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Adverse Drug reactions in an Ageing PopulaTion (ADAPT) study protocol: a cross-sectional and prospective cohort study of hospital admissions related to adverse drug reactions in older patients
Introduction Older people experience greater morbidity with a corresponding increase in medication use resulting in a potentially higher risk of adverse drug reactions (ADRs). The aim of this study is to determine the prevalence and characteristics of ADR-related hospital admissions among older patients (≥65 years) and their associated health and cost outcomes. Methods and analysis The proposed study will include a cross-sectional study of ADR prevalence in all patients aged ≥65 years admitted acutely to a large tertiary referral hospital in Ireland over a 9-month period (2016–2017) and a prospective cohort st...
Source: BMJ Open - June 9, 2017 Category: General Medicine Authors: Cahir, C., Curran, C., Byrne, C., Walsh, C., Hickey, A., Williams, D. J., Bennett, K. Tags: Open access, Geriatric medicine Protocol Source Type: research

Practice patterns and outcomes associated with early sedation depth in mechanically ventilated patients: a systematic review protocol
Introduction Mechanical ventilation is a commonly performed intervention in critically ill patients. Frequently, these patients experience deep sedation early in their clinical course. Emerging data suggest that the practice of early deep sedation may negatively impact patient outcomes. The purpose of this review is to assess the world’s literature to describe and determine the impact of early deep sedation on the outcomes of mechanically ventilated patients. Methods and analysis Randomised controlled trials and non-randomised studies will be eligible for inclusion in this systematic review. With the assistance of a...
Source: BMJ Open - June 9, 2017 Category: General Medicine Authors: Stephens, R. J., Dettmer, M. R., Roberts, B. W., Fowler, S. A., Fuller, B. M. Tags: Open access, Intensive care Protocol Source Type: research

Evaluation of a physiatrist-directed prehabilitation intervention in frail patients with colorectal cancer: a randomised pilot study protocol
This study has been approved by the Hamilton Integrated Research Ethics Board (HIREB reference number 2015–0090-GRA). The results of this pilot study will be used to design a full-scale study and published in peer-reviewed journals. Trial registration number NCT02531620; Pre-results. (Source: BMJ Open)
Source: BMJ Open - June 9, 2017 Category: General Medicine Authors: Wong, S. G., Maida, E., Harvey, D., Wagner, N., Sonnadara, R., Amin, N. Tags: Open access, Surgery Protocol Source Type: research

Coding of Barretts oesophagus with high-grade dysplasia in national administrative databases: a population-based cohort study
Conclusions HES is not suitable to support national studies looking at the management of HGD. This is one reason for the UK to adopt an extended ICD system (akin to ICD-10-CM). (Source: BMJ Open)
Source: BMJ Open - June 9, 2017 Category: General Medicine Authors: Chadwick, G., Varagunam, M., Brand, C., Riley, S. A., Maynard, N., Crosby, T., Michalowski, J., Cromwell, D. A. Tags: Open access, Gastroenterology and hepatology Research Source Type: research

Timing of two versus three doses of quadrivalent HPV vaccine and associated effectiveness against condyloma in Sweden: a nationwide cohort study
Conclusion A two-dose schedule for qHPV vaccine with 4–7 months between the first and second doses may be as effective against condyloma in girls and women initiating vaccination under 20 years as a three-dose schedule. Results from this nationwide study support immunogenicity data from clinical trials. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: F, L., E, H., A, P., I, U., K, S., P, S., L, A.-D. Tags: Open access, Epidemiology Research Source Type: research

Cohort profile: the Nordic Antireflux Surgery Cohort (NordASCo)
Purpose To describe a newly created all-Nordic cohort of patients with gastro-oesophageal reflux disease (GORD), entitled the Nordic Antireflux Surgery Cohort (NordASCo), which will be used to compare participants having undergone antireflux surgery with those who have not regarding risk of cancers, other diseases and mortality. Participants Included were individuals with a GORD diagnosis recorded in any of the nationwide patient registries in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) in 1964–2014 (with various start and end years in different countries). Data regarding cancer, other diseas...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Maret-Ouda, J., Wahlin, K., Artama, M., Brusselaers, N., Färkkilä, M., Lynge, E., Mattsson, F., Pukkala, E., Romundstad, P., Tryggvadottir, L., Euler-Chelpin, M. v., Lagergren, J. Tags: Open access, Gastroenterology and hepatology Cohort profile Source Type: research

Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study
This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. Methods and analysis This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context–mechanism–outcome configuration. The following steps will be taken: (1) developing a theory, (2...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Lovink, M. H., Persoon, A., van Vught, A. J., Schoonhoven, L., Koopmans, R. T., Laurant, M. G. Tags: Open access, Geriatric medicine Protocol Source Type: research

General practitioners views of clinically led commissioning: cross-sectional survey in England
Conclusion CCGs need to engage in active succession planning to find the next generation of GP leaders. GPs believe that CCGs have a legitimate role in influencing their work, suggesting that there may be scope for CCGs to involve GPs more fully in roles short of formal leadership. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Moran, V., Checkland, K., Coleman, A., Spooner, S., Gibson, J., Sutton, M. Tags: Open access, Health policy Research Source Type: research

The Optimal Screening for Prediction of Referral and Outcome (OSPRO) in patients with musculoskeletal pain conditions: a longitudinal validation cohort from the USA
Purpose There is an increased need for determining which patients with musculoskeletal pain benefit from additional diagnostic testing or psychologically informed intervention. The Optimal Screening for Prediction of Referral and Outcome (OSPRO) cohort studies were designed to develop and validate standard assessment tools for review of systems and yellow flags. This cohort profile paper provides a description of and future plans for the validation cohort. Participants Patients (n=440) with primary complaint of spine, shoulder or knee pain were recruited into the OSPRO validation cohort via a national Orthopaedic Physical...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: George, S. Z., Beneciuk, J. M., Lentz, T. A., Wu, S. S. Tags: Open access, Evidence based practice Cohort profile Source Type: research

Assessing the diagnostic accuracy of PCR-based detection of Streptococcus pneumoniae from nasopharyngeal swabs collected for viral studies in Canadian adults hospitalised with community-acquired pneumonia: a Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research (CIRN) study
Conclusions While further optimisation may be needed to increase the sensitivity of PCR-based detection, its high specificity suggests there is a value for pneumococcal surveillance. With many laboratories archiving specimens for influenza virus surveillance, this specimen type could provide a non-culture-based method for pneumococcal surveillance. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Gillis, H. D., Lang, A. L. S., ElSherif, M., Martin, I., Hatchette, T. F., McNeil, S. A., LeBlanc, J. J., on behalf of the Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research (CIRN) Tags: Open access, Research methods Source Type: research

Development and validation of a risk stratification model for prediction of disability and hospitalisation in patients with heart failure: a study protocol
Background Chronic heart failure (CHF) reduces quality of life and causes hospitalisation and death. Identifying predictive factors of such events may help change the natural history of this condition. Aim To develop and validate a stratification system for classifying patients with CHF, according to their degree of disability and need for hospitalisation due to any unscheduled cause, over a period of 1 year. Methods and analysis Prospective, concurrent, cohort-type study in two towns in the Madrid autonomous region having a combined population of 1 32 851. The study will include patients aged over 18 years who meet the ...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Garcia-Olmos, L., Rodriguez-Salvanes, F., Batlle-Perez, M., Aguilar-Torres, R., Porro-Fernandez, C., Garcia-Cabello, A., Carmona, M., Ruiz-Alonso, S., Garrido-Elustondo, S., Alberquilla, A., Sanchez-Gomez, L. M., Sanchez de Madariaga, R., Monge-Navarrete, Tags: Open access, General practice / Family practice Protocol Source Type: research

Optimal timing for elective caesarean delivery in a Chinese population: a large hospital-based retrospective cohort study in Shanghai
Conclusion For women undergoing elective CD, neonatal outcome data suggest that delivery at 39–39 6/7 complete weeks is optimal timing in a Chinese population. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: HU, Y., Shen, H., Landon, M. B., Cheng, W., Liu, X. Tags: Open access, Obgyn Research Source Type: research

