Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units.

Introduction: Recent evidence suggests that choice of fluid used for resuscitation may influence mortality in critically ill patients.

Methods: We conducted a cross-sectional study in 391 intensive care units across 25 countries to describe the types of fluids administered during resuscitation episodes. We used generalized estimating equations to examine the association between patient, prescriber and geographic factors and the type of fluid administered (classified as crystalloid, colloid or blood products).

Smoking, diabetes and cardiovascular diseases in men in the Asia Pacific region.

Background: To assess whether there is a statistical interaction between smoking and diabetes that is related to the risk of cardiovascular disease (CVD) in men in the Asia Pacific region.

Methods: An individual participant data meta-analysis was conducted on 34 cohort studies, involving 16 492 participants with diabetes (47.4% smokers) and 188 897 without (47.

Effects of internet-based tailored advice on the use of cholesterol-lowering interventions: a randomized controlled trial.

Background: Elevated low-density lipoprotein (LDL) cholesterol is a leading risk factor for cardiovascular disease. Despite the availability of proven interventions to lower LDL cholesterol, their use remains subobtimal. Many websites provide interactive, tailored advice on cardiovascular risk in an attempt to help bridge this evidence-practice gap, yet there is little evidence that provision of such a tool is effective in changing practice.

Temporal trends in overweight and obesity of children and adolescents from nine Provinces in China from 1991-2006.

Objectives: To assess temporal changes in mean body mass index (BMI) and the impact of socio-economic status on the prevalence of overweight and obesity among Chinese children and adolescents in nine provinces between 1991 and 2006.

Methods: Analysis of height and weight data in children and adolescents aged 7-17 years with complete information on age, gender, region, height and weight from consecutive China Health and Nutrition Surveys (CHNS). Measurements were recorded in 1991, 1993, 1997, 2000, 2004 and 2006.

Nutrient content of products served by leading Australian fast food chains.

With more consumers purchasing meals outside the home, fast food products contribute substantially to daily energy intakes. Improving the nutrient composition of fast food would have significant health benefits. Nutrient content data for menu items provided by nine companies representing >90% of the fast food market in Australia were collected.

Core journals that publish clinical trials of physical therapy interventions.

Objective: The objective of this study was to identify core journals in physical therapy by identifying those that publish the most randomized controlled trials of physical therapy interventions, provide the highest-quality reports of randomized controlled trials, and have the highest journal impact factors.

Design: This study was an audit of a bibliographic database.

Methods: All trials indexed in the Physiotherapy Evidence Database (PEDro) were analyzed.

Associations of diabetes mellitus with site-specific cancer mortality in the Asia-Pacific region.

Background: Owing to the increasing prevalence of obesity and diabetes in Asia, and the paucity of studies, we examined the influence of raised blood glucose and diabetes on cancer mortality risk.

Materials And Methods: Thirty-six cohort Asian and Australasian studies provided 367, 361 participants (74% from Asia); 6% had diabetes at baseline. Associations between diabetes and site-specific cancer mortality were estimated using time-dependent Cox models, stratified by study and sex, and adjusted for age.

Oral disease and subsequent cardiovascular disease in people with type 2 diabetes: a prospective cohort study based on the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) trial.

Aims/hypothesis: While there are plausible biological mechanisms linking oral health with cardiovascular disease (CVD) and mortality rates, no study, to our knowledge, has examined this association in a representative population of people with type 2 diabetes.

Methods: We used the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) study, a large, detailed, randomised controlled trial among a general population of individuals with type 2 diabetes. For the purposes of the present analyses, data from the trial are used within a prospective cohort study design.

Rationale and design of the Kanyini guidelines adherence with the polypill (Kanyini-GAP) study: a randomised controlled trial of a polypill-based strategy amongst indigenous and non indigenous people at high cardiovascular risk.

Background: The Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP) Study aims to examine whether a polypill-based strategy (using a single capsule containing aspirin, a statin and two blood pressure-lowering agents) amongst Indigenous and non-Indigenous people at high risk of experiencing a cardiovascular event will improve adherence to guideline-indicated therapies, and lower blood pressure and cholesterol levels.

Methods/design: The study is an open, randomised, controlled, multi-centre trial involving 1000 participants at high risk of cardiovascular events recruited from mainstream general practices and Aboriginal Medical Services, followed for an average of 18 months. The participants will be randomised to one of two versions of the polypill, the version chosen by the treating health professional according to clinical features of the patient, or to usual care.

Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain.

Pain self-efficacy and fear of movement have been proposed to explain how pain can lead to disability for patients with chronic low back pain. However the extent to which pain self-efficacy and fear of movement mediate the relationship between pain and disability over time has not been investigated. This study aimed to investigate whether pain self-efficacy and/or fear of movement mediate the relationship between pain intensity and disability in patients with recent onset chronic low back pain.

Comparison of recovery patterns and prognostic indicators for ischemic and hemorrhagic stroke in China: the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) Registry study.

Background And Purpose: Limited data exist on the comparative recovery patterns and outcomes of patients with ischemic stroke and intracerebral hemorrhage in China.

Methods: Data on baseline characteristics and outcomes of 6354 patients at 3 and 12 months poststroke are from ChinaQUEST (QUality Evaluation of Stroke Care and Treatment), a multicenter, prospective, 62-hospital registry study in China. Logistic regression was used to determine factors associated with a poor outcome defined by death/dependency (modified Rankin Scale score of 3 to 5) on follow-up.

PACE--the first placebo controlled trial of paracetamol for acute low back pain: design of a randomised controlled trial.

