Correction
Rachiotis G, Stuckler D, McKee M, et al. What has happened to suicides during the Greek economic crisis? Findings from an ecological study of suicides and their determinants (2003–2012). BMJ Open 2015;5: e007295. doi: 10.1136/bmjopen-2014-007295 A funding statement was not included for author David Stuckler. The Funding statement should have included "DS is funded by ERC HRES 313590." (Source: BMJ Open)
Source: BMJ Open - March 9, 2017 Category: Journals (General) Tags: Open access Correction Source Type: research

Implementation of 'Goals of Patient Care medical treatment orders in residential aged care facilities: protocol for a randomised controlled trial
Introduction Systematic reviews demonstrate that advance care planning (ACP) has many positive effects for residents of aged care facilities, including decreased hospitalisation. The proposed Residential Aged Care Facility (RACF) ‘Goals of Patient Care’ (GOPC) form incorporates a resident's prior advance care plan into medical treatment orders. Where none exists, it captures residents' preferences. This documentation helps guide healthcare decisions made at times of acute clinical deterioration. Methods and analysis This is a mixed methods study. An unblinded cluster randomised controlled trial is proposed in ...
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Martin, R. S., Hayes, B. J., Hutchinson, A., Yates, P., Lim, W. K. Tags: Open access, Geriatric medicine, Health services research, Palliative care Protocol Source Type: research

Maternal education, empowerment, economic status and child polio vaccination uptake in Pakistan: a population based cross sectional study
Objectives To explore the association of maternal education and empowerment with childhood polio vaccination using nationally representative data of Pakistani mothers in a reproductive age group. Design Cross-sectional. Setting Secondary analysis of Pakistan Demographic and Health Survey (PDHS), 2012–2013 data was performed. Participants Of the 13 558 mothers included in the survey sample, 6982 mothers were able to provide information regarding polio vaccinations. Main outcome measures Polio vaccination coverage among children aged up to 5 years was categorised as complete vaccination (all four oral pol...
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Khan, M. T., Zaheer, S., Shafique, K. Tags: Open access, Epidemiology, Infectious diseases, Public health Research Source Type: research

Quality of clinical practice guidelines in delirium: a systematic appraisal
Conclusions Delirium guidelines are best sourced by a systematic grey literature search. Delirium guideline quality varied across all six AGREE II domains, demonstrating the importance of using a formal appraisal tool prior to guideline adaptation and implementation into clinical settings. Adding more knowledge translation resources to guidelines may improve their practical application and effective monitoring. More delirium guideline evaluation studies are needed to determine their effect on clinical practice. (Source: BMJ Open)
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Bush, S. H., Marchington, K. L., Agar, M., Davis, D. H. J., Sikora, L., Tsang, T. W. Y. Tags: Open access, Evidence based practice, Geriatric medicine, Intensive care, Palliative care Research Source Type: research

From breathless to failure: symptom onset and diagnostic meaning in patients with heart failure--a qualitative study
Objectives To explore 2 key points in the heart failure diagnostic pathway—symptom onset and diagnostic meaning—from the patient perspective. Design Qualitative interview study. Setting Participants were recruited from a secondary care clinic in central England following referral from primary care. Participants Over age 55 years with a recent (
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Taylor, C. J., Hobbs, F. D. R., Marshall, T., Leyva-Leon, F., Gale, N. Tags: Open access, Cardiovascular medicine, Diagnostics Research Source Type: research

Systematic literature review and network meta-analysis in highly active relapsing-remitting multiple sclerosis and rapidly evolving severe multiple sclerosis
Conclusions Data limitations are apparent when conducting an informative indirect comparison for the HA and RES RRMS subgroups as the subgroups analyses were retrospective analyses of studies powered to indicate differences across entire study populations. Comparisons across treatments in HA or RES RRMS will be associated with high levels of uncertainty until new data are collected for these subgroups. (Source: BMJ Open)
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Huisman, E., Papadimitropoulou, K., Jarrett, J., Bending, M., Firth, Z., Allen, F., Adlard, N. Tags: Open access, Health economics, Neurology, Pharmacology and therapeutics, Qualitative research Source Type: research

