BMJ Open

IntroductionThis is the study protocol of an ongoing prospective randomised controlled trial (RCT) written as per the SPIRIT guidelines. This RCT is designed to assess the safety and efficacy of early enteral nutrition after elective enterostomy closure in paediatric patients. Methods and analysisThis is a multicentre, RCT that will be conducted in two Australian tertiary paediatric hospitals with a planned sample size of 68. Children that meet the inclusion criteria aged between three months a...

IntroductionRandomised controlled trials (RCTs) investigate the safety and efficacy of interventions. It has become clear however that some RCTs include fabricated data. The INSPECT-SR tool assesses the trustworthiness of RCTs in systematic reviews of healthcare-related interventions. However, where individual participant data (IPD) can be obtained, a more thorough assessment of trustworthiness is possible. Consequently, INSPECT-SR recommends obtaining IPD to resolve uncertainties, though there ...

IntroductionThe growing burden of cardiovascular disease (CVD) threatens the sustainability of our healthcare systems. In the Netherlands, two-thirds of CVD-related healthcare is delivered in primary care practices, primarily by practice nurses. Given the increasing staffing shortages and the substantial heterogeneity of the population of primary care patients at increased risk of CVD, cardiovascular risk management strategies should be better tailored to individual patients needs and risk profi...

AimTo outline the opportunities and barriers when using hairdressing salons as a novel site for enhancing cardiovascular risk factor assessment and management in women. MethodsA process evaluation nested within a cluster-randomised trial, Hairdressers for Health. The trial evaluated a nudge intervention advising women [≥]45years attending hairdressing salons to undertake a Heart Health Check with their General Practitioner. The UK Medical Research Council process evaluation framework was ...

BackgroundWithin the UK, more than a million people cannot speak English well or at all. The lack of data on English proficiency means that the link between English proficiency and health status and care utilisation is not comprehensively quantified. ObjectiveDescribe the association between English proficiency and patients health status and healthcare utilisation, and demonstrate that GP data can be useful in understanding the health burdens of those with poor language proficiency. MethodsThe...

BackgroundDespite national efforts to improve research inclusion, people from underserved communities remain underrepresented in dementia trials. Barriers occur at the point of initial engagement and also within the participation pathway itself, as the structure and burden of early screening procedures can discourage continuation. ACCESS D (Advancing Community Collaboration and Engagement Strategies in Dementia) aims to address these challenges by testing a community-based model that combines co...

IntroductionPrimary care is facing multiple crises, including an increase in health misinformation. Digital health messaging by primary care providers has been shown to reach a diverse patient population. With the uptake of Generative Artificial Intelligence (GenAI) usage in healthcare, there is an important opportunity to rapidly create messages that are tailored to different populations and conditions. However, thoroughly assessing AI-generated content is essential, as GenAI raises concerns re...

Endometriosis Nurse and Pelvic Health and Wellbeing Co-ordinator (PHWC) roles were introduced in each health board across Wales in early 2020. They were established to improve endometriosis and pelvic health care, as women can face severe problems and with major impacts across their quality of life, requiring expert care. How these staff roles have been incorporated into each health board has differed according to local need and as such, is not fully understood, nor are the benefits of the role ...

IntroductionRecent evidence from randomized controlled trials and meta-analyses in the critically ill suggest small but clinically important differences in death and requirement for renal replacement therapy that favor Ringers lactate as compared to normal saline. To futher contribute to this evidence base, we will perform a secondary analysis of the FLUID trial with a focus on critically ill patients (FLUID - ICU). The FLUID trial was hospital wide cluster randomized cross-over trial that compa...

IntroductionWith global populations ageing, demand for palliative care is increasing. Population-level assessments of unmet palliative care needs are essential for strategic planning, yet rigorous methods to estimate unmet needs are lacking. This study aimed to develop methods and estimate current and future population-level prevalence of unmet palliative care needs among adults in England and Wales. MethodsSecondary analyses of data from a nationally representative post-bereavement survey in E...

