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Mashup Score: 0Patient and caregiver characteristics associated with differential use of primary care for children and young people in the UK: a scoping review - 4 hour(s) ago
Objective To systematically map evidence to answer the research question: What is the relationship between the characteristics of children and young people (CYP) or their caregivers and primary care service use in the UK, taking into account underlying healthcare needs? Design Scoping review. Setting Primary care. Eligibility criteria English-language quantitative or mixed-methods studies published between 2012 and 2022. Data sources Medline, Embase, Scopus and Web of Science Social Sciences Citation Index, and grey literature. Results 22 eligible studies were identified, covering general practice (n=14), dental health (n=4), child mental health (MN) services (n=3) and immunisation (n=1). Only eight studies (36%) controlled for variables associated with healthcare need (eg, age, birth weight and long-term conditions). In these, evidence of horizontal inequity in primary care use was reported for CYP living in deprived areas in England, with and without complex needs. Horizontal inequit
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Mashup Score: 13Who dies from venous thromboembolism after hospitalisation for other reasons in England?: a national retrospective cohort study - 9 hour(s) ago
Objectives Venous thromboembolism (VTE) is a major cause of morbidity and mortality globally, with hospital-associated thrombosis (HAT) accounting for at least half of VTE. We set out to understand more about deaths from HAT in England, to focus improvement efforts where they are needed most. Design A retrospective cohort combining death certification and hospital activity data to identify people with an inpatient or day case hospitalisation where no VTE diagnosis was recorded, and who died from VTE in a hospital or within 90 days of discharge, between April 2017 and March 2020. Setting All deaths occurring in England and all National Health Service-funded hospital care in England. Participants After 0.1% of cases were excluded due to duplicate but conflicting records, a cohort of 13 995 deaths remained; 54% were women, and 26% were aged under 70 years. Outcome measures Analysis of age, gender, primary diagnosis, type of admission, specialties and (for day cases) procedure types were p
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Mashup Score: 2Prevalence of neural tube defect and its identification during antenatal period: a cross-sectional study in eastern Indian state - 17 hour(s) ago
Objective To estimate the prevalence of neural tube defects among all birth outcomes in Odisha during 2016–2022. Additionally, to estimate the identification rate of neural tube defects during Pradhan Mantri Surakshit Matritva Abhiyan sessions. Design A population-based cross-sectional study with a household survey for neural tube defects using pictorial card as well as a hospital-based study for antenatal ultrasonography data. Setting The sample population was selected through multistage random sampling. In the first stage, one district from each zone was selected randomly. In the second stage, using simple random sampling, one community health centre and one urban primary health centre were selected from each district. In the third stage, the population from a block and ward were picked from the selected rural and urban settings, respectively. Participants All married women in the reproductive age group (18–49 years) residing in these cluster villages in the selected districts were e
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Mashup Score: 1Body mass index and all-cause mortality in HUNT and UK biobank studies: revised non-linear Mendelian randomisation analyses - 1 day(s) ago
Objectives To estimate the shape of the causal relationship between body mass index (BMI) and mortality risk in a Mendelian randomisation framework. Design Mendelian randomisation analyses of two prospective population-based cohorts. Setting Individuals of European ancestries living in Norway or the UK. Participants 56 150 participants from the Trøndelag Health Study (HUNT) in Norway and 366 385 participants from UK Biobank recruited by postal invitation. Outcomes All-cause mortality and cause-specific mortality (cardiovascular, cancer, non-cardiovascular non-cancer). Results A previously published non-linear Mendelian randomisation analysis of these data using the residual stratification method suggested a J-shaped association between genetically predicted BMI and mortality outcomes with the lowest mortality risk at a BMI of around 25 kg/m2. However, the ‘constant genetic effect’ assumption required by this method is violated. The reanalysis of these data using the more reliable doubl
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Mashup Score: 3