QUIT EMR trial: a prospective, observational, multicentre study to evaluate quality and 24 hours post-transport morbidity of interhospital transportation of critically ill patients: study protocol
Introduction It is widely accepted that transportation of critically ill patients is high risk. Unfortunately, however, there are currently no evidence-based criteria with which to determine the quality of various interhospital transport systems and their impact on the outcomes for patients. We aim to rectify this by assessing 2 scores which were developed in our hospital in a prospective, observational study. Primarily, we will be examining the Quality of interhospital critical care transportation in the Euregion Meuse-Rhine (QUIT EMR) score, which focuses on the quality of the transport system, and secondarily the SEMROS...
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Strauch, U., Bergmans, D. C. J. J., Habers, J., Jansen, J., Winkens, B., Veldman, D. J., Roekaerts, P. M. H. J., Beckers, S. K. Tags: Open access, Emergency medicine, Intensive care, Patient-centred medicine Protocol Source Type: research

Comparative effectiveness and safety of erythropoiesis-stimulating agents (biosimilars vs originators) in clinical practice: a population-based cohort study in Italy
Conclusions In both settings, our findings are suggestive of no difference between biosimilars and originators on relevant effectiveness and safety outcomes. This study may contribute to settling future drug policy for the health services and provides reassurance on the approval pathway for biosimilars. The oncology setting merits further research, taking into account tumour types, tumour stage and anticancer chemotherapy administered. (Source: BMJ Open)
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Trotta, F., Belleudi, V., Fusco, D., Amato, L., Mecozzi, A., Mayer, F., Sansone, M., Davoli, M., Addis, A. Tags: Open access, Epidemiology, Evidence based practice, Health services research, Pharmacology and therapeutics Source Type: research

Exploring stroke survivors' and physiotherapists' views of self-management after stroke: a qualitative study in the UK
Conclusions If self-management support approaches are to be used, further work is required to explore the language and strategies used by professionals to support self-management, and the barriers to supporting self-management at different time points after stroke. (Source: BMJ Open)
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Sadler, E., Wolfe, C. D. A., Jones, F., McKevitt, C. Tags: Open access, Health services research, Qualitative research Source Type: research

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing
Conclusions Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. Trial registration number NCT01425502. (Source: BMJ Open)
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Grant, A., Dreischulte, T., Guthrie, B. Tags: Open access, Evidence based practice, General practice / Family practice, Health informatics, Health services research, Qualitative research Source Type: research

Prevalence of latent TB infection and TB disease among adolescents in high TB burden countries in Africa: a systematic review protocol
Introduction Almost a third of the world population has latent tuberculosis (TB) infection (LTBI), ~10 million of whom develop TB disease annually, despite existence of effective, but lengthy, preventive and curative drug regimens. Although adolescents appear to have a very high force of LTBI, their reported incidence of TB disease is less than that of their corresponding general population. The few available studies on adolescent TB infection and disease prevalence are not sufficient to address the apparent discordance between rates of infection and disease in high TB burden countries in Africa. Therefore, we aim to perfo...
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Bunyasi, E. W., Schmidt, B.-M., Abdullahi, L. H., Mulenga, H., Tameris, M., Luabeya, A., Shenje, J., Scriba, T., Geldenhuys, H., Wood, R., Hatherill, M. Tags: Open access, Epidemiology, Evidence based practice, Global health, Infectious diseases, Public health, Research methods Protocol Source Type: research

Factors influencing young men's decision to undergo health screening in Malaysia: a qualitative study
Objectives Uptake of health screening is low in men, particularly among those aged
Source: BMJ Open - March 9, 2017 Category: Journals (General) Authors: Teo, C. H., Ng, C. J., White, A. Tags: Open access, Health services research, Public health, Qualitative research, Sociology Source Type: research

Increased household financial strain, the Great Recession and child health--findings from the UK Millennium Cohort Study
Conclusions FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the ‘Great Recession’, measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. (Source: BMJ Open)
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: McKenna, C., Law, C., Pearce, A. Tags: Open access, Epidemiology, Paediatrics, Public health Research Source Type: research

Simplified Mortality Score for the Intensive Care Unit (SMS-ICU): protocol for the development and validation of a bedside clinical prediction rule
Introduction Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU). Methods and analysis During the first phase of the study, we will develop and internally validate a clinical prediction ru...
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: Granholm, A., Perner, A., Krag, M., Hjortrup, P. B., Haase, N., Holst, L. B., Marker, S., Collet, M. O., Jensen, A. K. G., Moller, M. H. Tags: Open access, Intensive care Protocol Source Type: research