Effect of physical activity and dietary restriction interventions on weight loss and the musculoskeletal function of overweight and obese older adults with knee osteoarthritis: a systematic review and mixed method data synthesis
Conclusion The quality of evidence of benefit of combining exercise and dietary interventions in older overweight/obese adults with knee OA is unclear. Trail registration number CRD42015019088 and ISRCTN, ISRCTN12906938. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Alrushud, A. S., Rushton, A. B., Kanavaki, A. M., Greig, C. A. Tags: Open access, Geriatric medicine Research Source Type: research

Cross-sectional study of factors associated with community health centre use in a recently urbanised community in Chengdu, China
Conclusions Neighbourhood CHC in urban areas provides important services to these residents living in a recently urbanised community. All three categories of factors in the Andersen model help explain the likelihood of CHC use. There is much room for improvement in CHC to enhance customer satisfaction. Future research is needed to improve access to CHCs and promote their use in urbanised populations with low to modest education. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Liu, D., Meng, H., Dobbs, D., Conner, K. O., Hyer, K., Li, N., Ren, X., Gao, B. Tags: Open access, Public health Research Source Type: research

A self-efficacy education programme on foot self-care behaviour among older patients with diabetes in a public long-term care institution, Malaysia: a Quasi-experimental Pilot Study
Objective A pilot self-efficacy education programme was conducted to assess the feasibility, acceptability and potential impact of the self-efficacy education programme on improving foot self-care behaviour among older patients with diabetes in a public long-term care institution. Method A prequasi-experimental and postquasi-experimental study was conducted in a public long-term care institution in Selangor, Malaysia. Patients with diabetes aged 60 years and above who fulfilled the selection criteria were invited to participate in this programme. Four self-efficacy information sources; performance accomplishments, vicario...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Sharoni, S. K. A., Abdul Rahman, H., Minhat, H. S., Shariff Ghazali, S., Azman Ong, M. H. Tags: Open access, Diabetes and Endocrinology Research Source Type: research

Social epidemiology of hypertension in Buffalo City Metropolitan Municipality (BCMM): cross-sectional study of determinants of prevalence, awareness, treatment and control among South African adults
This study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape. Design A cross-sectional analytical study. Settings The three largest outpatient clinics in BCMM. Participants Ambulatory adults (aged 18 years and over) attending the study settings during the study period (n=998). Primary outcome measure The prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of ...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Owolabi, E. O., Goon, D. T., Adeniyi, O. V., Seekoe, E. Tags: Open access, Epidemiology Research Source Type: research

Are self-reported unhealthy food choices associated with an increased risk of breast cancer? Prospective cohort study using the British Food Standards Agency nutrient profiling system
Conclusions These results suggested that unhealthy food choices, as characterised by the FSA-NPS, may be associated with an increase in breast cancer risk, supporting the potential public health relevance of using this profiling system in the framework of public health nutritional measures. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Deschasaux, M., Julia, C., Kesse-Guyot, E., Lecuyer, L., Adriouch, S., Mejean, C., Ducrot, P., Peneau, S., Latino-Martel, P., Fezeu, L. K., Fassier, P., Hercberg, S., Touvier, M. Tags: Open access, Epidemiology Research Source Type: research

Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study
Objectives Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates. Methods Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014. Demographics, comorbidities, p...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Abdullah, H. R., Sim, Y. E., Hao, Y., Lin, G. Y., Liew, G. H. C., Lamoureux, E. L., Tan, M. H. Tags: Open access, Health services research Source Type: research

Serious gaming during multidisciplinary rehabilitation for patients with complex chronic pain or fatigue complaints: study protocol for a controlled trial and process evaluation
Introduction Many individuals suffer from chronic pain or functional somatic syndromes and face boundaries for diminishing functional limitations by means of biopsychosocial interventions. Serious gaming could complement multidisciplinary interventions through enjoyment and independent accessibility. A study protocol is presented for studying whether, how, for which patients and under what circumstances, serious gaming improves patient health outcomes during regular multidisciplinary rehabilitation. Methods and analysis A mixed-methods design is described that prioritises a two-armed naturalistic quasi-experiment. An expe...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Vugts, M. A. P., Joosen, M. C. W., Mert, A., Zedlitz, A., Vrijhoef, H. J. M. Tags: Open access, Rehabilitation medicine Protocol Source Type: research

