This study is aimed at exploring the levels of peripheral blood circular RNAs (circRNAs) as biomarker candidates for the diagnosis of new-onset rheumatoid arthritis (RA). The selected twenty-two circRNAs in peripheral blood from new-onset RA patients and healthy controls (HC) were determined by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The levels of hsa_circ_0002715, hsa_circ_0001947, hsa_circ_0000367, and hsa_circ_0035197 were significantly increased in the peripheral...
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IntroductionThe aim of this systematic review with meta-analysis is to evaluate the clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for any type of acute and chronic pain in adults. Methods and analysisWe intend to search electronic databases (Cochrane Library, MEDLINE, Embase, CINAHL, PsycINFO, LILACS, PEDRO, Web of Science, AMED and SPORTDiscus) from inception to the present day to identify all randomised controlled trials (RCT) on the use of TENS in adults for any type...
ObjectivesModifying lifestyle can prevent the progression of chronic kidney disease (CKD) but the specific elements which lead to favourable behaviour change are not well understood. We aimed to identify and evaluate behaviour change techniques and functions in lifestyle interventions for preventing the progression of CKD. DesignSystematic review. Data sourcesMEDLINE, EMBASE, CINAHL and PsycINFO. Eligibility criteriaTrials of lifestyle behaviour change interventions (including diet, physical activity,...
IntroductionOptimal medication management is one of the basic conditions necessary for home-dwelling older adults living with multiple chronic conditions (OAMCC) to be able to remain at home and preserve their quality of life. Currently, the reasons for such high numbers of emergency department visits and the very significant rate of hospitalisations for OAMCC, due to medication-related problems (MRPs), is poorly explored. This study aims to reveal the current state of the medication management practices...
IntroductionAdvance care planning (ACP), an ongoing communication and planning process, aims to clarify a person’s values and preferences, so these guide decision-making if the person becomes unable to make his or her own decisions. Ideally, ACP results in completion of advance care directives (ACD), documents completed by competent people outlining their values, treatment preferences and/or appointment of a substitute decision-maker (SDM). ACDs are most effective at the point of care, where they...
IntroductionKnee osteoarthritis (OA) is the most common joint disease worldwide. As of today, there are no disease-modifying drugs, but there is evidence that muscle strengthening exercises can substantially reduce pain and improve function in this disorder, and one very well tested physiotherapy protocol is the ‘Better Management of Patients with Osteoarthritis’ developed in Sweden. Given the high prevalence of knee OA, a potentially cost-effective, digitally delivered approach to treat knee OA...
ObjectivesTo describe healthcare use and spending before and on becoming a new (incident) senior high-cost user (HCU) compared with senior non-HCUs; to estimate the incremental costs, overall and by service category, attributable to HCU status; and to quantify its monetary impact on the provincial healthcare budget in Ontario, Canada. DesignWe conducted a retrospective, population-based comparative cohort study using administrative healthcare records. Incremental healthcare utilisation and costs...
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Zusammenfassung Fußdeformitäten und Probleme mit der Schuhversorgung treten bei „Rheumatikern“ im zeitlichen Verlauf fast regelhaft auf. Dabei unterliegen die destruktiven Prozesse meist recht typischen Charakteristika. Als Vollbild resultiert zuletzt im Rück- und Mittelfuß ein Pes planovalgus, im Vorfuß ein Hallux valgus, Spreizfuß und Krallenzehen. Trotz der enormen Verbesserungen der medikamentösen Therapie in den letzten Jahren kann die Entwicklung einer rheumatischen Fußdeformität...
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IntroductionWithin the UK, chest pain is one of the most common reasons for emergency (999) ambulance calls and the most common reason for emergency hospital admission. Diagnosing acute coronary syndromes (ACS) in a patient with chest pain in the prehospital setting by a paramedic is challenging. The Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision rule is a validated tool used in the emergency department (ED) to stratify patients with suspected ACS following a single blood test....
