Process evaluation of a randomised pilot trial of home-based rehabilitation compared to usual care in patients with heart failure with preserved ejection fraction and their caregiver's.

Background: Whilst almost 50% of heart failure (HF) patients have preserved ejection fraction (HFpEF), evidence-based treatment options for this patient group remain limited. However, there is growing evidence of the potential value of exercise-based cardiac rehabilitation. This study reports the process evaluation of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention for HFpEF patients and their caregivers conducted as part of the REACH-HFpEF pilot trial.

Associations Between Systolic Interarm Differences in Blood Pressure and Cardiovascular Disease Outcomes and Mortality: Individual Participant Data Meta-Analysis, Development and Validation of a Prognostic Algorithm: The INTERPRESS-IPD Collaboration.

Systolic interarm differences in blood pressure have been associated with all-cause mortality and cardiovascular disease. We undertook individual participant data meta-analyses to (1) quantify independent associations of systolic interarm difference with mortality and cardiovascular events; (2) develop and validate prognostic models incorporating interarm difference, and (3) determine whether interarm difference remains associated with risk after adjustment for common cardiovascular risk scores. We searched for studies recording bilateral blood pressure and outcomes, established agreements with collaborating authors, and created a single international dataset: the Inter-arm Blood Pressure Difference - Individual Participant Data (INTERPRESS-IPD) Collaboration.

Diagnosing Dementia-Related Psychosis: Using Tools and Communicating With Patients and Caregivers.

​​​​​​ Psychosis is common in patients with dementia; therefore, clinicians should carefully evaluate psychotic symptoms reported by patients or their caregivers. A variety of tools exist for the diagnosis of DRP, such as the Neuropsychiatric Inventory and new diagnostic criteria. It is important to talk with patients and caregivers about the impact of DRP on well-being, their level of distress (and patients' insight), the potential risks of medication to treat DRP, and the potential course of DRP because, then, it is possible for people to contribute knowledgably to discussions of the best treatment options.

Use of the patientMpower App With Home-Based Spirometry to Monitor the Symptoms and Impact of Fibrotic Lung Conditions: Longitudinal Observational Study.

Background: Daily home-based spirometry in idiopathic pulmonary fibrosis (IPF) has been shown to be feasible and clinically informative. The patientMpower app facilitates home-based spirometry along with home-based monitoring of IPF-related symptoms. The patientMpower app can be downloaded to the user's mobile phone or tablet device, enabling the recording of objective and subjective data.

Ethical framework for adult social care in COVID-19.

In March 2020, the Government produced a document entitled " ('The Ethical Framework'). In this article, we summarise the key features of the proposed ethical framework and subject it to critical analysis. We highlight three primary issues.

New developments in our understanding of ankylosing spondylitis pathogenesis.

Ankylosing spondylitis (AS) is a common immune-mediated inflammatory arthritis with a strong genetic predisposition. We review recent data from genetic and animal studies highlighting the importance of Type 17 immune responses. Furthermore, the efficacy (or lack thereof) of different anti-cytokine monoclonal antibodies has highlighted the diversity of Type 17 immune cells and cytokines critical to AS and related spondyloarthritis pathogenesis.

Immune Surveillance in Clinical Regression of Preinvasive Squamous Cell Lung Cancer.

Before squamous cell lung cancer develops, precancerous lesions can be found in the airways. From longitudinal monitoring, we know that only half of such lesions become cancer, whereas a third spontaneously regress. Although recent studies have described the presence of an active immune response in high-grade lesions, the mechanisms underpinning clinical regression of precancerous lesions remain unknown.

The value of social practice theory for implementation science: learning from a theory-based mixed methods process evaluation of a randomised controlled trial.

Background: Although there is trial evidence that complex interventions are effective for the self-management of heart failure, little evidence supports their effectiveness in routine practice. We used Social Practice Theory to guide a Type 1 Hybrid Trial: a mixed methods process evaluation of a complex intervention for heart failure. The objective of this paper is to explore the value of Social Practice Theory for implementation science.

Development and validation of a tool to measure belongingness as a proxy for participation in undergraduate clinical learning.

Background: 'Participation' in a 'community of practice' is often proposed as a mechanism for clinical learning; however, the use of both terms is variable - ranging from technical to vernacular. Belongingness is a related single concept and development of a tool that measures belongingness may therefore be useful in adding to our understanding of when participation and hence learning takes place in clinical settings.

Methods: After identifying relevant material from the literature, a draft belongingness assessment tool was developed, based on previously published work.

What factors influence the introduction of a national undergraduate general practice curriculum in the UK?

A national undergraduate curriculum for General Practice might address current concerns regarding intellectual challenge and recruitment through articulating disciplinary knowledge and providing teaching guidance. However, there is ambivalence regarding this idea and the reasons appear incompletely understood. : To better understand ambivalence towards a GP curriculum and to assess the acceptability of a new approach to national curriculum design.

Regulation of nerve growth and patterning by cell surface protein disulphide isomerase.

Contact repulsion of growing axons is an essential mechanism for spinal nerve patterning. In birds and mammals the embryonic somites generate a linear series of impenetrable barriers, forcing axon growth cones to traverse one half of each somite as they extend towards their body targets. This study shows that protein disulphide isomerase provides a key component of these barriers, mediating contact repulsion at the cell surface in chick half-somites.

Public involvement in health research: what does 'good' look like in practice?

Plain English Summary: Patient and public involvement means researchers working with members of the public, patients or carers to jointly plan and carry out research. This article is written by members of three involvement groups, and the university employees that they work with. We wanted to jointly reflect on what enables our collaborative work, and what the challenges are for everyone involved.

Are COPD self-management mobile applications effective? A systematic review and meta-analysis.

The burden of chronic obstructive pulmonary disease (COPD) to patients and health services is steadily increasing. Self-management supported by mobile device applications could improve outcomes for people with COPD. Our aim was to synthesize evidence on the effectiveness of mobile health applications compared with usual care.

Correction: Measurement of blood pressure in people with atrial fibrillation.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Humanity's Best Friend: A Dog-Centric Approach to Addressing Global Challenges.

No other animal has a closer mutualistic relationship with humans than the dog (). Domesticated from the Eurasian grey wolf (), dogs have evolved alongside humans over millennia in a relationship that has transformed dogs and the environments in which humans and dogs have co-inhabited. The story of the dog is the story of recent humanity, in all its biological and cultural complexity.

Weight change and sulfonylurea therapy are related to 3 year change in microvascular function in people with type 2 diabetes.

Aims/hypothesis: Although cardiovascular disease is the biggest cause of death in people with diabetes, microvascular complications have a significant impact on quality of life and financial burden of the disease. Little is known about the progression of microvascular dysfunction in the early stages of type 2 diabetes before the occurrence of clinically apparent complications. We aimed to explore the determinants of endothelial-dependent and -independent microvascular function progression over a 3 year period, in people with and without both diabetes and few clinical microvascular complications.

The median and the mode as robust meta-analysis estimators in the presence of small-study effects and outliers.

Meta-analyses based on systematic literature reviews are commonly used to obtain a quantitative summary of the available evidence on a given topic. However, the reliability of any meta-analysis is constrained by that of its constituent studies. One major limitation is the possibility of small-study effects, when estimates from smaller and larger studies differ systematically.