Performance-based functional impairment and readmission and death: a prospective study
Conclusions Functional impairment at discharge of an acute medical hospitalisation was associated with higher risk of death, but not of unplanned readmission within 6 months after discharge. Simple performance-based assessment may represent a better prognostic measure for mortality than for readmission. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Aubert, C. E., Folly, A., Mancinetti, M., Hayoz, D., Donze, J. D. Tags: Open access, General practice / Family practice Research Source Type: research

Night work and prostate cancer in men: a Swedish prospective cohort study
Conclusions The results, together with previous studies, suggest that night work does not seem to constitute a risk factor for prostate cancer. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Akerstedt, T., Narusyte, J., Svedberg, P., Kecklund, G., Alexanderson, K. Tags: Open access, Epidemiology Research Source Type: research

Systematic review and meta-analysis of prevalence of, and risk factors for, pelvic floor disorders in community-dwelling women in low and middle-income countries: a protocol study
Introduction Pelvic floor disorders (PFDs) including urinary incontinence, faecal incontinence and pelvic organ prolapse are common debilitating conditions among women in high-income countries. However, PFDs in women in low/middle-income countries (LMICs) have not been studied extensively. We aim to conduct a systematic review and meta-analysis of the available literature to determine the prevalence of, and/or risk factors for, PFDs in women in LMIC. Methods and analysis We will search electronic databases including MEDLINE, EMBASE, PsycINFO, CINAHL, Maternity & Infant Care and Google Scholar for eligible studies. Inc...
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Islam, R. M., Oldroyd, J., Karim, M. N., Hossain, S. M., Md Emdadul Hoque, D., Romero, L., Fisher, J. Tags: Open access, Urology Protocol Source Type: research

A mixed-methods evaluation of the Educational Supervision Agreement for Wales
Conclusions Our evidence suggests that respondents believed the Agreement would professionalise and support their Educational Supervisor role. Respondents showed enthusiasm for the Agreement and its role in maintaining high standards of training. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Webb, K. L., Bullock, A., Groves, C., Saayman, A. G. Tags: Open access, Medical education and training Research Source Type: research

Weight cycling and the subsequent onset of type 2 diabetes mellitus: 10-year cohort studies in urban and rural Japan
Conclusions In Japan, weight cycling was associated with a significant reduction in the risk of diabetes for men from urban regions. The associations were unclear for women from urban regions and both men and women from rural regions. These results differ from those in Western studies, probably because of differences in diet, insulin secretion and sensitivity and weight-consciousness. (Source: BMJ Open)
Source: BMJ Open - June 8, 2017 Category: General Medicine Authors: Yokomichi, H., Ohde, S., Takahashi, O., Mochizuki, M., Takahashi, A., Yoda, Y., Tsuji, M., Akiyama, Y., Yamagata, Z. Tags: Open access, Epidemiology Research Source Type: research

Adverse childhood or adult experiences and risk of bilateral oophorectomy: a population-based case-control study
Objectives Bilateral oophorectomy has commonly been performed in conjunction with hysterectomy even in women without a clear ovarian indication; however, oophorectomy may have long-term deleterious consequences. To better understand this surgical practice from the woman’s perspective, we studied the possible association of adverse childhood or adult experiences with the subsequent occurrence of bilateral oophorectomy. Design Population-based case–control study. Setting Olmsted County, Minnesota (USA). Participants From an established population-based cohort study, we sampled 128 women who underwent bilateral...
Source: BMJ Open - June 7, 2017 Category: General Medicine Authors: Gazzuola Rocca, L., Smith, C. Y., Grossardt, B. R., Faubion, S. S., Shuster, L. T., Stewart, E. A., Rocca, W. A. Tags: Open access, Obgyn Research Source Type: research

Correction
Laver K, Dyer S, Whitehead C, et al. Interventions to delay functional decline in people with dementia: a systematic review of systematic reviews. BMJ Open 2016;6:e010767. doi:10.1136/bmjopen-2015-010767 The data reported in the abstract, text, Figure 2 and Table 2 were incorrect due to an error in the calculation. The effect size for the dyadic interventions is 0.31 (95% CI 0.02 to 0.59) and this information is based on 10 trials with 1359 participants. This is instead of the presented information which reads that 8 trials (988 participants) had an effect size of 0.37 (95%CI 0.05 to 0.69). The authors apologise for this e...
Source: BMJ Open - June 7, 2017 Category: General Medicine Authors: Editorial Team, B. O. Tags: Open access Miscellaneous Source Type: research

