1,639,307 results match your criteria: "UK; Vale University Health Board[Affiliation]"

Objectives: The burden of cardiovascular disease (CVD) is increasing. Cardiac rehabilitation (CR) is a complex intervention offered to patients with CVD, following a heart event, diagnosis or intervention, and it aims to reduce mortality and morbidity. The objective of this within-trial economic evaluation was to compare the cost-effectiveness of metacognitive therapy (MCT) plus usual care (UC) to UC, from a health and social care perspective in the UK.

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Objectives: To examine the acceptability of implementing, trialling and estimating the cost of the Sexual health and healthy relationships for Further Education (SaFE) intervention.

Design: Two-arm repeated cross-sectional pilot cluster randomised controlled trial (cRCT) of SaFE compared with usual practice, including a process evaluation and an economic assessment.

Setting: Eight further education (FE) settings in South Wales and the West of England, UK.

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Objectives: Hypertension is one of the most prevalent non-communicable diseases in West Africa, which responds to effective primary care. This scoping review explored factors influencing primary care access, utilisation and quality for patients with hypertension in West Africa.

Design: Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews.

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Article Synopsis
  • The study evaluates the validity and applicability of RCTs comparing minimally invasive and open surgeries for oesophageal cancer from January 2012 to June 2023.
  • Only nine RCTs were found, with just one deemed pragmatic due to narrow eligibility criteria and single-centre designs limiting the generalizability of results.
  • Recommendations include developing clearer guidelines for defining pragmatic trials to potentially enhance the applicability of future surgical RCTs in clinical practice.
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Objectives: Investigate the correlation between the percentage of predicted forced expiratory volume in 1 s (FEV1%pred) and survival outcomes, namely relapse-free survival (RFS) and overall survival (OS), in patients diagnosed with operable early-stage non-small cell lung cancer (NSCLC).

Design: Prospective observational study.

Setting: Clinical settings in Xiangya Hospital, Central South University, Hunan, China.

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Prognostic signature of multimorbidity, geriatric syndromes and resources cluster in older in- and outpatients: a pooled secondary analysis with a 6-month follow-up.

BMJ Open

December 2024

Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, University Hospital Cologne, Cologne, Nordrhein-Westfalen, Germany

Objective: The prognosis of older adults is strongly influenced by the relation of multifactorial geriatric syndromes (GS) and their health-maintaining counterparts, geriatric resources (GR). The present analysis aimed to identify clusters of comorbidities, GS and GR, and to measure their multidimensional prognostic signature in older patients admitted to different healthcare settings.

Design: Pooled secondary analysis of three longitudinal interventional studies with the 3- and 6-month follow-up data collection on mortality and rehospitalisation.

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Objective: To gain insights into the experience, and impact, of using security staff to facilitate physical restraints for nasogastric tube feeding.

Design: A cross-sectional design using 39 individual interviews, three online focus groups and three written submissions involving young people with lived experience (PWLE), parents/carers, paediatric staff and security staff involved in nasogastric feeding under restraint in paediatric settings in England. Qualitative semistructured interviews were transcribed and thematically analysed.

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Introduction: In Germany, there has been no population-level pharmacoepidemiological study on the safety of the COVID-19 vaccines. One factor preventing such a study so far relates to challenges combining the different relevant data bodies on vaccination with suitable outcome data, specifically statutory health insurance claims data. Individual identifiers used across these data bodies are of unknown quality and reliability for data linkage.

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Introduction: A diagnosis of melanoma in situ presents negligible risk to a person's lifespan or physical well-being, but existing terminology makes it difficult for patients to distinguish these from higher risk invasive melanomas. This study aims to explore whether using an alternative label for melanoma in situ may influence patients' management choices and anxiety levels.

Methods And Analysis: This study is a between-subjects randomised online experiment, using hypothetical scenarios.

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Objectives: Intensive care unit (ICU) clinicians stop antibiotics more often, with a negative infection: point-of-care test (PCR-POCT). Simulated cases of diagnostic uncertainty regarding infection resolution led clinicians to choose options such as procalcitonin (PCT) and/or PCR-POCTs +/- de-escalation to aid stop decisions. We hypothesised that a direct infection indicator, PCR-POCT, would influence stop judgements more than indirect PCT.

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Objectives: Suboptimal intrapartum electronic fetal heart rate monitoring using cardiotocography has remained a persistent problem (EFM-CTG). We aimed to identify the range of influences on the safety of using EFM-CTG in practice.

Design: Scoping review to identify influences related to the practice of intrapartum EFM.

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Introduction: Ewing sarcoma is a rare paediatric cancer. Currently, there is no way of accurately predicting these patients' survival at diagnosis. Disease type (ie, localised disease, lung/pleuropulmonary metastases and other metastases) is used to guide treatment decisions, with metastatic patients generally having worse outcomes than localised disease patients.

