinoids has been questioned. The beneficial and harmful effects of cannabinoids in patients with pain is unknown. Accordingly, we aim to assess the efficacy, tolerability and...
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IntroductionChronic, non-specific low back pain is a major global cause of disability. One factor which might potentially contribute to ongoing pain is maladaptive variation in the level of activity in the lumbar musculature. Several studies have investigated this activity using surface electromyography, in varied muscles and during a number of functional activities. Due to differences in the applied methodology, the results have been difficult to compare, and previous reviews have been limited in...
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ObjectiveAdvance care planning (ACP) assists people to identify their goals, values and treatment preferences for future care. Ideally, preferences are documented in an advance care directive (ACD) and used by doctors to guide medical decision-making should the patient subsequently lose their decision-making capacity. However, studies demonstrate that ACDs are not always adhered to by doctors in clinical practice. We aim to describe the attitudes and perspectives of doctors regarding ACD adherence...
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ObjectiveTo investigate the axial length (AL) elongation in primary school-age children during 3-year follow-up period and evaluate the associations of AL elongation with spherical equivalent (SE), AL at baseline, body height and weight. DesignA 3-year observational cohort study from 2014 to 2017. SettingJinshan Hospital of Fudan University in Shanghai. MethodsA total of 452 children successfully completed their measurements in the 3-year follow-up period. The mean age of those children was 6.9±0.7...
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IntroductionFamily-based behavioural weight management interventions are efficacious and widely used to address childhood obesity. Curriculum and strategies vary extensively and scale-up often depends on ensuring that the intervention fits the adoption context. Aims and objectivesTo evaluate the impact and implementation of a ‘made in British Columbia’ (BC) family-based early intervention programme (EIP) for 8–12 years old with overweight and obesity and their families. Methods and analysisA randomised...
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ObjectiveGains in life expectancy have faltered in several high-income countries in recent years. Scotland has consistently had a lower life expectancy than many other high-income countries over the past 70 years. We aim to compare life expectancy trends in Scotland to those seen internationally and to assess the timing and importance of any recent changes in mortality trends for Scotland. SettingAustria, Croatia, Czech Republic, Denmark, England and Wales, Estonia, France, Germany, Hungary, Iceland,...
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IntroductionAlthough evidence has been provided on the associations between psychosocial work exposures and morbidity outcomes in the literature, knowledge appears much more sparse on mortality outcomes. The objective of STRESSJEM is to explore the prospective associations between psychosocial work exposures and mortality outcomes among the national French working population. In this paper, we describe the study protocol, study population, data sources, method for exposure assessment, data analysis...
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ObjectiveTo assess the prevalence of undiagnosed diabetes mellitus (DM) and associated factors among adult inhabitants of Bahir Dar city, northwest Ethiopia. DesignA community-based cross-sectional study was conducted on adults (n=607) of Bahir Dar city from 10 March to 20 May 2018. MeasurementsData were collected using structured interviewer-administered questionnaire, and anthropometric measurements were taken from each participant. Fasting blood sugar (FBS) level was determined by samples taken...
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ObjectivesThis study investigates students’ adoption of LeiKA, a new extracurricular longitudinal general practice (GP) teaching project. LeiKA aims to attract a broad range of students, not only those who are already planning to become GPs. This study compares participants’ and non-participants’ characteristics, career preferences and job-related value orientations to assess the programme’s initial potential to increase the number of students subsequently entering GP careers. Additionally, students’...
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IntroductionAlthough studies showed that physical activity (PA) and sedentary behaviour (SB) were associated with cardiometabolic risk factors and cognitive function, both independent and combined associations among them are inconsistent. Cardiometabolic risk factors are also associated with cognitive function, but research of children is limited. Additionally, the brain level mechanisms have not been fully established. The proposed study aims to explore the associations and mechanisms of PA and...
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IntroductionDepression is a common disorder among older people living in residential aged care facilities. Several trials have demonstrated the effectiveness of behavioural therapies in treating depressive symptoms in older adults living in the community and in residential aged care. Behavioural Activation is demonstrably effective even when delivered by non-specialists (staff without formal psychological training), although strategies for adapting its use in residential aged care facilities are...
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ObjectivesSchools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The ‘Healthy Primary School of the Future’ (HPSF) aims to improve children’s health and well-being by enhancing school health promotion. The current study aims to assess the effect of HPSF on children’s body mass index (BMI) z-score after 1 and 2 years follow-up and to investigate whether HPSF has different effects within specific subgroups of children. DesignA...
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IntroductionHIV-associated neurocognitive disorder (HAND) may affect 30%–50% of people ageing with HIV. HAND may increase stress and anxiety, and impede coping. Psychosocial group therapy may ameliorate HAND’s symptoms, yet the ideal intervention is unclear. This protocol outlines a pilot randomised controlled trial (RCT)—designed using community-based participatory research—to pilot cognitive remediation group therapy (CRGT) against an active comparator. Methods and analysisThis is a pilot, parallel...
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ObjectivesTo examine knowledge and beliefs about the biological roles of dietary inorganic nitrate in UK-based nutrition professionals, and to explore potential differences by participants’ education level. SettingAn online questionnaire was administered to UK-based nutrition professionals, exploring knowledge and/or beliefs across five areas: (1) health and performance effects of nitrate; (2) current and recommended intake values for nitrate; (3) dietary sources of nitrate; (4) methods of evaluating...