Facilitators and barriers to chlamydia testing in general practice for young people using a theoretical model (COM-B): a systematic review protocol
Introduction Chlamydia is a key health concern with high economic and social costs. There were over 200 000 chlamydia diagnoses made in England in 2015. The burden of chlamydia is greatest among young people where the highest prevalence rates are found. Annual testing for sexually active young people is recommended; however, many of those at risk do not receive testing. General practice has been identified as an ideal setting for testing, yet efforts to increase testing in this setting have not been effective. One theoretical model which may provide insight into the underpinnings of chlamydia testing is the Capability...
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: McDonagh, L. K., Saunders, J. M., Cassell, J., Bastaki, H., Hartney, T., Rait, G. Tags: Open access, General practice / Family practice, Health services research, Infectious diseases, Sexual health Protocol Source Type: research

Association between highly active antiretroviral therapy and selected cardiovascular disease risk factors in sub-Saharan Africa: a systematic review and meta-analysis protocol
Introduction The increasing highly active antiretroviral therapy (HAART) coverage in sub-Saharan Africa (SSA) has been associated with increasing cardiovascular disease (CVD) incidence. However, the epidemiology of the association between HAART and CVD risk factors in SSA is sparse. We aim to assess the extent to which HAART is associated with selected cardiovascular risk factors (hypertension, diabetes, dyslipidaemia and metabolic syndrome) in SSA. Methods and analysis This will be a systematic review and meta-analysis of published studies on the association between HAART and CVD risk factors retrieved from Medline, Emba...
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: Dimala, C. A., Blencowe, H. Tags: Open access, Cardiovascular medicine, Epidemiology, HIV AIDS Protocol Source Type: research

Incidence and relative risk for developing cancer among patients with COPD: a nationwide cohort study in Taiwan
Objectives This observational study aimed to examine the incidence of malignant diseases, including specific cancer types, after the diagnosis of chronic obstructive pulmonary disease (COPD) in Taiwanese patients. Setting Taiwan's National Health Insurance Research Database. Participants The definition of a patient with COPD was a patient with a discharge diagnosis of COPD or at least 3 ambulatory visits for COPD. The index date was the date of the first COPD diagnosis. Patients with a history of malignancy disorders before the index date were excluded. After matching age and gender, 13 289 patients with COPD and 26...
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: Ho, C.-H., Chen, Y.-C., Wang, J.-J., Liao, K.-M. Tags: Open access, Oncology, Respiratory medicine Research Source Type: research

What proportion of patients with psychosis is willing to take part in research? A mental health electronic case register analysis
Conclusions About two-thirds of patients with psychotic disorders were willing to be contacted about participation in research. The patients who were approached had better clinical outcomes than those who were not, suggesting that clinicians were more likely to approach patients who were less unwell. (Source: BMJ Open)
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: Patel, R., Oduola, S., Callard, F., Wykes, T., Broadbent, M., Stewart, R., Craig, T. K. J., McGuire, P. Tags: Open access, Epidemiology, Health informatics, Health services research, Mental health, Research methods Source Type: research

Multicentre randomised study of the effect and experience of an early inhome programme (PreHomeCare) for preterm infants using video consultation and smartphone applications compared with inhospital consultations: protocol of the PreHomeCare study
Introduction Although premature infants and their parents are discharged earlier to inhomecare programmes, how to optimally support parents during this transition remains unknown. The aim of this study is to compare the effects of early inhomecare (PreHomeCare) including video consultations and mobile applications with those of inhospital consultations regarding breast feeding, parental confidence and parent–infant interactions. Methods and analysis A randomised controlled intervention study will be conducted in four neonatal departments offering PreHomeCare (ie, premature infant inhomecare) in Denmark. Parents of h...
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: Hägi-Pedersen, M.-B., Norlyk, A., Dessau, R., Stanchev, H., Kronborg, H. Tags: Open access, Evidence based practice, Health services research, Nursing, Paediatrics, Qualitative research Protocol Source Type: research

Clinical characteristics associated with diagnostic delay of pulmonary embolism in primary care: a retrospective observational study
Conclusions Diagnostic delay of more than 7 days in the diagnosis of PE is common in primary care, especially in the elderly, and if chest symptoms, like pain on inspiration, are absent. (Source: BMJ Open)
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: Hendriksen, J. M. T., Koster-van Ree, M., Morgenstern, M. J., Oudega, R., Schutgens, R. E. G., Moons, K. G. M., Geersing, G.-J. Tags: Open access, Cardiovascular medicine, Diagnostics, Epidemiology, General practice / Family practice Research Source Type: research