Objectives The acute respiratory distress syndrome (ARDS) is a heterogeneous condition, and identification of subphenotypes may help in better risk stratification. Our study objective is to identify ARDS subphenotypes using new simpler methodology and readily available clinical variables. Setting This is a retrospective Cohort Study of ARDS trials. Data from the US ARDSNet trials and from the international ART trial. Participants 3763 patients from ARDSNet data sets and 1010 patients from the ART data set. Primary and secondary outcome measures The primary outcome was 60-day or 28-day mortality, depending on what was reported in the original trial. K-means cluster analysis was performed to identify subgroups. Sets of candidate variables were tested to assess their ability to produce different probabilities for mortality in each cluster. Clusters were compared with biomarker data, allowing identification of subphenotypes. Results Data from 4773 patients were analysed. Two subphenotypes
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Mashup Score: 4How prepared are newly qualified allied health professionals for practice in the UK? A systematic review - 1 day(s) ago
Objectives It is important that allied health professionals (AHPs) are prepared for clinical practice from the very start of their working lives to provide quality care for patients, for their personal well-being and for retention of the workforce. The aim of this study was to understand how well newly qualified AHPs were prepared for practice in the UK. Design Systematic review. Data sources Embase, MEDLINE, CINAHL, ERIC and BEI were searched from 2012 to 2024. Grey literature searching and citation chasing were also conducted. Eligibility criteria We included primary studies reporting the preparedness for practice of UK graduates across 15 professions; all study types; participants included graduates who were up to 2 years postgraduation, their supervisors, trainers, practice educators and employers; and all outcome measures. Data extraction and synthesis A standardised data extraction form was used. Studies were quality assessed using the Quality Appraisal for Diverse Studies tool.
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Mashup Score: 18Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance - 2 day(s) ago
Objective The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals. Design/setting An international research priority-setting partnership. Participants People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb. Methods A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021–October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second internati
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Mashup Score: 15Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance - 4 day(s) ago
Objective The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals. Design/setting An international research priority-setting partnership. Participants People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb. Methods A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021–October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second internati
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Mashup Score: 0
Objectives Long-term benzodiazepine use is common despite known risks. In the original Eliminating Medications Through Patient Ownership of End Results (EMPOWER) Study set in Canada, patient education led to increased rates of benzodiazepine cessation. We aimed to determine the effectiveness of implementing an adapted EMPOWER quality improvement (QI) initiative in a US-based healthcare system. Design We used a pre–post design with a non-randomised control group. Setting A network of primary care clinics. Participants Patients with ≥60 days’ supply of benzodiazepines in 6 months and ≥1 risk factor (≥65 years of age, a concurrent high-risk medication prescribed or a diazepam equivalent daily dose ≥10) were eligible. Intervention In March 2022, we engaged 22 primary care physicians (PCPs), and 308 of their patients were mailed an educational brochure, physician letter and flyer detailing benzodiazepine risks; the control group included 4 PCPs and 291 of their patients. Primary and seconda
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Mashup Score: 1Paediatric off-label use of drugs in Gansu, China: a multicentre cross-sectional study - 4 day(s) ago
Objective To examine the current prevalence and cost of paediatric off-label drug prescriptions in Gansu, China, and the potential influencing factors. Design The prevalence of off-label prescriptions in paediatrics was evaluated according to the National Medical Products Administration drug instructions in the China Pharmaceutical Reference (China Pharmaceutical Reference, MCDEX) database. The evidence of the prescription was determined by existing clinical practice guidelines and the Thomson Grade in the Micromedex 2021 compendium. We used logistic regression to investigate the characteristics that influence paediatric off-label drug use after single-factor regression analysis. Setting A multicentre cross-sectional study of outpatient paediatric prescriptions in 196 secondary and tertiary hospitals in Gansu Province, China, in March and September 2020. Results We retrieved 104 029 paediatric prescriptions, of which 39 480 (38.0%) contained off-label use. The most common diseases trea
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Patient and caregiver characteristics associated with differential use of primary care for children and young people in the UK: a scoping review. https://t.co/Fncbgv3zoa https://t.co/I5UtajnyQ9