The impact of temperature extremes on mortality: a time-series study in Jinan, China
Conclusions Both cold spells and heat waves have increased the risk of death in Jinan, China. (Source: BMJ Open)
Source: BMJ Open - May 2, 2017 Category: Journals (General) Authors: Han, J., Liu, S., Zhang, J., Zhou, L., Fang, Q., Zhang, J., Zhang, Y. Tags: Research Source Type: research

Effects of different amounts of exercise on preventing depressive symptoms in community-dwelling older adults: a prospective cohort study in Taiwan
Conclusion Consistent exercise with at least 15 min per time, three times a week of moderate intensity is significantly associated with lower risk of depressive symptoms. This low amount of exercise may be easier to promote at the community and population level than other alternatives. Trial registration Registry number 104040 of the Institutional Ethics Committee of Chia-Yi Christian Hospital. (Source: BMJ Open)
Source: BMJ Open - May 2, 2017 Category: Journals (General) Authors: Chang, Y.-C., Lu, M.-C., Hu, I.-H., Wu, W.-C. I., Hu, S. C. Tags: Research Source Type: research

Invasive meningococcal disease in the Veneto region of Italy: a capture-recapture analysis for assessing the effectiveness of an integrated surveillance system
This study aimed to analyse the cases reported in institutional data recording systems to estimate the burden of invasive meningococcal diseases (IMDs) and assess the effectiveness of surveillance in Veneto region (Italy). Methods Analysis was performed from 2007 to 2014 on data recorded in different systems: Mandatory Notification System, National Surveillance of Invasive Bacterial Diseases System and Laboratories Surveillance System (LSS), which were pooled into a combined surveillance system (CSS) and hospital discharge records (HDRs). A capture-recapture method was used and completeness of each source estimated. Numbe...
Source: BMJ Open - May 2, 2017 Category: Journals (General) Authors: Baldovin, T., Lazzari, R., Cocchio, S., Furlan, P., Bertoncello, C., Saia, M., Russo, F., Baldo, V. Tags: Open access, Epidemiology Research Source Type: research

High adherence to the 'Wise List treatment recommendations in Stockholm: a 15-year retrospective review of a multifaceted approach promoting rational use of medicines
Conclusions High and increasing adherence to the Wise List recommendations was seen for all prescriber categories. The transparent process for developing recommendations involving respected experts and clinicians using strict criteria for handling potential conflicts of interests, feedback to prescribers, continuous medical education and financial incentives are possible contributing factors. High-quality evidence-based recommendations to prescribers, such as the Wise List, disseminated through a multifaceted approach, will become increasingly important and should be developed further to include recommendations and introdu...
Source: BMJ Open - May 2, 2017 Category: Journals (General) Authors: Eriksen, J., Gustafsson, L. L., Ateva, K., Bastholm-Rahmner, P., Ovesjö, M.-L., Jirlow, M., Juhasz-Haverinen, M., Lärfars, G., Malmström, R. E., Wettermark, B., Andersen-Karlsson, E., Alsaody, Aspelin, Barany, Beitner, Bratt, Brism Tags: Open access, Evidence based practice, Health economics, Health policy, Health services research, Pharmacology and therapeutics Source Type: research

Essential components of integrated care for youth with mental health and addiction needs: protocol for a scoping review
The objectives of this scoping review are to: (1) identify the populations, settings, service providers, interventions, infrastructure and care coordination methods that have been included in integrated care for youth with mental health and/or addiction needs and (2) identify constructs that have been measured and evaluated (eg, outcomes, engagement) in the context of youth integrated care. Methods and analysis Seven electronic databases and several grey literature sources will be searched for material from 2001 to 2016. Inclusion criteria will be broad with respect to type of work, as we will include all types of researc...
Source: BMJ Open - April 28, 2017 Category: Journals (General) Authors: Settipani, C. A., Cleverley, K., Hawke, L. D., Rice, M., Henderson, J. L. Tags: Protocol Source Type: research

What is the difference between comprehensive and selective primary health care? Evidence from a five-year longitudinal realist case study in South Australia
Conclusion The study demonstrates the difference between selective and comprehensive approaches to PHC in a rich country setting and is useful in informing debates on PHC especially in the context of the Sustainable Development Goals. (Source: BMJ Open)
Source: BMJ Open - April 28, 2017 Category: Journals (General) Authors: Baum, F., Freeman, T., Lawless, A., Labonte, R., Sanders, D. Tags: Research Source Type: research