Association of comorbidity and health service usage among patients with dementia in the UK: a population-based study
This study aimed to identify subgroups with higher healthcare needs, by analysing how primary care consultations, number of prescriptions and hospital admissions by people with dementia varies with having additional long-term diseases (comorbidity). Methods A retrospective cohort study based on health data from the Clinical Practice Research Datalink (CPRD) was conducted. Incident cases of dementia diagnosed in the year starting 1/3/2008 were selected and followed for up to 5 years. The number of comorbidities was obtained from a set of 34 chronic health conditions. Service usage (primary care consultations, hospital...
Source: BMJ Open - March 8, 2017 Category: Journals (General) Authors: Browne, J., Edwards, D. A., Rhodes, K. M., Brimicombe, D. J., Payne, R. A., Brayne, Wilson Tags: Open access, General practice / Family practice, Geriatric medicine, Health services research, Public health Source Type: research

Cohort analysis of outcomes in 69 490 emergency general surgical admissions across an international benchmarking collaborative
This study aims to use the Dr Foster Global Comparators Network (GC) database to examine differences in outcomes following high-risk emergency general surgery (EGS) admissions in participating centres across 3 countries and to determine whether hospital infrastructure factors can be linked to the delivery of high-quality care. Design A retrospective cohort analysis of high-risk EGS admissions using GC's international administrative data set. Setting 23 large hospitals in Australia, England and the USA. Methods Discharge data for a cohort of high-risk EGS patients were collated. Multilevel hierarchical logistic regressio...
Source: BMJ Open - March 7, 2017 Category: Journals (General) Authors: Chana, P., Joy, M., Casey, N., Chang, D., Burns, E. M., Arora, S., Darzi, A. W., Faiz, O. D., Peden, C. J. Tags: Open access, Global health, Health policy, Health services research, Surgery Source Type: research

Conjoint analysis to understand preferences of patients with multiple sclerosis for disease-modifying therapy attributes in Spain: a cross-sectional observational study
Conclusions Patient DMT preferences were mainly driven by risk minimisation, route of administration and treatment schedule. The risk–benefit spectrum of available DMT for MS is becoming increasingly complicated. Understanding which treatment characteristics are meaningful to patients may help to tailor information for them and facilitate shared decision-making in clinical practice. (Source: BMJ Open)
Source: BMJ Open - March 7, 2017 Category: Journals (General) Authors: Arroyo, R., Sempere, A. P., Ruiz-Beato, E., Prefasi, D., Carreno, A., Roset, M., Maurino, J. Tags: Open access, Neurology, Patient-centred medicine Research Source Type: research

Effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of cardiovascular disease: protocol for an overview of systematic reviews
The objective of this overview will be to assess the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD compared with standard care. Methods and analysis We will include SRs and meta-analyses which take into account RCTs and quasi-RCTs investigating the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD. SRs will be retrieved from 4 bibliographical databases and reference lists of identified reviews. Additionally, the PROSPERO database will be searched for unpublished, ongoing or recently completed SRs. 2 reviewers will asses...
Source: BMJ Open - March 7, 2017 Category: Journals (General) Authors: Studzinski, K., Tomasik, T., Krzyszton, J., Jozwiak, J., Windak, A. Tags: Open access, Cardiovascular medicine, General practice / Family practice Protocol Source Type: research

Pattern, correlates and implications of non-communicable disease multimorbidity among older adults in selected Indian states: a cross-sectional study
Conclusions Multimorbidity needs to be considered for planning NCD healthcare services provision particularly inpatient facilities focusing on alcohol users, tobacco users and women. Further studies are required to find out reasons for higher rates of multimorbidity among the wealthier group other than higher healthcare services usage and detection rates. (Source: BMJ Open)
Source: BMJ Open - March 7, 2017 Category: Journals (General) Authors: Mini, G. K., Thankappan, K. R. Tags: Open access, Epidemiology, Public health Research Source Type: research