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Objectives: To adapt and apply a model for evaluating the functional benefits and cost efficiency of specialist inpatient rehabilitation to the Australian context, comparing functional outcomes and savings in the cost of ongoing care after acquired brain injury.

Design: An observational cohort analysis of prospectively collected clinical data from admission to discharge, with follow-up to 3 years.

Setting: A newly established state-wide inpatient postacute rehabilitation unit in Victoria, Australia for patients with moderate to severe acquired brain injury.

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Introduction: Cortisol is an essential stress hormone and failure of its production, known as adrenal insufficiency (AI), is associated with significant mortality due to adrenal crisis. The Short Synacthen Test (SST) is the current diagnostic test of choice for AI, but it is both invasive and resource intensive. Globally, there is an unmet need for a non-invasive, cost-effective test.

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Experience, access and utilisation of fertility care for infertile men within the biomedical sector in urban Bangladesh: protocol for a qualitative study.

BMJ Open

December 2024

Department of Sexual and Reproductive Health and Research, Human Reproduction Program, World Health Organization, Geneva, Switzerland.

Introduction: One in six people of reproductive age experience infertility in their lifetime throughout the world, often with devastating consequences. Men are often invisible in infertility research and services, yet masculinity and reproductive agency intersect within social, cultural and religious contexts to shape their experiences of infertility and masculine expression. This study aims to provide insights into the lived experience of male infertility, the availability and access of infertility services for men within the biomedical sector in Bangladesh and the potential willingness of men to use home-based semen testing.

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Introduction: The megalencephaly capillary malformation polymicrogyria (MCAP syndrome) results from mosaic gain-of-function variants. The main clinical features are macrocephaly, somatic overgrowth, neurodevelopmental delay and brain anomalies. Alpelisib (Vijoice) is a recently FDA-approved PI3Kα-specific inhibitor for patients with PIK3CA-related overgrowth spectrum (PROS).

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Introduction: Individuals with hearing loss and hearing aid users report higher levels of listening effort and fatigue in daily life compared with those with normal hearing. However, there is a lack of objective measures to evaluate these experiences in real-world settings. Recent studies have found that higher sound pressure levels (SPL) and lower signal-to-noise ratios (SNR) are linked to increased heart rate and decreased heart rate variability, reflecting the greater effort required to process auditory information.

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Healthcare ethics and artificial intelligence: a UK doctor survey.

BMJ Open

December 2024

Centre for Social Ethics and Policy, Department of Law, School of Social Sciences, University of Manchester, Manchester, UK

Article Synopsis
  • The study surveyed 272 UK doctors about their use of artificial intelligence (AI) in healthcare, focusing on their knowledge, concerns, and views on regulation.
  • Most doctors felt they had limited knowledge of AI, with men rating themselves higher than women, and younger doctors in training were more likely to use AI compared to more experienced doctors.
  • Concerns about AI included patient safety and confidentiality, leading to a strong call from doctors for more regulatory guidelines from professional bodies regarding AI usage in their practices.
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Objective: To estimate the resource use of patients with obstructive hypertrophic cardiomyopathy (HCM), stratified by New York Heart Association (NYHA) class, in the English and Northern Irish healthcare systems via expert elicitation.

Design: Modified Delphi framework methodology.

Setting: UK HCM secondary care centres (n=24).

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Introduction: Ischaemic heart disease (IHD) and cerebrovascular disease are leading causes of morbidity and mortality worldwide. Cerebral small vessel disease (CSVD) is a leading cause of dementia and stroke. While coronary small vessel disease (coronary microvascular dysfunction) causes microvascular angina and is associated with increased morbidity and mortality.

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Background: Efforts to minimise inequity in palliative and end-of-life care (PEoLC) are well-researched. This is frequently explained by differences related to singular factors. The concept of intersectionality recognises that the combination of variables exacerbates disparities.

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Article Synopsis
  • The manosphere is an online network promoting male dominance and antifeminist views, attracting a significant number of young men.
  • There is limited systematic research on the long-term effects of this content on young people's mental health, but preliminary findings indicate a rise in sexist attitudes and harmful messages that could worsen inequalities in schools.
  • The commentary calls for urgent interventions to address the negative influence of the manosphere on young men’s attitudes and its broader impact on the mental health of women and girls.
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Background: The failure rate of anterior cruciate ligament (ACL) reconstruction in children and adolescents is a significant concern. Of the multitude of clinical factors that contribute to this risk, delayed maturation and graft laxity are potentially related and modifiable elements. The aim was to investigate knee anterior laxity and graft maturation in children and adolescents.

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The tumor microenvironment (TME) is integral to cancer progression, impacting metastasis and treatment response. It consists of diverse cell types, extracellular matrix components, and signaling molecules that interact to promote tumor growth and therapeutic resistance. Elucidating the intricate interactions between cancer cells and the TME is crucial in understanding cancer progression and therapeutic challenges.

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