IntroductionThe scale-up of integrated Human Immunodeficiency Virus (HIV) and tuberculosis (TB) treatment has been an important intervention to curb the burden of HIV and TB co-infection worldwide. Uptake of and adherence to antiretroviral therapy (ART) are key determinants of the quality and therapeutic endpoints of this intervention. This study aims to conduct an up-to-date collection and synthesis of evidence on barriers to and facilitators of uptake of and adherence to ART in HIV/TB integrated...
IntroductionCreutzfeldt-Jakob disease (CJD) is a human prion disease that occurs in sporadic, genetic and acquired forms. Variant CJD (vCJD) is an acquired form first identified in 1996 in the UK. To date, 178 cases of vCJD have been reported in the UK, most of which have been associated with dietary exposure to the bovine spongiform encephalopathy agent. Most vCJD cases have a young age of onset, with a median age at death of 28 years. In the UK, suspected cases of vCJD are reported to the UK National...
ObjectivesLifestyle and working conditions of truck drivers predisposes them to risk-factors associated with communicable and non-communicable diseases, but little is known about the health status of African truck driver. This study aims to assess a cross-section of truckers in South Africa to describe their health information. SettingThe study took place across three truck-stop rest areas in the South African provinces of Free State and Gauteng. ParticipantsEligibility criteria included being...
ObjectiveA person’s concept of pain can be defined as how they understand what pain actually is, what function it serves and what biological processes are thought to underpin it. This study aimed to explore the concept of pain in children with and without persistent pain. DesignIn-depth, face-to-face interviews with drawing tasks were conducted with 16 children (aged 8–12 years) in New South Wales, Australia. Thematic analysis was used to analyse and synthesise the data. SettingChildren with persistent...
IntroductionCancer diagnosis in primary care is an important challenge for general practitioners (GPs) due to the relatively low frequency of any single type of cancer and the heterogeneous signs and symptoms that can be present. In addition to analytical reasoning, GPs may become aware of gut feelings (GFs) as they suspect that a patient may have cancer or another serious disease. We aimed to investigate the prevalence and the predictive value of GFs for the diagnosis of cancer and serious diseases....
ObjectiveThe objective of this study was to ascertain the effects of high-intensity chronic endurance training on cardiovascular markers of active populations and athletes. MethodsThis review was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We used databases of PubMed, Science Direct, SPORTDiscus, Google Scholar and grey literatures with Mesh and free-text search as well as manual searches to identify relevant studies from...
IntroductionIn addition to their high mortality rates, road traffic collisions (RTC) are considered a burden within those who do survive. In Africa, injuries related to RTC have been identified as the 10th most common cause of disability-adjusted life years lost for all ages and categories. Moreover, non-fatal RTC are the biggest cause associated with the burden of musculoskeletal disorders (MSD) in Africa. Despite this, the epidemiology of MSD related to non-fatal RTC within this region is still...
ObjectivesTo explore relevant Finnish stakeholders’ perceptions on the automatic substitution of biological medicines with particular focus on medication safety and issues that need to be considered to create an appropriate model for automatic biological product substitution. DesignQualitative interview study. MethodsData were collected in semistructured individual (n=17), pair (n=7) and group (n=8) interviews (32 interviews, 62 participants) in 2018. Participants represented a wide range of stakeholders...
IntroductionMetabolically healthy obese phenotype (MHO) refers to obese individuals with an adequate metabolic profile and absence of metabolic syndrome. Many prospective studies have reported the benign condition relating the MHO phenotype and its potential role in reducing risk of cardiovascular disease, total cancer, and all-cause and cause-specific mortality. However, inconsistent results were found and the question remains controversial. We aim to conduct a systematic review and meta-analysis...
ObjectivesThis study aimed to estimate the prevalence of, and factors associated with, accessing maternal healthcare services (MHC) by Indigenous women in the Chittagong Hill Tracts (CHT), Bangladesh. DesignThis was a cross-sectional survey among Indigenous women of reproductive age. SettingTwo upazillas (subdistricts) of Khagrachhari hill district of the CHT. ParticipantsIndigenous women (15–49 years) within 36 months of delivery were surveyed about accessing MHC services (antenatal care, delivery...