Identifying opportunities for nature engagement in cancer care practice and design: protocol for four-round modified electronic Delphi
Introduction Opportunities to engage with nature have shown relevance in experiences of health and recovery of patients with cancer and are attracting interest in cancer care practice and design. Such healthcare innovations can widen the horizon of possible supportive care solutions but require deliberate and rigorous investigation to ensure responsible action is taken and wastage avoided. This protocol outlines a study designed to solicit knowledge from relevant experts drawn from a range of healthcare practitioners, management representatives, designers and researchers to explore levels of opinion consensus for determini...
Source: BMJ Open - March 7, 2017 Category: Journals (General) Authors: Blaschke, S., O'Callaghan, C. C., Schofield, P. Tags: Open access, Oncology, Qualitative research Protocol Source Type: research

Predicting AKI in emergency admissions: an external validation study of the acute kidney injury prediction score (APS)
Conclusions On external validation the APS on admission shows moderate discrimination and acceptable calibration to predict HA-AKI and may be useful as a severity marker when HA-AKI occurs. Harnessing linked data from primary care may be one way to achieve more accurate risk prediction. (Source: BMJ Open)
Source: BMJ Open - March 7, 2017 Category: Journals (General) Authors: Hodgson, L. E., Dimitrov, B. D., Roderick, P. J., Venn, R., Forni, L. G. Tags: Open access, Renal medicine, Research methods Source Type: research

MRI-based comparative study of different mild cognitive impairment subtypes: protocol for an observational case-control study
This study is designed to analyse neuroimages of brain in patients with VaMCI and aMCI using multimodality MRI (structural MRI (sMRI), functional MRI and diffusion tensor imaging (DTI)). Methods and analysis In this study, 80 participants diagnosed with aMCI, 80 participants diagnosed with VaMCI, and 80 age-matched, gender-matched and education-matched normal controls (NCs) will be recruited to the Hongqi Hospital of Mudanjiang Medical University, Heilongjiang, China. All participants will undergo neuroimaging and neuropsychological evaluations. The primary outcome measures will be (1) microstructural alterations revealed...
Source: BMJ Open - March 7, 2017 Category: Journals (General) Authors: Yu, Y., Zhao, W., Li, S., Yin, C. Tags: Open access, Neurology Protocol Source Type: research

Association between perceived weight discrimination and physical activity: a population-based study among English middle-aged and older adults
Conclusions Independent of BMI, individuals who perceive unfair treatment on the basis of their weight are less physically active than those who do not perceive discrimination. This has important implications for the health and well-being of individuals who experience weight-based discrimination, and may also contribute to a cycle of weight gain and further mistreatment. (Source: BMJ Open)
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Jackson, S. E., Steptoe, A. Tags: Open access, Epidemiology, Nutrition and metabolism, Public health Research Source Type: research

Correction
Dudley L, Kettle C, Thomas PW, et al. Perineal resuturing versus expectant management following vaginal delivery complicated by a dehisced wound (PREVIEW): a pilot and feasibility randomised controlled trial. BMJ Open 2017;7:e012766. doi:10.1136/bmjopen-2016-012766 The superscript "3" should not be next to author Lynn Dudley as this is not one of their affiliations. (Source: BMJ Open)
Source: BMJ Open - March 6, 2017 Category: Journals (General) Tags: Open access Correction Source Type: research

Qualitative analysis of young adult ENDS users' expectations and experiences
Conclusions Participants used ENDS to construct rituals that recreated or replaced smoking attributes, and that varied in the emphasis given to device appearance, nicotine delivery, and social performance. Identifying how ENDS users create new rituals and the components they privilege within these could help promote full transition from smoking to ENDS and identify those at greatest risk of dual use or relapse to cigarette smoking. (Source: BMJ Open)
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Hoek, J., Thrul, J., Ling, P. Tags: Open access, Public health, Qualitative research, Smoking and tobacco Source Type: research

Labouring Together: collaborative alliances in maternity care in Victoria, Australia--protocol of a mixed-methods study
Introduction For over a decade, enquiries into adverse perinatal outcomes have led to reports that poor collaboration has been detrimental to the safety and experience of maternity care. Despite efforts to improve collaboration, investigations into maternity care at Morecambe Bay (UK) and Djerriwarrh Health Services (Australia) have revealed that poor collaboration and decision-making remain a threat to perinatal safety. The Labouring Together study will investigate how elements hypothesised to influence the effectiveness of collaboration are reflected in perceptions and experiences of clinicians and childbearing women in ...
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Watkins, V., Nagle, C., Kent, B., Hutchinson, A. M. Tags: Open access, Health services research, Patient-centred medicine, Qualitative research, Obgyn Protocol Source Type: research