Finnish Subacromial Impingement Arthroscopy Controlled Trial (FIMPACT): a protocol for a randomised trial comparing arthroscopic subacromial decompression and diagnostic arthroscopy (placebo control), with an exercise therapy control, in the treatment of shoulder impingement syndrome
Introduction Arthroscopic subacromial decompression (ASD) is the most commonly performed surgical intervention for shoulder pain, yet evidence on its efficacy is limited. The rationale for the surgery rests on the tenet that symptom relief is achieved through decompression of the rotator cuff tendon passage. The primary objective of this superiority trial is to compare the efficacy of ASD versus diagnostic arthroscopy (DA) in patients with shoulder impingement syndrome (SIS), where DA differs only by the lack of subacromial decompression. A third group of supervised progressive exercise therapy (ET) will allow for pragmati...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Paavola, M., Malmivaara, A., Taimela, S., Kanto, K., Järvinen, T. L., on behalf of the FIMPACT Investigators Tags: Open access, Surgery Protocol Source Type: research

A systematic review of alcohol screening and assessment measures for young people: a study protocol
Introduction Alcohol consumption creates a significant public health burden, and young people who drink alcohol place themselves at risk of harm. Expert guidance and reviews have highlighted the pressing need for reliable and valid, age-appropriate alcohol screening and assessment measures for young people. The proposed systematic review will evaluate existing alcohol screening and assessment measures for young people aged 24 and under. Methods and analysis Six electronic databases will be searched for published and grey literature. In addition, reverse and forward citation searching and consultation with experts will be ...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Toner, P., Böhnke, J. R., McCambridge, J. Tags: Open access, Addiction Protocol Source Type: research

Utilising advance care planning videos to empower perioperative cancer patients and families: a study protocol of a randomised controlled trial
This study has been approved by the Johns Hopkins School of Medicine institutional review board and is registered on clinicaltrials.gov (NCT02489799, First received: July 1, 2015). Trial registration number clinicaltrials.gov, NCT02489799. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Aslakson, R. A., Isenberg, S. R., Crossnohere, N. L., Conca-Cheng, A. M., Yang, T., Weiss, M., Volandes, A. E., Bridges, J. F. P., Roter, D. L. Tags: Open access, Surgery Protocol Source Type: research

Rehabilitation interventions to improve patient-reported outcomes and physical fitness in survivors of muscle invasive bladder cancer: a systematic review protocol
Introduction Survivors of muscle invasive bladder cancer (MIBC) experience physical and psychosocial side effects of cancer diagnosis and treatment. These negative side effects have a crucial impact on their health-related quality of life (HRQoL). To date, there is evidence that rehabilitation interventions such as physical activity and psychosocial support have a positive effect on the HRQoL of cancer survivors. Unfortunately, there are no specific guidelines for rehabilitation or survivorship programmes for MIBC survivors. Therefore, this systematic review aims to assess the effects of exercise-based and psychosocial reh...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Rammant, E., Bultijnck, R., Sundahl, N., Ost, P., Pauwels, N. S., Deforche, B., Pieters, R., Decaestecker, K., Fonteyne, V. Tags: Open access, Urology Protocol Source Type: research

The STOP-AB trial protocol: efficacy and safety of discontinuing patient antibiotic treatment when physicians no longer consider it necessary
Introduction Since 2011, the Spanish Society of Family Medicine has recommended general practitioners (GPs) to ask their patients to stop taking antibiotics when they suspect a viral infection. However, this practice is seldom used because uncertainty about diagnosis, and fear of consequences of discontinuing antibiotic therapy, as well as perceived pressure to continue prescribing antibiotics and potential conflict with patients are more of a concern for GPs than antibiotic resistance. The main objective of this study is to determine whether discontinuation of antibiotic therapy when a GP no longer considers it necessary ...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Llor, C., Moragas, A., Bayona, C., Cots, J. M., Molero, J. M., Ribas, J., Fothy, J. F., Gutierrez, I., Sanchez, C., Ortega, J., Arranz, J., Botanes, J., Robles, P. Tags: Open access, General practice / Family practice Protocol Source Type: research

