Growth, Body Composition, and Lung Function in Prepubertal Children with Cystic Fibrosis Diagnosed by Newborn Screening.

Background: Children with cystic fibrosis (CF) are at risk of altered body composition (BC). Newborn screening (NBS) may lead to improved BC outcomes. We investigated BC and its relationship with lung function in prepubertal children diagnosed with CF by NBS.

Capturing complexity in clinician case-mix: classification system development using GP and physician associate data.

Background: There are limited case-mix classification systems for primary care settings which are applicable when considering the optimal clinical skill mix to provide services.

Aim: To develop a case-mix classification system (CMCS) and test its impact on analyses of patient outcomes by clinician type, using example data from physician associates' (PAs) and GPs' consultations with same-day appointment patients.

Design & Setting: Secondary analysis of controlled observational data from six general practices employing PAs and six matched practices not employing PAs in England.

The uptake of Bayesian methods in biomedical meta-analyses: A scoping review (2005-2016).

Aim: Bayesian statistical methods can allow for more complete and accurate incorporation of evidence in meta-analyses. However, these methods remain under-utilized.

Methods: A scoping review was conducted to examine the proportion of biomedical meta-analyses that used Bayesian methods in the period 2005-2016.

Exercise facilities for neurologically disabled populations - Perceptions from the fitness industry.

Background: People with neurological disabilities (pwND) face many barriers to undertaking physical activity. One option for exercise alongside formal physiotherapy is local fitness facilities but accessibility is often found wanting and gyms are seen as unwelcoming to pwND.

Objective: The objective of this exploratory study was to investigate the perceptions of fitness facility managers with respect to exercise for pwND in a gym environment.

Physician associates and GPs in primary care: a comparison.

Background: Physician associates [PAs] (also known as physician assistants) are new to the NHS and there is little evidence concerning their contribution in general practice.

Aim: This study aimed to compare outcomes and costs of same-day requested consultations by PAs with those of GPs.

Design And Setting: An observational study of 2086 patient records presenting at same-day appointments in 12 general practices in England.

Evaluation of the effectiveness of a home-based inspiratory muscle training programme in patients with chronic obstructive pulmonary disease using multiple inspiratory muscle tests.

Purpose: To evaluate the effectiveness of a home-based inspiratory muscle training (IMT) programme using multiple inspiratory muscle tests.

Method: Sixty-eight patients (37 M) with moderate to severe chronic obstructive pulmonary disease (COPD) (Mean [SD], FEV1 36.1 [13.

Sniff nasal inspiratory pressure in patients with moderate-to-severe chronic obstructive pulmonary disease: learning effect and short-term between-session repeatability.

Background: Sniff nasal inspiratory pressure (SNIP) is a non-invasive measure of inspiratory muscle function often used as an outcome measure in clinical studies. An initial period of familiarisation with the test is recommended to minimise the learning effect. The repeatability of SNIP in patients with chronic obstructive pulmonary disease (COPD) is currently unknown.

Trends over time in prescribing by English primary care nurses: a secondary analysis of a national prescription database.

Background: A growing number of countries legislate for nurses to have medication prescribing authority although it is a contested issue. The UK is one of these countries, giving authority to nurses with additional qualifications since 1992 and incrementally widened the scope of nurse prescribing, most recently in 2006. The policy intention for primary care was to improve efficiency in service delivery through flexibility between medical and nursing roles.

First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database.

Background: Dementia is one of the most disabling and burdensome diseases. Incontinence in people with dementia is distressing, adds to carer burden, and influences decisions to relocate people to care homes. Successful and safe management of incontinence in people with dementia presents additional challenges.

Predictors of two forms of attrition in a longitudinal health study involving ageing participants: an analysis based on the Whitehall II study.

Background: Longitudinal studies are crucial providers of information about the needs of an ageing population, but their external validity is affected if partipants drop out. Previous research has identified older age, impaired cognitive function, lower educational level, living alone, fewer social activities, and lower socio-economic status as predictors of attrition.

Methods: This project examined attrition in participants of the Whitehall II study aged between 51-71 years, using data from questionnaires participants have completed biennially since 1985 when the study began.

Graduates from dual qualification courses, registered nurse and health visitor: a career history study.

Background: Educationalists and managers internationally are challenged to find ways of preparing, recruiting early in their careers, and retaining nurses into public health roles in primary care. Public health nursing qualifications are post-initial nurse registration in the United Kingdom as in some other countries. In the mid twentieth century there were a number of innovative programmes of dual qualification: registered nurse and health visitor (the United Kingdom term for public health nurse).

Challenges in comparing the quality of life of older people between ethnic groups, and the implications for national well-being indicators: a secondary analysis of two cross-sectional surveys.

Background: The current international interest in well-being indicators among governmental agencies means that many quality of life scales are potential components of such national indicator sets. Measuring well-being in minority groups is complex and challenging. Scales are available that have been validated in specific parts of the population, such as older people.

Value of information in the osteoarthritis setting: cost effectiveness of COX-2 selective inhibitors, traditional NSAIDs and proton pump inhibitors.

Background: Recent National Institute for Health and Clinical Excellence (NICE) guidance recommended that when traditional NSAIDs or cyclo-oxygenase (COX)-2 selective inhibitors are used by people with osteoarthritis (OA), they should be prescribed along with a proton pump inhibitor (PPI). However, specific recommendations about the type of NSAID or COX-2 could not be made due to high levels of uncertainty in the economic evaluation.

Objective: To investigate the value of obtaining further evidence to inform the economic evaluation of NSAIDs, COX-2s and PPIs for people with OA.

Cost effectiveness of COX 2 selective inhibitors and traditional NSAIDs alone or in combination with a proton pump inhibitor for people with osteoarthritis.

Objectives: To investigate the cost effectiveness of cyclo-oxygenase-2 (COX 2) selective inhibitors and traditional non-steroidal anti-inflammatory drugs (NSAIDs), and the addition of proton pump inhibitors to these treatments, for people with osteoarthritis.

Design: An economic evaluation using a Markov model and data from a systematic review was conducted. Estimates of cardiovascular and gastrointestinal adverse events were based on data from three large randomised controlled trials, and observational data were used for sensitivity analyses.

Staffing levels and patient dependence in English stroke units.

Little research has been performed to determine how a stroke unit should be staffed and what the links are between patient dependency and staffing. For this study, 140 stroke units were randomly selected--35 from each of the four quartiles of performance in the National Sentinel Audit of Stroke. A questionnaire was sent to each of the units to collect data on patient numbers and dependency, staffing numbers and therapy, and nursing contact times on a single weekday.

Using prescribing indicators to measure the quality of prescribing to elderly medical in-patients.

Objectives: to evaluate the performance of hospitals using eight indicators designed to assess prescribing practice in medical in-patients aged > or =65 years.

Design: local coalition teams were invited to collect cross-sectional prescribing and clinical data on 100 consecutive medical in-patients aged > or =65 years during a specific week in April 1999.

Setting: 102 hospitals across England.

False negative biliary scintigraphy in gangrenous cholecystitis.

Gangrenous cholecystitis is a serious complication of acute cholecystitis and is associated with increased morbidity and mortality rates. We report a case in which the diagnosis was suggested by ultrasound, but cholecystectomy delayed due to atypical clinical presentation and a false negative radionuclide biliary scan.