Accuracy of testing for anti-Helicobacter pylori IgG in urine for H. pylori infection diagnosis: a systematic review and meta-analysis
Conclusions Anti-H. pylori antibody in urine might serve as a good marker in diagnosing H. pylori infection. However, further validation based on a larger sample is still required. (Source: BMJ Open)
Source: BMJ Open - April 28, 2017 Category: Journals (General) Authors: Gong, Y., Li, Q., Yuan, Y. Tags: Research Source Type: research

Barriers to evidence-based acute stroke care in Ghana: a qualitative study on the perspectives of stroke care professionals
Conclusion Barriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes. (Source: BMJ Open)
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Baatiema, L., de-Graft Aikins, A., Sav, A., Mnatzaganian, G., Chan, C. K. Y., Somerset, S. Tags: Research Source Type: research

Quality of reporting in abstracts of RCTs published in emergency medicine journals: a protocol for a systematic survey of the literature
Introduction The quality of reporting of abstracts of randomised controlled trials (RCTs) in major general medical journals and in some category-specific journals was shown to be poor before the publication of the ConsolidatedStandards of ReportingTrials (CONSORT) extension for abstracts in 2008, and an improvement in the quality of reporting of abstracts was observed after its publication. The effect of the publication of the CONSORT extension for abstracts on the quality of reporting of RCTs in emergency medicine journals has not been studied. In this paper, we present the protocol of a systematic survey of the literatur...
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Germini, F., Marcucci, M., Fedele, M., Galli, M. G., Mbuagbaw, L., Salvatori, V., Veronese, G., Worster, A., Thabane, L. Tags: Protocol Source Type: research

Improving teaching about medically unexplained symptoms for newly qualified doctors in the UK: findings from a questionnaire survey and expert workshop
Conclusions There is an urgent need to improve foundation level training about MUS, as current provision is very limited. An interactive approach covering a range of topics is recommended, but must be delivered within a realistic time frame for the curriculum. (Source: BMJ Open)
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Yon, K., Habermann, S., Rosenthal, J., Walters, K. R., Nettleton, S., Warner, A., Lamahewa, K., Buszewicz, M. Tags: Research Source Type: research

Immunisation coverage of children in the child welfare system: a systematic review protocol
Introduction Children may be placed in the care of the child welfare system when they require additional supports or intervention to ensure their safety and security. Transitions in living arrangements (eg, home to foster care and return to home) and other difficult circumstances for these children may result in interruptions in routine preventive healthcare, such as childhood immunisations. The purpose of this systematic literature review is to determine whether immunisation coverage is a problem among children in the child welfare system and identify any known supports and/or barriers to vaccine uptake in this population...
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Hermann, J. S., Featherstone, R. M., Russell, M. L., MacDonald, S. E. Tags: Protocol Source Type: research

Positive percentages of urine morphine tests among methadone maintenance treatment clients with HIV/AIDS: a 12-month follow-up study in Guangdong Province, China
In this study, we reviewed 293 clients with opioid dependence, who were HIV seropositive, 18 years or older, provided informed consent and had at least 10 records of urine morphine tests during the study period. Primary and secondary outcome measures The positive percentages of urine morphine tests were calculated and underlying predictors were estimated. Results The highest positive percentage (95.9%) was observed in the first month. After excluding the highest percentage in the first month, the average positive percentage was 40.9% for month 2 to month 12. Positive percentages of urine morphine tests that were 80% were...
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Luo, X., Gong, X., Zhao, P., Zou, X., Chen, W., Ling, L. Tags: Research Source Type: research

What does patient feedback reveal about the NHS? A mixed methods study of comments posted to the NHS Choices online service
Conclusions Although technical competence constitutes an undoubtedly fundamental aspect of healthcare provision, staff members were much more likely to be evaluated both positively and negatively according to their interpersonal skills. Therefore, the findings reported in this study highlight the salience of such ‘soft’ skills to patients and emphasise the need for these to be focused upon and developed in staff training programmes, as well as ensuring that decisions around NHS funding do not result in demotivated and rushed staff. The findings also reveal a significant overlap between the four key themes in th...
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Brookes, G., Baker, P. Tags: Research Source Type: research