The influence of multisite pain and psychological comorbidity on prognosis of chronic low back pain: longitudinal data from the Norwegian HUNT Study
This study aimed to investigate the prospective influence of multisite pain, depression, anxiety, self-rated health and pain-related disability on recovery from chronic low back pain (LBP). Setting The data is derived from the second (1995–1997) and third (2006–2008) wave of the Nord-Trøndelag Health Study (HUNT) in Norway. Participants The study population comprises 4484 women and 3039 men in the Norwegian HUNT Study who reported chronic LBP at baseline in 1995–1997. Primary outcome measures The primary outcome was recovery from chronic LBP at the 11-year follow-up. Persons not reporting pain a...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Nordstoga, A. L., Nilsen, T. I. L., Vasseljen, O., Unsgaard-Tondel, M., Mork, P. J. Tags: Open access, Epidemiology Research Source Type: research

Attitudes and behaviours of adolescents towards antibiotics and self-care for respiratory tract infections: a qualitative study
Conclusion Addressing adolescents’ misperceptions about antibiotics and the treatment of RTIs using a behaviour change intervention should help improve antibiotic awareness and may break the cycle of patient demand for antibiotics to treat RTIs amongst this group. Schools should consider educating all students in further education about antibiotic usage and AMR, not only those taking science. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Hawking, M. K., Lecky, D. M., Touboul Lundgren, P., Aldigs, E., Abdulmajed, H., Ioannidou, E., Paraskeva-Hadjichambi, D., Khouri, P., Gal, M., Hadjichambis, A. C., Mappouras, D., McNulty, C. A. Tags: Open access, Qualitative research Source Type: research

Bacterial meningitis in Finland, 1995-2014: a population-based observational study
Conclusions Substantial decreases in bacterial meningitis were associated with infant conjugate vaccination against pneumococcal meningitis and secular trend in meningococcal meningitis in the absence of vaccination programme. Ongoing epidemiological surveillance is needed to identify trends, evaluate serotype distribution, assess vaccine impact and develop future vaccination strategies. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Polkowska, A., Toropainen, M., Ollgren, J., Lyytikäinen, O., Nuorti, J. P. Tags: Open access, Epidemiology Research Source Type: research

The eSMART study protocol: a randomised controlled trial to evaluate electronic symptom management using the advanced symptom management system (ASyMS) remote technology for patients with cancer
Introduction While some evidence exists that real-time remote symptom monitoring devices can decrease morbidity and prevent unplanned admissions in oncology patients, overall, these studies have significant methodological weaknesses. The electronic Symptom Management using the Advanced Symptom Management System (ASyMS) Remote Technology (eSMART) study is designed to specifically address these weaknesses with an appropriately powered, repeated-measures, parallel-group stratified randomised controlled trial of oncology patients. Methods and analysis A total of 1108 patients scheduled to commence first-line chemotherapy (CTX...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Maguire, R., Fox, P. A., McCann, L., Miaskowski, C., Kotronoulas, G., Miller, M., Furlong, E., Ream, E., Armes, J., Patiraki, E., Gaiger, A., Berg, G. V., Flowerday, A., Donnan, P., McCrone, P., Apostolidis, K., Harris, J., Katsaragakis, S., Buick, A. R., Tags: Open access, Oncology Protocol Source Type: research

Patient-reported outcome measures (PROMs) for assessing perceived listening effort in hearing loss: protocol for a systematic review
Introduction In the UK, it is estimated that a disabling hearing loss (HL) affects 1 in 6 people. HL has functional, economic and social-emotional consequences for affected individuals. Intervention for HL focuses on improving access to the auditory signal using hearing aids or cochlear implants. However, even if sounds are audible and speech is understood, individuals with HL often report increased effort when listening. Listening effort (LE) may be measured using self-reported measures such as patient-reported outcome measures (PROMs). PROMs are validated questionnaires completed by patients to measure their perceptions ...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Hughes, S. E., Rapport, F. L., Boisvert, I., McMahon, C. M., Hutchings, H. A. Tags: Open access, Ear, nose and throat/otolaryngology Protocol Source Type: research

