Minimising disability and falls in older people through a post-hospital exercise program: a protocol for a randomised controlled trial and economic evaluation.

Background: Disability and falls are particularly common among older people who have recently been hospitalised. There is evidence that disability severity and fall rates can be reduced by well-designed exercise interventions. However, the potential for exercise to have these benefits in older people who have spent time in hospital has not been established.

Verbal autopsy coding: are multiple coders better than one?

Objective: To assess the impact on the reported cause-of-death patterns of a verbal autopsy coding strategy based on a review of every death by multiple coders versus a single coder.

Methods: Deaths in 45 villages (total population 180,162) in southern India were documented during 12 months in 2003-2004, and a standard verbal autopsy questionnaire was completed for each death. Two physician coders, each unaware of the other's decisions, assigned an underlying cause of death in accordance with the causes listed in the chapter headings of the International classification of diseases and related health problems, 10th revision (ICD-10).

Early intervention for cognitive decline: is there a role for multiple medical or behavioural interventions?

Aim: Early medical or behavioural intervention to slow cognitive decline might be a viable strategy for reducing disability and rates of institutional care in older persons. This paper details the published work supporting cross-sectional and longitudinal associations between vascular risk factors, depressive symptoms and progressive cognitive decline. Evidence for the beneficial effects of providing relevant interventions is assessed.

Classical cardiovascular risk factors and all-cause mortality in rural Cameroon.

Background: High levels of cardiovascular risk factors have been reported in rural Africa. How these translate into major outcomes remain unknown.

Aim: To assess the association between selected risk factors and all-cause mortality in rural Cameroon.

Analgesic effects of treatments for non-specific low back pain: a meta-analysis of placebo-controlled randomized trials.

Objective: Estimates of treatment effects reported in placebo-controlled randomized trials are less subject to bias than those estimates provided by other study designs. The objective of this meta-analysis was to estimate the analgesic effects of treatments for non-specific low back pain reported in placebo-controlled randomized trials.

Methods: Medline, Embase, Cinahl, PsychInfo and Cochrane Central Register of Controlled Trials databases were searched for eligible trials from earliest records to November 2006.

Effective exercise for the prevention of falls: a systematic review and meta-analysis.

Objectives: To determine the effects of exercise on falls prevention in older people and establish whether particular trial characteristics or components of exercise programs are associated with larger reductions in falls.

Design: Systematic review with meta-analysis. Randomized controlled trials that compared fall rates in older people who undertook exercise programs with fall rates in those who did not exercise were included.

After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought.

Study Design: Inception cohort study.

Objective: To provide the first reliable estimate of the 1-year incidence of recurrence in subjects recently recovered from acute nonspecific low back pain (LBP) and to determine factors predictive of recurrence in 1 year.

Summary Of Background Data: Previous studies provide potentially flawed estimates of recurrence of LBP because they do not restrict the cohort to those who have recovered and are therefore eligible for a recurrence.

Cardiovascular risk management at a Maori-led Primary Health Organisation--findings from a cross-sectional audit.

Aim: To examine the cardiovascular disease (CVD) risk profile and management for the first 12 months of an electronic risk assessment program at Tamaki Healthcare, Auckland.

Methods: An audit of risk assessment and medication data supplemented by a manual case record review.

Results: 1522 people were screened representing around 15.

Proteinuria and stroke: a meta-analysis of cohort studies.

Background: The associations between decreased kidney function and cardiovascular disease recently have been established. However, there is uncertainty about the consistency between the independent associations of proteinuria as a risk factor across all cardiovascular end points. We undertook a meta-analysis of published cohort studies to provide a reliable estimate of the strength of association between proteinuria and risk of stroke.

Motor control exercise for persistent, nonspecific low back pain: a systematic review.

Background: Previous systematic reviews have concluded that the effectiveness of motor control exercise for persistent low back pain has not been clearly established.

Objective: The objective of this study was to systematically review randomized controlled trials evaluating the effectiveness of motor control exercises for persistent low back pain.

Methods: Electronic databases were searched to June 2008.

Global inequalities in access to cardiovascular health care: our greatest challenge.

Cardiovascular disease (CVD) was the leading cause of death globally in 2005, responsible for 17.5 million deaths, more than 80% of which occurred in low- and middle-income countries (LMIC). In these regions, CVD occurs at a much younger age than in high-income countries, thereby contributing disproportionately to lost potential years of healthy life as well as lost economic productivity.

Mobility training after hip fracture: a randomised controlled trial.

Objective: to compare the effects of two different exercise programmes after hip fracture.

Design: assessor-blinded randomised controlled trial.

Setting: hospital rehabilitation units, with continued intervention at home.

Differences in range of motion between dominant and nondominant sides of upper and lower extremities.

Objective: The objective of this study was to compare ranges of motion (ROM) between dominant and nondominant sides for the joints of the upper and lower extremities.

Methods: Ninety healthy white women from 18 to 59 years of age were measured in this study. Active and passive ROM were measured for the ankle, knee, hip, shoulder, elbow, and wrist using a standard goniometer.

Blood pressure lowering with fixed combination perindopril-indapamide: key findings from ADVANCE.