Can care staff accurately assess health-related quality of life of care home residents? A secondary analysis of data from the OPERA trial
Conclusions Care home residents and staff appear to differ fundamentally in their assessment of the health-related quality of life, as measured by the EQ-5D, of residents with different levels of depression, pain and/or cognitive impairment. This could lead to interventions evaluated using proxy-based quality-adjusted life year estimates being wrongly rejected on cost-effectiveness grounds and may also make it difficult for carers to act as advocates with health and social care professionals for certain groups of residents. A more resident-focussed approach to assessment of health-related quality of life is needed. (Source: BMJ Open)
Source: BMJ Open - April 27, 2017 Category: Journals (General) Authors: Parker, B., Petrou, S., Underwood, M., Madan, J. Tags: Open access, Health economics, Research methods Source Type: research

Quitting patient care and career break intentions among general practitioners in South West England: findings of a census survey of general practitioners
Conclusions A substantial majority of GPs in South West England report low morale. Many are considering career intentions which, if implemented, would adversely impact GP workforce capacity within a short time period. Study registration NIHR HS&DR - 14/196/02, UKCRN ID 20700. (Source: BMJ Open)
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Fletcher, E., Abel, G. A., Anderson, R., Richards, S. H., Salisbury, C., Dean, S. G., Sansom, A., Warren, F. C., Campbell, J. L. Tags: Open access Research Source Type: research

The value of different aspects of person-centred care: a series of discrete choice experiments in people with long-term conditions
Conclusion This is the first study to measure the value patients place on different aspects of person-centred care. Professional training needs to emphasise the substance of clinical communication—working responsively with individuals on what matters to them—as well as the style of its delivery. (Source: BMJ Open)
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Burton, C. D., Entwistle, V. A., Elliott, A. M., Krucien, N., Porteous, T., Ryan, M. Tags: 1722 Source Type: research

Impact of different dietary approaches on blood pressure in hypertensive and prehypertensive patients: protocol for a systematic review and network meta-analysis
Introduction Lifestyle modification is one of the cornerstones in the management of hypertension. According to the most recent guidelines by the American Heart Association, all patients with hypertension should adopt the following dietary advices: increased consumption of fresh fruits, vegetables, low-fat dairy products and sodium reduction. The aim of the present study is to assess the efficacy of different dietary approaches on systolic and diastolic blood pressure in patients with hypertension and high normal blood pressure in a systematic review including a pairwise and network meta-analysis of randomised trials. Meth...
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Schwingshackl, L., Chaimani, A., Hoffmann, G., Schwedhelm, C., Boeing, H. Tags: Protocol Source Type: research

Effectiveness of befriending interventions: a systematic review and meta-analysis
Conclusions There was moderate quality evidence to support the use of befriending for the treatment of individuals with different physical and mental health conditions. This evidence refers to an overall improvement benefit in patient-reported primary outcomes, although with a rather small effect size. The current evidence base does not allow for firm conclusions on more specific outcomes. Future trials should hypothesise a model for the precise effects of befriending and use specified inclusion and outcome criteria. (Source: BMJ Open)
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Siette, J., Cassidy, M., Priebe, S. Tags: Research Source Type: research

Experiences, attitudes and possibilities for improvement concerning the cooperation between occupational physicians, rehabilitation physicians and general practitioners in Germany from the perspectives of the medical groups and rehabilitation patients - a protocol for a qualitative study
Introduction Rehabilitation measures for patients in the working age primarily aim at maintaining employability, restoring fitness for work or timely return to work (RTW). To facilitate RTW after long sick leave in Germany, both rehabilitation physicians' knowledge about the patients' workplace and communication between the rehabilitation physician and the occupational physician need to be improved. This research will record the experiences and attitudes of occupational physicians, rehabilitation physicians and general practitioners, as well as of rehabilitation patients, to indicate barriers and possibilities for improvem...
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Voelter-Mahlknecht, S., Stratil, J. M., Kaluscha, R., Krischak, G., Rieger, M. A. Tags: Open access, Health services research, Occupational and environmental medicine, Qualitative research, Rehabilitation medicine Protocol Source Type: research

Evaluation of the COPING parent online universal programme: study protocol for a pilot randomised controlled trial
Trial sponsor Bangor University, Brigantia Building, College Road, Bangor, LL57 2AS, UK Introduction The COPING parent online universal programme is a web-based parenting intervention for parents of children aged 3-8 years with an interest in positive parenting. The programme focuses on strengthening parent-child relationships and encouraging positive child behaviour. This trial will evaluate whether the intervention is effective in increasing the use of positive parenting strategies outlined in the programme using parent report and blind observation measures. Methods and analysis This is a pilot randomised controlled tr...
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Owen, D. A., Griffith, N., Hutchings, J. Tags: 1326 Source Type: research

Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers
Introduction In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Methods and analysis Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment ...
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Leece, P., Buchman, D. Z., Hamilton, M., Timmings, C., Shantharam, Y., Moore, J., Furlan, A. D., on behalf of the Safer Prescribing of Opioids (SPO) Investigators Tags: Protocol Source Type: research

Comparison of Ticagrelor Pharmacokinetics and Pharmacodynamics in STEMI and NSTEMI Patients (PINPOINT): protocol for a prospective, observational, single-centre study
Introduction The most common classification of acute myocardial infarction (AMI) is based on electrocardiographic findings and distinguishes ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Both types of AMI differ concerning their epidemiology, clinical approach and early outcomes. Ticagrelor is a P2Y12 receptor inhibitor, constituting the first-line treatment for STEMI and NSTEMI. According to available data, STEMI may be associated with lower plasma concentration of ticagrelor in the first hours of AMI, but currently there are no studies directly comparing ticagrelor pharma...
Source: BMJ Open - April 26, 2017 Category: Journals (General) Authors: Adamski, P., Ostrowska, M., Sikora, J., Obonska, K., Buszko, K., Krintus, M., Sypniewska, G., Marszałł, M. P., Kozinski, M., Kubica, J. Tags: Open access, Cardiovascular medicine, Pharmacology and therapeutics Protocol Source Type: research

Multicentre, non-interventional study to assess the profile of patients with uncontrolled rhinitis prescribed a novel formulation of azelastine hydrochloride and fluticasone propionate in a single spray in routine clinical practice in the UK
Conclusions In the UK, MP-AzeFlu was prescribed for individuals (≥12 years) with moderate/severe AR irrespective of (1) previous AR treatment (mono or multiple), (2) previous or likely treatment failure, (3) phenotype, (4) number of previous physician visits for AR and (5) for the relief of both acute symptoms and in anticipation of allergen exposure. (Source: BMJ Open)
Source: BMJ Open - April 24, 2017 Category: Journals (General) Authors: Scadding, G., Price, D., El-Shanawany, T., Ahmed, S., Ray, J., Sargur, R., Kumar, N. Tags: Open access, Ear, nose and throat/otolaryngology, Epidemiology, Respiratory medicine Research Source Type: research

Association between exposure in the cement production industry and non-malignant respiratory effects: a systematic review
Conclusions Lack of power, adjustment for possible confounders and other methodological issues are limitations of many of the included studies. Hence, no firm conclusions can be drawn. There are few longitudinal data, but recent studies report a dose–response relationship between cement production dust exposure and declining lung function indicating a causal relationship, and underlining the need to reduce exposure among workers in this industry. (Source: BMJ Open)
Source: BMJ Open - April 24, 2017 Category: Journals (General) Authors: Fell, A. K. M., Nordby, K. C. Tags: Open access, Epidemiology, Occupational and environmental medicine, Respiratory medicine Research Source Type: research

Correction
Cohen RV, Pereira TV, Aboud CM on behalf of MOMS Study Investigators, et al. Microvascular Outcomes after Metabolic Surgery (MOMS) in patients with type 2 diabetes mellitus and class I obesity: rationale and design for a randomised controlled trial. BMJ Open 2017;7:e013574. doi: 10.1136/bmjopen-2016-013574 The author Carel le Roux should be listed as Carel W le Roux. His ORCID number is 0000000155215445. (Source: BMJ Open)
Source: BMJ Open - April 22, 2017 Category: Journals (General) Tags: 1506 Source Type: research

Correction
Selinheimo S, Vuokko A, Sainio M, et al. Comparing cognitive-behavioural psychotherapy and psychoeducation for non-specific symptoms associated with indoor air: a randomised control trial protocol. BMJ Open 2016;6:e011003. doi:10.1136/bmjopen-2015-011003 Some Competing interests were missed out of the original publication. The full Competing interests sections should read: Competing interests All authors have completed the ICMJE uniform disclosure at www.icmje.org/coi_disclosure.pdf and declare: Financial support for the submitted work from The Finnish Work Environment Fund (ref 113076) and the Social Insurance Instit...
Source: BMJ Open - April 22, 2017 Category: Journals (General) Tags: 1506 Source Type: research