A preconsultation web-based tool to generate an agenda for discussion in diabetes outpatient clinics to improve patient outcomes (DIAT): a feasibility study
Conclusions A randomised controlled trial of the preconsultation web-based intervention as set out in our current protocol is not feasible without significant modification to improve recruitment and follow-up of participants. The study also provides insights into the feasibility and challenges of conducting complex intervention trials in everyday clinical practice. Trial registration ISRCTN75070242. (Source: BMJ Open)
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Ukoumunne, O. C., Vaidya, B., Frost, J., Anderson, R., Argyle, C., Daly, M., Harris-Golesworthy, F., Harris, J., Gibson, A., Ingram, W., Pinkney, J., Vickery, J., Britten, N. Tags: Open access, Patient-centred medicine, Diabetes and Endocrinology Research Source Type: research

Does household access to improved water and sanitation in infancy and childhood predict better vocabulary test performance in Ethiopian, Indian, Peruvian and Vietnamese cohort studies?
Conclusions Access to ‘improved’ water and toilets had independent associations with children's PPVT scores that often persisted with adjustment for covariates. Our findings suggest that effects of W&S may go beyond subacute and acute infections and physical growth to include children's language performance, a critical component of cognitive development. (Source: BMJ Open)
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Dearden, K. A., Brennan, A. T., Behrman, J. R., Schott, W., Crookston, B. T., Humphries, D. L., Penny, M. E., Fernald, L. C. H., on behalf of the Young Lives Determinants and Consequences of Child Growth Project Team Tags: Open access, Global health, Nutrition and metabolism, Public health Research Source Type: research

Statin prescribing for people with severe mental illnesses: a staggered cohort study of 'real-world impacts
Conclusions We found that statin prescribing to people with SMI in UK primary care was effective for lipid modification but not CVD events. The latter finding may reflect insufficient power to detect a smaller effect size than that observed in randomised controlled trials of statins in people without SMI. (Source: BMJ Open)
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Blackburn, R., Osborn, D., Walters, K., Falcaro, M., Nazareth, I., Petersen, I. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Mental health Research Source Type: research

Understanding clinician influences and patient perspectives on outpatient discharge decisions: a qualitative study
Conclusions This study highlights the importance of accurately perceiving patients' perspectives in ensuring the appropriateness of outpatient discharge. There was a disparity between patients' and clinicians' perception on what was an appropriate discharge. This included discrepancies concerning diagnostic certainties, private healthcare as an alternative, need for easy reaccess and choice of words surrounding discharge. Medical education should include handling these issues. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Harun, N. A., Finlay, A. Y., Piguet, V., Salek, S. Tags: Open access, Dermatology, Patient-centred medicine Research Source Type: research

Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: a protocol for a systematic review and meta-analysis of randomised controlled trials
Introduction While anxiety is a major public health problem in adults with arthritis and other rheumatic diseases (AORD), the effects of exercise on anxiety in adults are not well established despite numerous studies on this topic. The purpose of this study is to conduct a systematic review with an aggregate data meta-analysis to determine the effects of community-deliverable exercise interventions (aerobic, strength training or both) on anxiety in adults with AORD. Methods and analysis Randomised controlled exercise intervention trials ≥4 weeks and published in any language up to 31 December 2016 will be included...
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Kelley, G. A., Kelley, K. S., Callahan, L. F. Tags: Open access, Evidence based practice, Sports and exercise medicine Protocol Source Type: research

Impact of gender on event rates at 1 year in patients with newly diagnosed non-valvular atrial fibrillation: contemporary perspective from the GARFIELD-AF registry
Conclusions Women have a higher risk of stroke/SE and the reduction in stroke/SE events rates with AC treatment is less in women than in men. Trial registration number NCT01090362. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Camm, A. J., Accetta, G., Al Mahmeed, W., Ambrosio, G., Goldhaber, S. Z., Haas, S., Jansky, P., Kayani, G., Misselwitz, F., Oh, S., Oto, A., Raatikainen, P., Steffel, J., van Eickels, M., Kakkar, A. K., for the GARFIELD-AF Investigators Tags: Open access, Cardiovascular medicine Research Source Type: research