IntroductionDepression is highly prevalent and the leading contributor to the burden of disease in young people worldwide, making it an ongoing priority for early intervention. As the current evidence-based interventions of medication and psychological therapy are only modestly effective, there is an urgent need for additional treatment strategies. This paper describes the rationale of the Improving Mood with Physical ACTivity (IMPACT) trial. The primary aim of the IMPACT trial is to determine the...
IntroductionInguinal hernia mesh repair is the standard care for symptomatic inguinal hernia. Mesh fixation is used to keep mesh in place for which various mesh fixation techniques have been used in open and laparoscopic inguinal hernia repair, but their effectiveness has remained inconclusive. Therefore, we developed a protocol for an umbrella review in order to summarise the evidences with integrate and update data of different mesh fixation techniques in both open and laparoscopic inguinal hernia...
ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region. DesignA cross-sectional study. SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain). ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database....
ObjectivesThis study describes the 2016 expansion of the British Columbia Take Home Naloxone (BCTHN) programme quantitatively and explores the challenges, facilitators and successes during the ramp up from the perspectives of programme stakeholders. DesignMixed-methods study. SettingThe BCTHN programme was implemented in 2012 to reduce opioid overdose deaths by providing naloxone kits and overdose recognition and response training in BC, Canada. An increase in the number of overdose deaths in 2016...
ObjectiveObesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations in Taiwan. DesignCross-sectional observational study. SettingCommunity-based investigation in Guishan Township of northern Taiwan. ParticipantsA total of 396 people were recruited from a northern Taiwan community for a cross-sectional...
IntroductionIn recent years, it has been demonstrated that photobiomodulation therapy (PBMT) using low-level laser therapy and/or light-emitting diode therapy combined to static magnetic field (sMF) has ergogenic effects, improving muscular performance and accelerating postexercise recovery. However, many aspects related to these effects and its clinical applicability remain unknown. Therefore, the aim of this project is to evaluate the ergogenic effects of PBMT/sMF in detraining after a strength-training...
ObjectivesThe aim of this study was to characterise the resources and challenges for surgical care and referrals at health centres (HCs) in South Wollo Zone, Ethiopia. SettingEight primary HCs in South Wollo Zone, Ethiopia. ParticipantsEight health officers and nurses staffing eight HCs completed a survey. DesignThe study was a survey-based, cross-sectional assessment of HCs in South Wollo Zone, Ethiopia and data were collected over a 30-day period from November 2014 to January 2015. Primary...
PurposeThe Monitoring Young Lifestyles (MyLife) project was initiated as an integrated quantitative and qualitative prospective investigation of correlates, causes, and consequences of adolescent substance use and other addictive behaviours in Norway. ParticipantsThe MyLife cohort was recruited from middle schools in Norway, which were selected from low, medium and high standard of living areas in both rural and urban regions of the country. A total of 3512 eighth, ninth and tenth graders (55% girls)...
ObjectivesTo describe public understanding and use of antibiotics. DesignIpsos MORI Capibus survey of randomly-selected households. SettingEngland, January–April 2017. Participants2283 adults (≥15 years) including 777 parents of children <5 years old. Data collection and analysisThe main survey was undertaken in January 2017 (n=1691); data from an additional sample of parents were collected in April 2017 (n=592). Analyses were weighted to obtain estimates representative of the population....
IntroductionEfficient communication and coordination between countries is needed for prevention, detection and response to international food safety events. While communication tools exist, current evidence suggests that they are only effective within certain contexts and only cover certain geographic areas. There is a need to unpack and explore the mechanisms of how and in what context such communication tools and their components are effective at facilitating international communication and coordination...
ObjectiveThe identification of susceptible non-smoking adolescents is an essential step in reducing smoking initiation among adolescents. The aim of this study was to examine the prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. DesignCross-sectional study. SettingPrimary and secondary schools in Malaysia. Participants11 246 non-smoking school-going adolescents. Outcome measuresThe prevalence and factors associated with smoking...