Correction
Hamilton I, Milner J, Chalabi Z, et al. Health effects of home energy efficiency interventions in England: a modelling study. BMJ Open 2015;5:e007298. doi: 10.1136/bmjopen-2014-007298 Some text was missed out of the Acknowledgements in the original paper. The full Acknowledgement statement should read: Acknowledgements The following persons were involved in the initial 2009 ‘Health impact of energy efficiency’ DECC funded project—LSHTM: Hutchinson E; Sheffield Hallam University: Wilson I, Green G, Gilbertson J, Stafford B; Warwick University: Ormandy D; Ulster University: Liddell C, Morris C; UCL: Ian Rid...
Source: BMJ Open - April 22, 2017 Category: Journals (General) Tags: 1506 Source Type: research

A realist review to explore how low-income pregnant women use food vouchers from the UKs Healthy Start programme
Conclusions This realist review suggests that some low-income pregnant women may use Healthy Start vouchers to increase their consumption of fruits and vegetables and plain cow’s milk, whereas others may use them to reduce food expenditure and save money for other things. (Source: BMJ Open)
Source: BMJ Open - April 21, 2017 Category: Journals (General) Authors: Ohly, H., Crossland, N., Dykes, F., Lowe, N., Hall-Moran, V. Tags: 1724 Source Type: research

The prevalence of acne in Mainland China: a systematic review and meta-analysis
Conclusions In Mainland China, primary and secondary students exhibited higher prevalence rates than undergraduate students; males had higher prevalence rates of acne than females; and the prevalence rates of acne in Southern China was higher than Northern China. (Source: BMJ Open)
Source: BMJ Open - April 20, 2017 Category: Journals (General) Authors: Li, D., Chen, Q., Liu, Y., Liu, T., Tang, W., Li, S. Tags: 1583 Source Type: research

Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia
This study was approved by the Institutional Review Boards at the Harvard T.H. Chan School of Public Health in Boston, USA and ERES Converge in Lusaka, Zambia. The findings of this trial will be presented at local, regional and international meetings and submitted to peer-reviewed journals for publication. Trial registration number Pre-results; NCT02827240. (Source: BMJ Open)
Source: BMJ Open - April 20, 2017 Category: Journals (General) Authors: Oldenburg, C. E., Ortblad, K. F., Chanda, M. M., Mwanda, K., Nicodemus, W., Sikaundi, R., Fullem, A., Barresi, L. G., Harling, G., Bärnighausen, T. Tags: Open access, Global health, Health services research, HIV AIDS Protocol Source Type: research

Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis
Conclusions Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies. Funding agencies and industry should openly document their research investments to improve better targeting of research investment. (Source: BMJ Open)
Source: BMJ Open - April 20, 2017 Category: Journals (General) Authors: Maruthappu, M., Head, M. G., Zhou, C. D., Gilbert, B. J., El-Harasis, M. A., Raine, R., Fitchett, J. R., Atun, R. Tags: Open access, Global health, Health economics, Health policy, Oncology, Public health Research Source Type: research

Clinical and cost-effectiveness, safety and acceptability of community intravenous antibiotic service models: CIVAS systematic review
Conclusions There were no systematic differences related to the impact of OPAT on treatment duration or adverse events. However, evidence of its clinical benefit compared with traditional inpatient treatment is lacking, primarily due to the dearth of good quality comparative studies. There was high patient satisfaction with OPAT use but the few studies considering practitioner acceptability highlighted organisational and logistic barriers to its delivery. (Source: BMJ Open)
Source: BMJ Open - April 20, 2017 Category: Journals (General) Authors: Mitchell, E. D., Czoski Murray, C., Meads, D., Minton, J., Wright, J., Twiddy, M. Tags: Open access, Evidence based practice, Health services research, Infectious diseases Source Type: research

Risk and burden of adverse intrapartum-related outcomes associated with non-cephalic and multiple birth in rural Nepal: a prospective cohort study
Conclusions Globally and in Nepal, a large percentage of stillbirths and neonatal mortality is associated with intrapartum-related complications. Despite the low incidence of non-cephalic and multiple birth, a notable proportion of adverse intrapartum-related outcomes is associated with these conditions. As the proportion of neonatal deaths attributable to intrapartum-related complications continues to rise, there is a need to investigate how best to advance diagnostic capacity and management of these conditions. Trial registration number NCT01177111; pre-results. (Source: BMJ Open)
Source: BMJ Open - April 20, 2017 Category: Journals (General) Authors: Kozuki, N., Katz, J., Khatry, S. K., Tielsch, J. M., LeClerq, S. C., Mullany, L. C. Tags: Open access, Epidemiology, Global health, Public health, Obgyn Research Source Type: research