IntroductionSkin-to-skin contact during the first hour of birth is recommended for healthy newborn infants and their mothers and improves early stabilisation and breastfeeding outcomes. Kangaroo Mother Care (KMC), involving prolonged skin-to-skin contact (SSC) and exclusive breastfeeding, provides an optimal physiological transition from intrauterine to extrauterine life for preterm and low birth weight infants, improving survival by 32% and conferring multiple clinical and neurodevelopmental be...

IntroductionPatient populations in Canadian community and academic hospitals may differ with respect to demographic and clinical characteristics, as well as outcomes. Community hospitals may also differ with respect to research capacity and trial performance. The objectives of this study are to examine differences between community and academic hospitals participating in the REVISE trial with respect to: 1) patient characteristics; 2) research capacity, and 3) trial metrics. Methods and analysi...

ObjectivesTo identify (a) sociodemographic inequities in treatment with antenatal MgSO4 for fetal neuroprotection in preterm birth, and (b) whether any inequities have improved following implementation of a national quality improvement programme to improve use of MgSO4. DesignSecondary data analysis study using adjusted logistic regression modelling. SettingNHS England maternity units from 2014 to 2024. ParticipantsMothers with a preterm baby born from 24 to under 30 weeks gestation and admit...

Introduction"Encompass" is a participatory group-based intervention originating from low- and middle-income countries, co-developed with parents and professionals to enhance the wellbeing, health literacy and empowerment of caregivers of young children with complex neurodisability. We aimed to assess feasibility and acceptability of a) intervention delivery in two socially deprived United Kingdom (UK) urban areas and b) evaluation methods including data collection on programme outcomes and costs...

ObjectivesCurrent methods of health expenditure reporting make spending on palliative care services difficult to quantify. This paper (1) examines trends in the components of government (public) spending on health-related long-term care reported in the UK Health Accounts for the period of 2013 to 2022 to establish the wider context of palliative care expenditure, and (2) relates these trends to existing knowledge of expenditure on specialist palliative care services in the UK. MethodsWe conduct...

ObjectivesTo explore the delivery of the train the trainer (TtT) model for Making Every Contact Count (MECC) training in the North East and North Cumbria (NENC) region of England. DesignA qualitative study, utilising semi-structured interviews. MethodsInterviews were conducted with 21 participants, including MECC TtT trainees (n = 13), eligible non-trainees (n = 6), and principal trainers (n = 2). Data analysis utilised the Framework Method guided by the Theoretical Domains Framework (TDF), an...

IntroductionThere is a lack of evidence to support clinical recommendations to delay cervical screening to 12-weeks postnatal. In previous studies, half of women were out of date for screening by the end of pregnancy and the majority would be more likely to take up cervical screening, if onered at the 6-week postnatal check-up. We explored views about postnatal cervical screening the acceptability of onering cervical screening, using conventional and urine self-sampling, earlier within the postn...

ImportanceThe United States is facing a projected shortage of 40,000 primary care physicians by 2034. Student-run clinics (SRCs) are widely regarded as service-learning environments that may encourage students to enter a primary care specialty, but prior studies have yielded conflicting results and are limited to non-generalizable, single site analyses. ObjectiveTo compare likelihood of practice in a primary care specialty between students who did and did not participate in an SRC via pooled me...

BackgroundCommunication issues across the primary-secondary care interface are considered one of the most important challenges in improving patient safety in primary care in the UK. Teleconferencing offers a potential means of improving communication during referrals but is largely unevaluated. AimTo explore teleconferencing as an alternative to written Advice and Guidance (A&G) referrals for neurology cases, by assessing its impact on GP-specialist communication and relationships, and explorin...

BackgroundTreatment outcomes and satisfaction improve when healthcare decisions align with patient preferences. However, little is known about general health preferences in older adults, and eliciting patient preferences is time consuming. AimTo describe the distribution of preferences for healthcare in general, and associations between preferences and patient characteristics in adults aged 50 years and over in England. Design and settingData were collected in wave 8 (2016/2017) of the English...