Retrospective review of Surgical Availability and Readiness in 8 African countries
Conclusions There are important gaps in the surgical services in the 8 African countries surveyed. Efforts are therefore urgently needed to address deficiencies in the availability and readiness to deliver surgical services in these nations, and this will require commitment from multiple stakeholders. SARA may be used to monitor availability and readiness at regular intervals, which will enable stakeholders to evaluate progress and identify gaps and areas for improvement. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Spiegel, D. A., Droti, B., Relan, P., Hobson, S., Cherian, M. N., O'Neill, K. Tags: Open access, Global health, Surgery Research Source Type: research

Head-to-head comparison of procalcitonin and presepsin for the diagnosis of sepsis in critically ill adult patients: a protocol for a systematic review and meta-analysis
Introduction Early diagnosis and immediate therapeutic intervention, including appropriate antibiotic therapy and goal-directed resuscitation, are necessary to reduce mortality in patients with sepsis. However, a single clinical or biological marker indicative of sepsis has not been adopted unanimously. Although procalcitonin and presepsin are promising biomarkers that can effectively differentiate between sepsis/infection and systemic inflammatory response syndrome of non-infectious origin, little is known about which marker is superior. Methods and analysis We will conduct a systematic review and meta-analysis of procal...
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Hayashida, K., Kondo, Y., Hara, Y., Aihara, M., Yamakawa, K. Tags: Open access, Diagnostics, Infectious diseases, Intensive care Protocol Source Type: research

Diagnosing malignant melanoma in ambulatory care: a systematic review of clinical prediction rules
Conclusions At their recommended cut-points, the ABCD dermoscopy rule is more useful for ruling out melanoma than the 7-point dermoscopy checklist. A focus on impact analysis will help translate melanoma risk prediction rules into useful tools for clinical practice. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Harrington, E., Clyne, B., Wesseling, N., Sandhu, H., Armstrong, L., Bennett, H., Fahey, T. Tags: Open access, Dermatology, Evidence based practice, General practice / Family practice Research Source Type: research

Translation of the international outcome inventory for hearing aids into Portuguese from Portugal
Conclusions In the present study a valid and reliable translation and adaptation of the IOI-HA into Portuguese from Portugal is proposed. This tool will be available for clinical assessment of hearing aid users. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Paiva, S. M. M., Simoes, J. F. C. P. M., Paiva, A. M. D., Sousa, F. J. F. C. e., Bebear, J.-P. Tags: Open access, Diagnostics, Ear, nose and throat/otolaryngology, Geriatric medicine Research Source Type: research

Potential determinants of vitamin D in Finnish adults: a cross-sectional study from the Northern Finland birth cohort 1966
Conclusions We demonstrate some differential associations of environmental and lifestyle factors with 25(OH)D2 and 25(OH)D3 raising important questions related to personalised healthcare. Future strategies could implement lifestyle modification and supplementation to improve vitamin D2 and D3 status, accounting for seasonal, lifestyle, metabolic and endocrine status. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Palaniswamy, S., Hyppönen, E., Williams, D. M., Jokelainen, J., Lowry, E., Keinänen-Kiukaanniemi, S., Herzig, K.-H., Järvelin, M.-R., Sebert, S. Tags: Open access, Epidemiology, Public health Research Source Type: research

Effects of school breaks on influenza-like illness incidence in a temperate Chinese region: an ecological study from 2008 to 2015
Objective To assess the effects of winter/summer school breaks on occurrences of influenza-like illness (ILI). Methods We jointly analysed ILI surveillance data with the timing of school breaks in a temperate district in Beijing, China from 2008 to 2015. ILI incidence rate ratios (IRRs) of schoolchildren (5–14 and 15–24 years of age) to adults (25–59 and>60 years of age) were used to measure the age shift of ILI incidence before, during and after the 4-week winter/7-week summer breaks. Serfling-based Poisson regression model with adjustment for unmeasured confounders was built to further ass...
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Chu, Y., Wu, Z., Ji, J., Sun, J., Sun, X., Qin, G., Qin, J., Xiao, Z., Ren, J., Qin, D., Zheng, X., Wang, X.-L. Tags: Open access, Epidemiology, Infectious diseases, Public health Research Source Type: research