Features of alcohol harm reduction advertisements that most motivate reduced drinking among adults: an advertisement response study
Conclusions The effectiveness of alcohol harm reduction campaigns may be improved by directly communicating alcohol's long-term harms to the general adult population of drinkers along with drinking guidelines. By doing so, campaigns can also efficiently influence high-risk drinkers and key demographic subgroups. (Source: BMJ Open)
Source: BMJ Open - April 20, 2017 Category: Journals (General) Authors: Wakefield, M. A., Brennan, E., Dunstone, K., Durkin, S. J., Dixon, H. G., Pettigrew, S., Slater, M. D. Tags: Open access, Press releases, Communication, Public health Research Source Type: research

Outcome of a screening programme for the prevention of neonatal invasive early-onset group B Streptococcus infection in a UK maternity unit: an observational study
Background Against a background of failure to prevent neonatal invasive early-onset group B Streptococcus infections (GBS) in our maternity unit using risk-based approach for intrapartum antibiotic prophylaxis, we introduced an antenatal GBS carriage screening programme to identify additional women to target for prophylaxis. Objectives To describe the implementation and outcome of an antepartum screening programme for prevention of invasive early-onset GBS infection in a UK maternity unit. Design Observational study of outcome of screening programme (intervention) with comparison to historical controls (preintervention)....
Source: BMJ Open - April 18, 2017 Category: Journals (General) Authors: Gopal Rao, G., Nartey, G., McAree, T., O'Reilly, A., Hiles, S., Lee, T., Wallace, S., Batura, R., Khanna, P., Abbas, H., Tilsed, C., Nicholl, R., Lamagni, T., Bassett, P. Tags: Open access, Press releases, Infectious diseases, Paediatrics Research Source Type: research

The UK Cardiac and Vascular Surgery Interventional Anaemia Response (CAVIAR) Study: protocol for an observational cohort study to determine the impact and effect of preoperative anaemia management in cardiac and vascular surgical patients
Introduction Preoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients. The aim of this study is to observe the impact and effect of anaemia and its management in patients undergoing cardiac and vascular surger...
Source: BMJ Open - April 18, 2017 Category: Journals (General) Authors: Chau, M., Richards, T., Evans, C., Butcher, A., Collier, T., Klein, A. Tags: Protocol Source Type: research

Optimal body fat percentage cut-off values for identifying cardiovascular risk factors in Mongolian and Han adults: a population-based cross-sectional study in Inner Mongolia, China
Objective The present study was designed to determine the optimal cut-off values of body fat percentage (BF%) for the detection of cardiovascular disease (CVD) risk factors in Mongolian and Han adults. Method This cross-sectional study involving 3221 Chinese adults (2308 Han and 913 Mongolian) aged 20–80 years was conducted in Inner Mongolia Autonomous Region, China, in 2014. Data from a standardised questionnaire, physical examination and blood sample were obtained. The BF% was estimated using bioelectrical impedance analysis. Optimal BF% cut-offs were analysed by receiver operating characteristic curves to predict...
Source: BMJ Open - April 17, 2017 Category: Journals (General) Authors: Li, Y., Wang, H., Wang, K., Wang, W., Dong, F., Qian, Y., Gong, H., Xu, G., Li, G., Pan, L., Zhu, G., Shan, G. Tags: Open access, Epidemiology Research Source Type: research

Person-centred transition programme to empower adolescents with congenital heart disease in the transition to adulthood: a study protocol for a hybrid randomised controlled trial (STEPSTONES project)
Introduction When a young person grows up, they evolve from an independent child to an empowered adult. If an individual has a chronic condition, this additional burden may hamper adequate development and independence. Transition programmes for young persons with chronic disorders aim to provide the necessary skills for self-management and participation in care. However, strong evidence on the effects of these interventions is lacking. Therefore, as part of the STEPSTONES project (Swedish Transition Effects Project Supporting Teenagers with chrONic mEdical conditionS), we propose a trial to assess the effectiveness of a st...
Source: BMJ Open - April 17, 2017 Category: Journals (General) Authors: Acuna Mora, M., Sparud-Lundin, C., Bratt, E.-L., Moons, P. Tags: Open access, Cardiovascular medicine, Paediatrics, Patient-centred medicine, Research methods Protocol Source Type: research

Education achievement and type 2 diabetes--what mediates the relationship in older adults? Data from the ESTHER study: a population-based cohort study
Conclusion By identifying the possible mediating factors of the relationship between education achievement and incident T2DM in older adults, the results of this study can be used to assist with the development of public health strategies that aim to reduce socioeconomic inequalities in T2DM. (Source: BMJ Open)
Source: BMJ Open - April 17, 2017 Category: Journals (General) Authors: Steele, C. J., Schöttker, B., Marshall, A. H., Kouvonen, A., O'Doherty, M. G., Mons, U., Saum, K.-U., Boffetta, P., Trichopoulou, A., Brenner, H., Kee, F. Tags: Research Source Type: research