Background: Clinical practice guidelines recommend that the initial treatment of acute low back pain (LBP) should consist of advice to stay active and regular simple analgesics such as paracetamol 4 g daily. Despite this recommendation in all international LBP guidelines there are no placebo controlled trials assessing the efficacy of paracetamol for LBP at any dose or dose regimen. This study aims to determine whether 4 g of paracetamol daily (in divided doses) results in a more rapid recovery from acute LBP than placebo.

The patient-specific functional scale is more responsive than the Roland Morris disability questionnaire when activity limitation is low.

The primary objective of this study was to determine which questionnaire, the Roland Morris disability questionnaire (RMDQ) or the patient-specific functional scale (PSFS), was better at detecting change in activity limitation in a large cohort of patients with low back pain undergoing rehabilitation. A secondary aim was to determine if the responsiveness of the questionnaires was influenced by the patient's level of activity limitation at baseline. Responsiveness statistics, including effect size statistics, Pearson's r correlations and receiver operative characteristic (ROC) curve analysis were used to determine ability to detect change in activity limitation on 831 patients with low back pain.

Comparison of waist-to-hip ratio and other obesity indices as predictors of cardiovascular disease risk in people with type-2 diabetes: a prospective cohort study from ADVANCE.

Aims: The aim of this study was to compare the strength of associations and discrimination capability of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with cardiovascular disease risk in individuals with type-2 diabetes.

Methods And Results: Eleven thousand, one hundred and forty men and women were followed for a mean of 4.8 years.

Diagnostic accuracy of a questionnaire and simple home monitoring device in detecting obstructive sleep apnoea in a Chinese population at high cardiovascular risk.

Background And Objective: OSA is a common condition associated with cardiovascular (CV) morbidity. It remains underdiagnosed globally in part due to the limited availability and technical requirements of polysomnography (PSG). The aim of this study was to test the accuracy of two simple methods for diagnosing OSA.

The Framingham Study, diabetes mellitus and cardiovascular disease: turning back the clock.

The global population of individuals with diabetes is important and rapidly growing. Because of the link between diabetes and cardiovascular disease (CVD), it is expected that diabetes will be an important driver of the future burden of CVD around the world. A connection between diabetes and CVD was suspected as earlier as in the mid 19th century.

Blood pressure and cardiovascular disease: tracing the steps from Framingham.

Around one-quarter of the world's adult population are defined as "hypertensive" however a much greater proportion are at risk of blood pressure-related disease because of the nature of the association between blood pressure and cardiovascular risk. The Framingham Study, together with other landmark observational studies, has been instrumental in elucidating this relationship. As early as the 1960s, Framingham showed that the association between blood pressure and cardiovascular risk was continuous and linear and was consistent across different age groups and for a range of major cardiovascular events.

Behavioural treatment for chronic low-back pain.

Background: Behavioural treatment is commonly used in the management of chronic low-back pain (CLBP) to reduce disability through modification of maladaptive pain behaviours and cognitive processes. Three behavioural approaches are generally distinguished: operant, cognitive, and respondent; but are often combined as a treatment package.

Objectives: To determine the effects of behavioural therapy for CLBP and the most effective behavioural approach.

Applying evidence into routine clinical care at a unit level: the exemplar of renal anaemia management.

Variability in implementing research evidence into clinical practice is widespread, including in the management of patients with kidney disease. There are numerous well-known barriers and facilitators to evidence implementation identified in other clinical settings and a few chronic kidney disease studies. The necessary changes to health systems that support evidence implementation take time to design, apply and to have a measurable effect.

Burden of lung cancer deaths due to smoking for men and women in the WHO Western Pacific and South East Asian regions.

Introduction: Eighty percent of all smokers live in low and middle-income countries of the Asia Pacific region but actual estimates of the burden of disease due to smoking in the region have yet to be quantified.

Methods: The burden of lung cancer due to smoking for all countries in the WHO Western Pacific and South East Asian regions was calculated from the population attributable fractions (PAFs). Nationally representative sex-specific prevalences of smoking were obtained from the World Health Organization, MEDLINE and/or national government documents and hazard ratios (HR) for lung cancer due to smoking in Asian and non-Asian populations were obtained from published data.

The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic review.

Background: The working alliance, or collaborative bond, between client and psychotherapist has been found to be related to outcome in psychotherapy.

Purpose: The purpose of this study was to investigate whether the working alliance is related to outcome in physical rehabilitation settings.

Data Sources: A sensitive search of 6 databases identified a total of 1,600 titles.

How is recovery from low back pain measured? A systematic review of the literature.

Recovery is commonly used as an outcome measure in low back pain (LBP) research. There is, however, no accepted definition of what recovery involves or guidance as to how it should be measured. The objective of the study was designed to appraise the LBP literature from the last 10 years to review the methods used to measure recovery.

Risky driving behavior and road traffic crashes among young Asian Australian drivers: findings from the DRIVE study.

Objective: To examine differences in risky driving behavior and likelihood of traffic crash according to the country of birth of recently licensed young drivers. The groups examined include those born in Australia, those born in Asia, and those born in other countries.

Design And Setting: The DRIVE study is a prospective cohort study of drivers aged 17-24 years holding their first-year provisional driver license in New South Wales, Australia.

Development of a tool for prediction of falls in rehabilitation settings (Predict_FIRST): a prospective cohort study.

Objective: To develop and internally validate a simple falls prediction tool for rehabilitation settings.

Design: Prospective cohort study.

Participants: A total of 533 inpatients.

The efficacy of lowering glycated haemoglobin with a gliclazide modified release-based intensive glucose lowering regimen in the ADVANCE trial.

The aim of these analyses was to examine the efficacy of the intensive gliclazide MR-based glucose lowering regimen used in the ADVANCE trial in lowering the level of glycated haemoglobin (HbA1c). All 11,140 randomised patients were included in analyses of treatment efficacy. Treatment efficacy was also examined in subgroups defined by baseline characteristics and treatments.