Computer-determined dosage of insulin in the management of neonatal hyperglycaemia (HINT2): protocol of a randomised controlled trial
Introduction Neonatal hyperglycaemia is frequently treated with insulin, which may increase the risk of hypoglycaemia. Computer-determined dosage of insulin (CDD) with the STAR-GRYPHON program uses a computer model to predict an effective dose of insulin to treat hyperglycaemia while minimising the risk of hypoglycaemia. However, CDD models can require more frequent blood glucose testing than common clinical protocols. The aim of this trial is to determine if CDD using STAR-GRYPHON reduces hypoglycaemia in hyperglycaemic preterm babies treated with insulin independent of the frequency of blood glucose testing. Methods and...
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Alsweiler, J., Williamson, K., Bloomfield, F., Chase, G., Harding, J. Tags: Open access, Intensive care, Paediatrics Protocol Source Type: research

Influence of psychological factors on the prognosis of chronic shoulder pain: protocol for a prospective cohort study
Introduction Shoulder pain is a highly prevalent condition. Psychological factors could play an essential role in the prognosis of chronic shoulder pain (CSP). The aims of the study will be to analyse the level of association between psychological factors and pain-disability at baseline and prospectively to assess their prognostic role; to evaluate the association of pain catastrophising and kinesiophobia at baseline and prospectively in the relationship between pain intensity and disability, or between self-efficacy and disability in patients with CSP; to explore the association of self-efficacy at baseline and prospectiv...
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Martinez-Calderon, J., Struyf, F., Meeus, M., Morales-Ascencio, J. M., Luque-Suarez, A. Tags: Open access, Epidemiology, Rehabilitation medicine Protocol Source Type: research

Cost-effectiveness analysis of an 18-week exercise programme for patients with breast and colon cancer undergoing adjuvant chemotherapy: the randomised PACT study
Conclusions Our results suggest that the 18-week exercise programme was cost-effective for colon cancer, but not for breast cancer. Trial registration number ISRCTN43801571. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: May, A. M., Bosch, M. J. C., Velthuis, M. J., van der Wall, E., Steins Bisschop, C. N., Los, M., Erdkamp, F., Bloemendal, H. J., de Roos, M. A. J., Verhaar, M., ten Bokkel Huinink, D., Peeters, P. H. M., de Wit, G. A. Tags: Open access, Health services research, Oncology, Rehabilitation medicine Source Type: research

Changing trends in reproductive/lifestyle factors in UK women: descriptive study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)
Conclusions The trends seen in this large cohort are likely to reflect the reproductive history of the UK female postmenopausal population of similar age. Since these are risk factors for hormone-related cancers, these trends are important in understanding the changing incidence of these cancers. Trial registration number International Standard Randomised Controlled Trial Number: 22488978. (Source: BMJ Open)
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Gentry-Maharaj, A., Glazer, C., Burnell, M., Ryan, A., Berry, H., Kalsi, J., Woolas, R., Skates, S. J., Campbell, S., Parmar, M., Jacobs, I., Menon, U. Tags: Open access, Epidemiology, Obgyn Research Source Type: research

025 pp: "a fresh set of eyes?" negotiating the realities of embedded research in public health
We describe the assumptions underpinning the approach, how collaborative relationships were established, and what they meant. We reflect on the ways in which this research design, data interpretation and reporting were affected. Examples are used to highlight the challenges and opportunities of a University and Local Authority collaborating in this way. We review what we have learned about collaboration, with a view to sharing transferable messages. The aim is to explore the effectiveness of embedded research, and prompt debate about the pros and cons of collaborating in this way, drawing on our experiences. (Source: BMJ Open)
Source: BMJ Open - March 3, 2017 Category: Journals (General) Authors: Cheetham, M., Wiseman, A., Gibson, E., Khazaeli, B., Graaf, P. V. d., Rushmer, R. Tags: Open access Theorising and Reflecting on Collaboration Source Type: research

024 pp: meaningful and engaging, or tokenistic? reflections on collaborative engagement in the process of designing sexual health interventions
Working with non-academic partners and including participants, and other stakeholders, in the design and delivery of research is emerging as a critical element in the field of health research. As researchers based in an interdisciplinary team with a focus on the development of sexual health interventions, we have long recognised that engagement with individuals and communities is a critical part of the research process, and actively sought out opportunities to collaborate with non-academic partners with a view to ensuring that our work is relevant in the ‘real-world’. While the increasing call for ‘collab...
Source: BMJ Open - March 3, 2017 Category: Journals (General) Authors: Boydell, N., McDaid, L. Tags: Open access Theorising and Reflecting on Collaboration Source Type: research