Cluster randomised controlled trial of a consumer behaviour intervention to improve healthy food purchases from online canteens: study protocol
Introduction School canteens represent an opportune setting in which to deliver public health nutrition strategies given their wide reach, and frequent use by children. Online school canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer behaviour strategies that impact on purchasing decisions. The aim of this study is to assess the efficacy of a consumer behaviour intervention implemented in an online school canteen ordering system in reducing the kilojoule, saturated fat, sugar and sodium content of primary ...
Source: BMJ Open - April 17, 2017 Category: Journals (General) Authors: Delaney, T., Wyse, R., Yoong, S. L., Sutherland, R., Wiggers, J., Ball, K., Campbell, K., Rissel, C., Wolfenden, L. Tags: Open access, Nutrition and metabolism, Public health Protocol Source Type: research

Has the role of personal income in alcohol drinking among teenagers changed between 1983 and 2013: a series of nationally representative surveys in Finland
Conclusions Disposable income has been a significant predictor of adolescent alcohol drinking in the past 30 years. However, in the recent years, the amount of disposable money has decreased in importance. (Source: BMJ Open)
Source: BMJ Open - April 17, 2017 Category: Journals (General) Authors: Lintonen, T., Nevalainen, J. Tags: Open access, Addiction, Epidemiology, Public health, Sociology Research Source Type: research

Prognostication in critically ill patients with severe traumatic brain injury: the TBI-Prognosis multicentre feasibility study
Conclusions In this multicentre prospective feasibility study, we achieved feasibility objectives pertaining to compliance to test, enrolment and follow-up. We conclude that the TBI-Prognosis prospective multicentre study in severe traumatic brain injury patients in Canada is feasible. (Source: BMJ Open)
Source: BMJ Open - April 17, 2017 Category: Journals (General) Authors: Turgeon, A. F., Lauzier, F., Zarychanski, R., Fergusson, D. A., Leger, C., McIntyre, L. A., Bernard, F., Rigamonti, A., Burns, K., Griesdale, D. E., Green, R., Scales, D. C., Meade, M. O., Savard, M., Shemilt, M., Paquet, J., Gariepy, J.-L., Lavoie, A., R Tags: Open access, Epidemiology, Intensive care Research Source Type: research

Protocol for a placebo-controlled, within-participants crossover trial evaluating the efficacy of intranasal oxytocin to improve pain and function among women with chronic pelvic musculoskeletal pain
Introduction This protocol presents the rationale and design for a trial evaluating the efficacy of intranasal oxytocin in improving pain and function among women with chronic pelvic musculoskeletal pain. Oxytocin is a neuropeptide traditionally recognised for involvement in labour, delivery and lactation. Novel evidence suggests that oxytocin decreases pain sensitivity in humans. While oxytocin administration has been reported to lower pain sensitivity among patients experiencing chronic back pain, headache, constipation and colon pain, no research has evaluated the association between intranasal oxytocin and chronic pelv...
Source: BMJ Open - April 16, 2017 Category: Journals (General) Authors: Rash, J. A., Toivonen, K., Robert, M., Nasr-Esfahani, M., Jarrell, J. F., Campbell, T. S. Tags: Open access, Anaesthesia, Pharmacology and therapeutics, Obgyn Protocol Source Type: research

Deprescribing anticholinergic and sedative medicines: protocol for a Feasibility Trial (DEFEAT-polypharmacy) in residential aged care facilities
This study will examine whether the proposed intervention is feasible at reducing the prescription of anticholinergic and sedative medicines in older people. Methods and analysis The Standard Protocol Items: Recommendations for Interventional trials (SPIRIT checklist) was used to develop and report the protocol. Single group (precomparison and postcomparison) feasibility study design. Study population 3 residential care homes have been recruited. Intervention This will involve a New Zealand registered pharmacist using peer-reviewed deprescribing guidelines, to recommend to general practitioners (GPs), sedative and antic...
Source: BMJ Open - April 16, 2017 Category: Journals (General) Authors: Ailabouni, N., Mangin, D., Nishtala, P. S. Tags: Open access, Evidence based practice, General practice / Family practice, Geriatric medicine, Medical management, Patient-centred medicine, Pharmacology and therapeutics Protocol Source Type: research