A cross-sectional study measuring vanadium and chromium levels in paediatric patients with CKD
Conclusions Our study suggests that paediatric patients with CKD have elevated plasma levels of V and Cr. This may be the result of both environmental exposure and a low eGFR. It may be necessary to monitor V and Cr levels in patients with an eGFR
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Filler, G., Kobrzynski, M., Sidhu, H. K., Belostotsky, V., Huang, S.-H. S., McIntyre, C., Yang, L. Tags: Open access, Renal medicine Research Source Type: research

Dyspnoea-12: a translation and linguistic validation study in a Swedish setting
Conclusion A Swedish version of the Dyspnoea-12 is now available for clinical validation and multidimensional measurement across diseases and settings with the aim of improved evaluation and management of dyspnoea. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Sundh, J., Ekström, M. Tags: Open access, Respiratory medicine Research Source Type: research

Protocol for a randomised controlled trial of the effect of dapagliflozin, metformin and exercise on glycaemic variability, body composition and cardiovascular risk in prediabetes (the PRE-D Trial)
Introduction The primary aim of this study is to compare the efficacy of three short-term glucose-lowering interventions (exercise, metformin and dapagliflozin) on glycaemic variability in overweight or obese men and women with elevated diabetes risk (ie, prediabetes, defined as haemoglobin A1c (HbA1c)39–47 mmol/mol / 5.7%–6.4%). The secondary aims are to investigate the effects of the interventions on body composition and cardiometabolic risk factors. Methods and analysis The Pre-D Trial is an investigator-initiated, randomised, controlled, parallel, open-label, superiority trial. The study aims to assign 120...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Faerch, K., Amadid, H., Nielsen, L. B., Ried-Larsen, M., Karstoft, K., Persson, F., Jorgensen, M. E. Tags: Open access, Diabetes and Endocrinology Protocol Source Type: research

Impact of iron fortification on the geospatial patterns of malaria and non-malaria infection risk among young children: a secondary spatial analysis of clinical trial data from Ghana
Conclusion In a clinical trial setting of iron fortification, where all children receive treated bed nets and access to malaria treatment, there may be geographical variation in the risk of infection with distinct high-risk and low-risk areas, particularly around municipal centres. Trial registration number clinicaltrials.gov, NCT01001871. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Aimone, A. M., Brown, P., Owusu-Agyei, S., Zlotkin, S. H., Cole, D. C. Tags: Open access, Epidemiology Research Source Type: research

Evaluating the short-term and long-term effects of an internet-based aural rehabilitation programme for hearing aid users in general clinical practice: a randomised controlled trial
Conclusions This study indicates that participants in an internet-based intervention applied in general clinical practice showed improved self-reported communication skills compared with a control group. Receiving a full intervention was not more effective in improving self-reported hearing problems than receiving just one element of the internet-based intervention. Trial registration number This trial is registered at ClinicalTrals.gov, NCT01837550; results. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Malmberg, M., Lunner, T., Kähäri, K., Andersson, G. Tags: Open access, Ear, nose and throat/otolaryngology Research Source Type: research

Interpregnancy weight changes and impact on pregnancy outcome in a cohort of women with a macrosomic first delivery: a prospective longitudinal study
Conclusions This longitudinal study demonstrates that within this cohort maternal interpregnancy weight change between a second and third pregnancy is associated with an increase in birth weight ≥4.0 kg. Additionally, a gain of more weight than the median (1.70 kg) is associated with a higher rate of gestational diabetes. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Crosby, D. A., Walsh, J. M., Segurado, R., McAuliffe, F. M. Tags: Open access, Obgyn Research Source Type: research

The Hoorn Diabetes Care System (DCS) cohort. A prospective cohort of persons with type 2 diabetes treated in primary care in the Netherlands
Purpose People with type 2 diabetes (T2D) have a doubled morbidity and mortality risk compared with persons with normal glucose tolerance. Despite treatment, clinical targets for cardiovascular risk factors are not achieved. The Hoorn Diabetes Care System cohort (DCS) is a prospective cohort representing a comprehensive dataset on the natural course of T2D, with repeated clinical measures and outcomes. In this paper, we describe the design of the DCS cohort. Participants The DCS consists of persons with T2D in primary care from the West-Friesland region of the Netherlands. Enrolment in the cohort started in 1998 and this ...
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: van der Heijden, A. A., Rauh, S. P., Dekker, J. M., Beulens, J. W., Elders, P., 't Hart, L. M., Rutters, F., van Leeuwen, N., Nijpels, G. Tags: Open access, Diabetes and Endocrinology Cohort profile Source Type: research