ObjectivesTo examine how prevalence and context of sexual inactivity varies across the life-course, assess dissatisfaction with sex life among those who are sexually inactive and identify associations with factors that may represent reasons for sexual inactivity. DesignAnalysis of cross-sectional probability sample survey data. SettingBritish general population. Participants14 623 participants (n men: 6045 unweighted, 7245 weighted), aged 16–74 years, of the third National Survey of Sexual Attitudes...
IntroductionAcute pulmonary embolism (PE) is a frequent life-threatening event and an important cause of hospitalisation, morbidity and mortality worldwide. Limited information on the long-term course of PE patients is available so far. The Lungenembolie Augsburg study will provide a view on the predisposing and PE-provoking factors, diagnostic procedures and short as well as long-term treatment options. Especially, the data on the long-term course of the disease—in combination with omics data obtained...
ObjectivesLow-income and middle-income countries are undergoing epidemiological transition, however, progression is varied. Bangladesh is simultaneously experiencing continuing burden of communicable diseases and emerging burden of non-communicable diseases (NCDs). For effective use of limited resources, an increased understanding of the shifting burden and better characterisation of risk factors of NCDs, including hypertension is needed. This study provides data on prevalence and factors associated...
ObjectivesTo study the association of place-based socioeconomic factors with disease distribution by comparing hospitalisation rates in California in 2001 and 2011 by zip code median household income. DesignSerial cross-sectional study testing the association between hospitalisation rates and zip code-level median income, with subgroup analyses by zip code income and race. Participants/settingOur study included all hospitalised adults over 18 years old living in California in 2001 and 2011 who...
ObjectivesTo describe dietary sources of free sugars in different age groups of the UK population considering food groups classified according to the NOVA system and to estimate the proportion of excessive free sugars that could potentially be avoided by reducing consumption of their main sources. Design and settingCross-sectional data from the UK National Diet and Nutrition Survey (2008–2014) were analysed. Food items collected using a 4-day food diary were classified according to the NOVA system....
IntroductionPregnant women faced with complications of pregnancy often require long-term hospital admission for maternal and/or fetal monitoring. Antenatal admissions cause a burden to patients as well as hospital resources and costs. A telemonitoring platform connected to wireless cardiotocography (CTG) and automated blood pressure (BP) devices can be used for telemonitoring in pregnancy. Home telemonitoring might improve autonomy and reduce admissions and thus costs. The aim of this study is to...
IntroductionLow back pain (LBP) is one of the most frequent encounters in General Practice. Investigation and referral remain common despite the self-limiting character of episodes that are not largely attributable to specific underlying injuries. Identifying patients’ ideas, concerns and expectations (ICE) is a well-established element within consultation skills training and has been shown to improve prescribing. It can be a powerful communication tool setting the base for transferring and adjusting...
ObjectivesThe knowledge of past asbestos exposure may lead to chronic psychological strain. In addition, the information about an increased cancer risk can place a psychological burden on individuals triggering mental health symptoms of depression or anxiety. This applies in particular to individuals with non-malignant asbestos-related disease (ARD) such as lung fibrosis and pleural thickening with or without lung function impairment. ARDs with or without lung function impairment may develop even...
ObjectivesExplore factors related to continuity of care and its association with diabetes and hypertensive care, and disease control. DesignCross-sectional study. SettingData from the Chilean Health National Survey 2009–2010. ParticipantsRegular users of primary care services aged 15 or older. Primary and secondary outcome measuresProportion of hypertensive and diabetic patients with a blood pressure <140/90 mm Hg and HbA1c<7.0% respectively, self-report of diagnosis, treatment and recent...
ObjectivesSex differences in respiratory physiology and predilection for developing chronic obstructive pulmonary disease (COPD) have been documented, suggesting that female sex hormones may influence pathogenesis. We investigated whether aspects of female reproductive health might play a role in risk of COPD among women. DesignPopulation-based prospective cohort study. SettingUK Biobank recruited across 22 centres in the UK between 2006 to 2010. Primary and secondary outcomes measuresWe examined...