07:20
ObjectivesThe goal of this study was to examine the relationship between measured teamwork and adverse safety events in the prehospital emergency care of children using high-fidelity simulation. We posit that non-technical skills such as leadership, teamwork, situation awareness and decision-making are associated with the clinical success of teams. DesignObservational study. SettingEmergency medical services (EMS) responders were recruited from public fire and private transport agencies in Oregon...
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ObjectivesTo study whether self-reported health problems predict sickness absence (SA) from work in employees from different industries. MethodsThe results of a health risk appraisal (HRA) were combined with archival data of SA of 21 608 employees (59% female, 56% clerical). Exposure variables were self-reported health problems, labelled as ‘work disability (WD) risk factors’ in the HRA, presence of problems with occupational well-being and obesity. Age, socioeconomic grading and the number of SA...
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AimNetworkZ is a simulation-based multidisciplinary team-training programme designed to enhance patient safety by improving communication and teamwork in operating theatres (OTs). In partnership with the Accident Compensation Corporation, its implementation across New Zealand (NZ) began in 2017. Our aim was to explore the experiences of staff – including the challenges they faced – in implementing NetworkZ in NZ hospitals, so that we could improve the processes necessary for subsequent implementation....
07:20
An 80-year-old man who was previously diagnosed with Philadelphia+ B cell-acute lymphoblastic leukaemia (B-ALL) in remission post-allogeneic matched unrelated donor peripheral blood stem cell transplant. Five years later, he was found to have unilateral testicular relapse of Philadelphia+ B-ALL proven by pathology after radical orchiectomy. Bone marrow aspirate and biopsy did not show evidence of leukaemia. Patient was treated with adjuvant radiation therapy and started on dasatinib 50 mg daily....
07:17
Diffuse idiopathic skeletal hyperostosis (DISH) is a common degenerative enthesopathy seen in the elderly with male preponderance. It is uncommon in patients before 50 years of age and is extremely rare in patients younger than 40 years. We report a case of 33-year-old unmarried woman who presented with inflammatory spinal pain and stiffness, limited chest expansion, decreased range of spinal motion and postural abnormalities, all of which suggested the diagnosis of ankylosing spondylitis, considering...
07:17
A 73-year-old man presented to accident and emergency with headache and diplopia. Examination of the eye movements revealed a bilateral complete horizontal gaze palsy. On admission, a CT scan of the brain was performed, which was unremarkable. An MRI of the brain was then performed, which confirmed tiny acute infarcts involving the pons and the right cerebellum. This man was promptly treated with aspirin 300 mg one time per day, as per the stroke pathway. Further diagnostic workup later revealed...
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Spindle cell lipomas are a rare subtype of lipoma typically occurring in the shawl region of middle-aged men with a characteristic histological appearance consisting of mature adipocytes, ropey collagen and spindle cells. Those of extraordinary size or atypical anatomic location require a proper immunohistological workup to rule out more ominous malignancy. The authors report the rare presentation of a 54-year-old man with a large mass of the left palm causing discomfort and paresthesia for 6 months....
07:17
Spontaneous hepatic rupture is an uncommon cause of haemorrhagic shock and very rarely happens due to amyloidosis. This report describes one such case in which a middle-aged man presented in extremis. He was managed initially with massive transfusion, interventional radiology embolisation and decompressive laparotomy for abdominal compartment syndrome. Subsequent coagulopathy was treated with activated factor VII due to deficient native activity. Serum protein electrophoresis and liver biopsy during...
07:17
Ultrasound (US) is undoubtedly an important modality for diagnosing a wide range of gastrointestinal and liver conditions. In addition, recently introduced non-invasive liver assessment techniques, particularly US-based modalities such as elastography and contrast-enhanced US, have resulted in a dramatic shift in the management of patients with chronic liver disease by allowing rapid and accurate assessment of hepatic fibrosis and liver lesions.1 Although these techniques are used by clinicians in...
Thu Oct 31, 2019 18:00
The aim of this four waves 9-year longitudinal study was to examine aggressive/depressive symptoms trajectories in a sample of N = 90 children with overweight and a matched group of children with normal weight...
Wed Oct 30, 2019 02:00
To assess the prevalence of antenatal depression and factors associated with antenatal depression among pregnant women in Aneded woreda, Northwest Ethiopia, 2019. A community based- cross sectional study was c...
Wed Oct 30, 2019 02:00
In this paper we study if and under what conditions crowdsourcing can be used as a reliable method for collecting high-quality emotion labels on pictures. To this end, we run a set of crowdsourcing experiments...
Wed Oct 30, 2019 02:00
The aim of this study was to determine the prevalence of Salmonella and Shigella, antibiotic susceptibility profile and associated factors among food handlers working in food establishment from June to December 2...
Wed Oct 30, 2019 02:00
The main objective of this study was to assess pesticide handling and storage practice, and its associated factors among farmers engaged in irrigation in Gondar town, Ethiopia, 2019. Community-based cross-sect...
Wed Oct 30, 2019 02:00
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