Dietary determinants of serum total cholesterol among middle-aged and older adults: a population-based cross-sectional study in Dar es Salaam, Tanzania
Conclusions Using palm oil for cooking was associated with higher serum total cholesterol levels in this peri-urban population in Dar es Salaam. Reduction of saturated fat content of edible oil may be considered as a population-based strategy for primary prevention of cardiovascular diseases. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Kakarmath, S. S., Zack, R. M., Leyna, G. H., Fahimi, S., Liu, E., Fawzi, W. W., Lukmanji, Z., Killewo, J., Sacks, F., Danaei, G. Tags: Open access, Nutrition and metabolism Research Source Type: research

Clinicians perspectives of parental decision-making following diagnosis of a severe congenital anomaly: a qualitative study
Conclusions The policy context in which these decisions are made strongly shapes how clinicians practise and what they want to see from the parents with whom they work. The ways in which they seek to overcome the difficulties in interpreting the law may result in variations in the offer of late TOP, both between and within units. This may inadvertently affect the options available to women least able to engage in this idealised form of decision-making. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Lotto, R., Smith, L. K., Armstrong, N. Tags: Open access, Reproductive medicine Research Source Type: research

Cross-sectional analysis of two social determinants of health in California cities: racial/ethnic and geographic disparities
Conclusions Disparities and inequities are widespread in California. Local health departments can use these findings to partner with cities in their jurisdiction and design strategies to reduce racial, ethnic and geographic differences in economic and educational outcomes. These analytic methods could be used in an ongoing surveillance system to monitor these determinants of health. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Bustamante-Zamora, D., Maizlish, N. Tags: Open access, Public health Research Source Type: research

Evidence for the effectiveness of minimum pricing of alcohol: a systematic review and assessment using the Bradford Hill criteria for causality
Conclusions Overall, the Bradford Hill criteria for causality were satisfied. There was very little evidence that minimum alcohol prices are not associated with consumption or subsequent harms. However the overall quality of the evidence was variable, a large proportion of the evidence base has been produced by a small number of research teams, and the quantitative uncertainty in many estimates or forecasts is often poorly communicated outside the academic literature. Nonetheless, price-based alcohol policy interventions such as MUP are likely to reduce alcohol consumption, alcohol-related morbidity and mortality. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Boniface, S., Scannell, J. W., Marlow, S. Tags: Open access, Addiction, Public health Research Source Type: research

A register-based 13-year to 43-year follow-up of 70 patients with obsessive-compulsive disorder treated with capsulotomy
Conclusions Malignant OCD has a poor long-term prognosis. Patients who are candidates for surgery should be informed that, while OCD symptoms may be ameliorated with surgery, they should not expect long-term freedom from medication and psychiatric care. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Rück, C., Larsson, J. K., Mataix-Cols, D., Ljung, R. Tags: Open access, Mental health Research Source Type: research

A content analysis of outdoor non-alcoholic beverage advertisements in Ghana
Conclusion This study demonstrates the frequency of outdoor SSB ads within a 4.7 km2 area of Accra, Ghana. Coca-Cola was featured in the majority of ads, and the child-targeted nature of some ads indicates a need to expand the Children’s Food and Beverage Advertising Initiative pledge to reduce child-targeted marketing on a global scale. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Bragg, M. A., Hardoby, T., Pandit, N. G., Raji, Y. R., Ogedegbe, G. Tags: Open access, Global health Research Source Type: research

Staffs and managers perceptions of how and when discrete event simulation modelling can be used as a decision support in quality improvement: a focus group discussion study at two hospital settings in Sweden
Conclusions Its potential as an information and communication tool and as an instrument for pedagogic work within healthcare improvement render a broader application and value of simulation modelling than previously reported. (Source: BMJ Open)
Source: BMJ Open - June 6, 2017 Category: General Medicine Authors: Hvitfeldt-Forsberg, H., Mazzocato, P., Glaser, D., Keller, C., Unbeck, M. Tags: Open access, Health services research Source Type: research