Objectives: ADVANCE was planned to investigate the effects of routine blood pressure lowering with the fixed combination perindopril-indapamide on major vascular events in people with type 2 diabetes, irrespective of initial blood pressures or the use of other blood pressure-lowering drugs, including angiotensin-converting enzyme inhibitors.

Methods: A total of 11140 individuals with type 2 diabetes were randomly assigned to fixed combination perindopril-indapamide or matching placebo, after a 6-week run-in period. The primary outcomes were composites of major macrovascular and major microvascular events, analysed jointly and separately, by intention to treat.

"All they said was my kidneys were dead": Indigenous Australian patients' understanding of their chronic kidney disease.

Objectives: To explore the understanding of both Indigenous and non-Indigenous Australians with end-stage kidney disease (ESKD) about the cause of their disease, and how this understanding could affect patients' engagement with their treatment.

Design, Setting And Participants: Qualitative study conducted in 2005-2006 in nine hospital renal units and 17 associated dialysis centres in four states and the Northern Territory as part of the IMPAKT (Improving Access to Kidney Transplants) study. In-depth interviews were conducted with 146 Indigenous and 95 non-Indigenous Australians with ESKD, covering personal history of illness, social and psychosocial context, attitudes to treatments including transplantation, adequacy of information and communication, and satisfaction with services.

The relationship between proteinuria and coronary risk: a systematic review and meta-analysis.

Background: Markers of kidney dysfunction such as proteinuria or albuminuria have been reported to be associated with coronary heart disease, but the consistency and strength of any such relationship has not been clearly defined. This lack of clarity has led to great uncertainty as to how proteinuria should be treated in the assessment and management of cardiovascular risk. We therefore undertook a systematic review of published cohort studies aiming to provide a reliable estimate of the strength of association between proteinuria and coronary heart disease.

Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best?

Study Design: Translation, cross-cultural adaptation, and clinimetric testing of self-report outcome measures.

Objective: The aims of this investigation were to perform the translation and cross-cultural adaptation of the Patient-Specific Functional Scale (PSFS) into Brazilian-Portuguese and to perform a head-to-head comparison of the clinimetric properties of the Brazilian-Portuguese versions of the PSFS, the Roland-Morris Disability Questionnaire (RMDQ) and the Functional Rating Index (FRI).

Summary Of Background Data: To date, there is no Brazilian-Portuguese version of the PSFS available and no head-to-head comparison of the Brazilian-Portuguese versions of the PSFS, RMDQ, and FRI has been undertaken.

Do men and women respond differently to blood pressure-lowering treatment? Results of prospectively designed overviews of randomized trials.

Aims: Large-scale observational studies show that lower blood pressure is associated with lower cardiovascular risk in both men and women although some studies have suggested that different outcomes between the sexes may reflect different responses to blood pressure-lowering treatment. The aims of these overview analyses were to quantify the effects of blood pressure-lowering treatment in each sex and to determine if there are important differences in the proportional benefits of treatment between men and women.

Methods And Results: Thirty-one randomized trials that included 103,268 men and 87,349 women contributed to these analyses.

Design, conduct, analysis and reporting of a multi-national placebo-controlled trial of activated protein C for persistent septic shock.

The role of drotrecogin alfa (activated) (DAA) in severe sepsis remains controversial and clinicians are unsure whether or not to treat their patients with DAA. In response to a request from the European Medicines Agency, Eli Lilly will sponsor a new placebo-controlled trial and history suggests the results will be subject to great scrutiny. An academic steering committee will oversee the conduct of the study and will write the study manuscripts.

Reducing the burden of road traffic injury: translating high-income country interventions to middle-income and low-income countries.

Objective: To increase seat belt restraint use in Guangzhou City, People's Republic of China.

Design: Comparison group pre-test, post-test design.

Setting: Guangzhou City.

Sociodemographic correlates of the increasing trend in prevalence of gestational diabetes mellitus in a large population of women between 1995 and 2005.

Objective: Gestational diabetes mellitus (GDM) is an increasingly prevalent risk factor for the development of type 2 diabetes in the mother and is responsible for morbidity in the child. To better identify women at risk of developing GDM we examined sociodemographic correlates and changes in the prevalence of GDM among all births between 1995 and 2005 in Australia's largest state.

Research Design And Methods: A computerized database of all births (n = 956,738) between 1995 and 2005 in New South Wales, Australia, was used in a multivariate logistic regression that examined the association between sociodemographic characteristics and the occurrence of GDM.

The effects of a reduced-sodium, high-potassium salt substitute on food taste and acceptability in rural northern China.

A potassium chloride-containing salt substitute lowers blood pressure levels, but its overall acceptability has been of concern due to its potential adverse effects on food taste. In a large-scale, blinded randomised trial evaluating the comparative effects of a salt substitute (65 % sodium chloride, 25 % potassium chloride and 10 % magnesium sulphate) and a normal salt (100 % sodium chloride) on blood pressure, we collected data on the saltiness, flavour and overall acceptability of food. We performed this at baseline, 1, 6 and 12 months post-randomisation using 100 mm visual analogue scales for assessments of both home-cooked foods and a standard salty soup.