ObjectivesTo assess the use, and evaluate the usefulness, of non-interventional studies and routinely collected healthcare data in postmarketing assessments conducted by the European Medicines Agency (EMA). DesignWe reviewed and systematically assessed all referrals to the EMA made due to safety or efficacy concerns that were evaluated between 1 January 2013 and 30 June 2017. We extracted information from the assessment report and the referral notification. Two reviewers independently assessed the...
ObjectiveThis study aimed to promote an understanding of spontaneous pneumothorax by analysing the prevalence rate and medical service use by patients with spontaneous pneumothorax according to sociodemographic characteristics. DesignA 12-year nationwide study. SettingData obtained from the Korean National Health Insurance Service Sharing Service. ParticipantsA total of 4658 participants who used medical services due to spontaneous pneumothorax between 2002 and 2013 in Korea. Outcome measuresFor...
ObjectiveTo map key policy documents worldwide and establish how they address the treatment and care needs of children and young people (CYP) who are suicidal. DesignWe conducted a scoping review to systematically identify relevant key policy documents following a pre-established published protocol. Data sourcesFour databases (CINAHL; Medline; PsycINFO; The Cochrane Database of Systematic reviews) and the websites of key government, statutory and non-statutory agencies were searched. Google and...
ObjectiveTo evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project. DesignRepeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017). SettingSeven acute care hospitals in Switzerland. ParticipantsThe survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated...
IntroductionPatient-reported outcome-based symptom monitoring and alerting have been attractive for patient care after a tumour-removal surgery. However, the implementation parameters of this patient-centred symptom management system in perioperative patients with lung cancer are still lacking. We aim to develop a perioperative symptom scale (PSS) for monitoring, to determine the optimal time points for symptom assessment and to define the alert thresholds for medical intervention. Methods and analysisThis...
IntroductionCervical cancer disproportionately burdens low-income and middle-income countries (LMICs) such as Guatemala. Self-collection testing for human papillomavirus (HPV) has been suggested as a form of cervical cancer screening to facilitate access in LMICs. This study assessed and compared the acceptability of self-collection HPV testing in two rural, indigenous and ethnically distinct communities in Guatemala: Santiago Atitlán, Sololá and Livingston, Izabal. MethodsAll participants, women...
ObjectiveTo examine the long-term effect of a socially differentiated cardiac rehabilitation (CR) intervention tailored to reduce social inequalities in health regarding use of healthcare services in general practice and hospital among socially vulnerable patients admitted with first-episode myocardial infarction (MI). DesignA prospective cohort study with 10 years’ follow-up. SettingDepartment of cardiology at a university hospital in Denmark between 2000 and 2004. ParticipantsPatients <70...
IntroductionOsteoarthritis (OA) is the leading cause of disability and pain in older adults. Although increasing physical activity (PA) can help reduce symptoms, patients with lower-limb OA are less active than the general public. Although physiotherapists commonly deliver PA programmes, they lack knowledge of key barriers and facilitators to adherence to prescribed PA that patients with lower-limb OA experience while attending physiotherapy appointments (treatment period) and after discharge (post-treatment...
IntroductionFamily-based physical activity (PA) interventions present a promising avenue to promote children’s activity; however, high-quality experimental research is lacking. This paper describes the protocol for the FRESH (Families Reporting Every Step to Health) pilot trial, a child-led family-based PA intervention delivered online. Methods and analysisFRESH is a three-armed, parallel-group, randomised controlled pilot trial using a 1:1:1 allocation ratio with follow-up assessments at 8 and...
ObjectivesTo investigate whether UK websites about cervical cancer screening targeted to the public include (1) information about benefits and risks of screening, possible screening results and cervical cancer statistics, (2) quantitative presentation formats recommended in the risk communication literature and (3) appeals for participation and/or informed decision-making. DesignCross-sectional analysis of websites using a comprehensive checklist of information items on screening benefits, risks,...