Long-term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study
Conclusions Individuals with T2D reduced routine medication costs following a long-term lifestyle intervention that started with a 3-week residential programme. Combining high exercise volume, restrictive diet and education effectively supported the health of T2D. The main factor explaining reduced medication costs was better glycaemic control, independent of weight changes. Despite limitations precluding generalisability, cost-effective results of reduced medication should contribute to the evidence base required to promote lifestyle interventions for individuals with T2D. Trial registration number NCT00917917; Post-resu...
Source: BMJ Open - April 16, 2017 Category: Journals (General) Authors: Lanhers, C., Walther, G., Chapier, R., Lesourd, B., Naughton, G., Pereira, B., Duclos, M., Vinet, A., Obert, P., Courteix, D., Dutheil, F. Tags: Open access, Health economics, Public health, Diabetes and Endocrinology Research Source Type: research

Reducing Medical Admissions into Hospital through Optimising Medicines (REMAIN HOME) Study: protocol for a stepped-wedge, cluster-randomised trial
Introduction A model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high-risk patients. Methods and analysis This protocol details a stepped-wedge, cluster-randomised trial that will recruit participants over 9 months with a 12-month follow-up. There will be 14 clusters each representing a different general practice medical centre. A total of 2240 par...
Source: BMJ Open - April 13, 2017 Category: Journals (General) Authors: Foot, H., Freeman, C., Hemming, K., Scott, I., Coombes, I. D., Williams, I. D., Connelly, L., Whitty, J. A., Sturman, N., Kirsa, S., Nicholson, C., Russell, G., Kirkpatrick, C., Cottrell, N. Tags: 1704 Source Type: research

Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a qualitative process evaluation
Conclusions Despite barriers for some participants, BA and CBT were perceived to have many benefits, to have brought about cognitive and behavioural change and to produce improvements in many domains of participants’ lives. To optimise the delivery of BA, inexperienced junior MHWs should be supported through good quality training and ongoing supervision. Trial registration number ISRCTN27473954, 09/12/2011 (Source: BMJ Open)
Source: BMJ Open - April 13, 2017 Category: Journals (General) Authors: Finning, K., Richards, D. A., Moore, L., Ekers, D., McMillan, D., Farrand, P. A., OMahen, H. A., Watkins, E. R., Wright, K. A., Fletcher, E., Rhodes, S., Woodhouse, R., Wray, F. Tags: 1704 Source Type: research

Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey, 2011
Conclusions Maternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal. (Source: BMJ Open)
Source: BMJ Open - April 13, 2017 Category: Journals (General) Authors: Shahabuddin, A., De Brouwere, V., Adhikari, R., Delamou, A., Bardaj, A., Delvaux, T. Tags: Research Source Type: research

Cohort profile: a data linkage cohort to examine health service profiles of people with intellectual disability in New South Wales, Australia
This study aims to interrogate a large linked administrative data set containing hospital admissions, presentations to emergency departments (ED) and mortality data to provide evidence to inform the development of improved health and mental health services for this population. Participants A retrospective cohort of people with intellectual disability (n=51 452) from New South Wales (NSW), Australia, to explore health and mental health profiles, mortality, pattern of health service use and associated costs between 2005 and 2013. The cohort is drawn from: the Disability Services Minimum Data Set; Admitted Patients Data...
Source: BMJ Open - April 12, 2017 Category: Journals (General) Authors: Reppermund, S., Srasuebkul, P., Heintze, T., Reeve, R., Dean, K., Emerson, E., Coyne, D., Snoyman, P., Baldry, E., Dowse, L., Szanto, T., Sara, G., Florio, T., Trollor, J. N. Tags: Open access, Epidemiology, Health economics, Health services research, Mental health Cohort profile Source Type: research

Systematic approach to evaluating and confirming the utility of a suite of national health system performance (HSP) indicators in Canada: a modified Delphi study
Conclusions A systematic evaluation of HSP indicators informed the development of objective recommendations for continued reporting. The evaluation was a fruitful exercise to identify technical considerations for calculating indicators, furthering our understanding of how measures are used by stakeholders, as well as harmonising actions that could be taken to ensure relevancy, reduce indicator chaos and build consensus with stakeholders. (Source: BMJ Open)
Source: BMJ Open - April 12, 2017 Category: Journals (General) Authors: Fekri, O., Leeb, K., Gurevich, Y. Tags: Open access, Health policy, Health services research Source Type: research