ObjectivesLow-level laser therapy (LLLT) is not recommended in major knee osteoarthritis (KOA) treatment guidelines. We investigated whether a LLLT dose–response relationship exists in KOA. DesignSystematic review and meta-analysis. Data sourcesEligible articles were identified through PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and Cochrane Central Register of Controlled Trials on 18 February 2019, reference lists, a book, citations...
Background and objectivesCardiovascular diseases (CVD) accounted for one-third of the deaths in India. We conducted a cohort study to estimate the incidence of CVD and the association of established risk factors with the incident CVD in a rural population in South India. Design, setting and participantsWe conducted a community-based cohort study among 6026 adults aged 25–64 years in five villages in Tiruvallur, Tamil Nadu. We did baseline (2005–2007) and two follow-up surveys in 2008–2009 and 2013–2015....
IntroductionCardiac rehabilitation (CR) programmes are well established, and their effectiveness and cost-effectiveness are proven. In spite of this, CR remains underused, especially in lower-resource settings such as Latin America. There is an urgent need to create more accessible CR delivery models to reach all patients in need. This trial aims to evaluate if the prevention of recurrent cardiovascular events is not inferior in a hybrid CR programme compared with a standard programme. Method and...
ObjectivesTo compare the use of short implants (≤6 mm) in atrophic posterior maxilla versus longer implants (≥10 mm) with sinus floor elevation. DesignA systematic review and meta-analysis based on randomised controlled trials (RCTs). Data sourcesElectronic searches were conducted in PubMed, Embase and the Cochrane CENTRAL. Retrospective and prospective hand searches were also performed. Eligibility criteriaRCTs comparing short implants (≤6 mm) and longer implants (≥10 mm) with sinus floor elevation...
IntroductionSeveral studies suggest that gut microbiota may play an important role in allergic diseases. The present trial aims to examine effects of the probiotic Enterococcus faecalis on symptoms of allergic rhinitis in patients. Effects of this probiotic on the immune system have been reported by several studies, but the majority of the previous trials were animal studies. In addition, it is well known that symptoms in allergic rhinitis are prone to exhibit high placebo responses. Moreover, recent...
IntroductionHealth-promoting lifestyle behaviours are part of the activities of daily living that influence individual happiness, values and well-being. They play a crucial role in prevention and control of non-communicable diseases (NCDs) among all age groups. Current statistics on mortality, disability and morbidity associated with NCDs are alarming globally. The use of information and communication technology (ICT) for a health-promoting lifestyle behaviour programme enhances health behaviours...
IntroductionAssisted reproductive technologies (ART), namely in vitro fertilisation and intracytoplasmic sperm injection, have become widely used to treat infertility. Although the use of ART is generally considered favourable, there are ongoing concerns about the prenatal and perinatal risks as well as long-term risks for the child. Epidemiological studies have demonstrated an association between pathological events during fetal development and future cardiovascular risk, raising concerns about...
ObjectiveTo investigate the association between diabetes and latent tuberculosis infections (LTBI) in high TB incidence areas. DesignCommunity-based comparison study. SettingOutpatient diabetes clinics at 4 hospitals and 13 health centres in urban and rural townships. A community-based screening programme was used to recruit non-diabetic participants. ParticipantsA total of 2948 patients with diabetes aged older than 40 years were recruited, and 453 non-diabetic participants from the community...
ObjectiveTo establish the prevalence and associations of systemic antibiotic prescription for impetigo by early-career general practitioners (GPs) (GP registrars in their first 18 months in general practice). DesignA cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study. SettingReCEnT is an ongoing multisite cohort study of Australian registrars’ in-consultation clinical practice across five Australian states. ParticipantsRegistrars participating in...
IntroductionGlobal prevalence of risk factors for cardiovascular disease (CVD) and all-cause mortality is increasing. Treatments are available but can only be implemented if individuals at risk are identified. General health checks have been suggested to facilitate this process. ObjectivesTo examine the long-term effect of population-based general health checks on CVD and all-cause mortality. Design and settingThe Ebeltoft Health Promotion Project (EHPP) is a parallel randomised controlled trial...
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