Rollinsmcclellan2484

This study has been approved by the Research Ethics Committee . Findings will be shared with participating hospitals and disseminated to the academic community through peer-reviewed publications and presentation at national and international meetings. Patients will be informed of the results through patient organisations and participant newsletters.

ISRCTN63614165.

ISRCTN63614165.

To assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with viral respiratory infections on acute severe adverse outcomes, healthcare utilisation, quality of life and long-term survival.

Rapid systematic review.

Humans with viral respiratory infections, exposed to systemic NSAIDs.

Acute severe adverse outcomes, healthcare utilisation, quality of life and long-term survival.

We screened 10 999 titles and abstracts and 738 full texts, including 87 studies. No studies addressed COVID-19, Severe Acute Respiratory Syndrome or Middle East Respiratory Syndrome; none examined inpatient healthcare utilisation, quality of life or long-term survival. Effects of NSAIDs on mortality and cardiovascular events in adults with viral respiratory infections are unclear (three observational studies; very low certainty). Children with empyema and gastrointestinal bleeding may be more likely to have taken NSAIDs than children without these conditions (two observational studies; very low certa2020176056.

Short-term metabolic and observational studies suggest that protein intake above the recommended dietary allowance of 0.83 g/kg body weight (BW)/day may support preservation of lean body mass and physical function in old age, but evidence from randomised controlled trials is inconclusive.

The PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) trial examines the effect of personalised dietary advice aiming at increasing protein intake with or without advice regarding timing of protein intake to close proximity of usual physical activity, on change in physical functioning after 6 months among community-dwelling older adults (≥65 years) with a habitual protein intake of <1.0 g/kg adjusted (a)BW/day. Participants (n=264) will be recruited in Finland and the Netherlands, and will be randomised into three groups; two intervention groups and one control group. Intervention group 1 (n=88) receives personalised dietary advice and protein-enriched food products in order to increase their protein iphysical functioning after 6 months among community-dwelling older adults with a habitual protein intake of <1.0 g/kg aBW/day.

The study has been approved by the Ethics Committee of the Helsinki University Central Hospital, Finland (ID of the approval HUS/1530/2018) and The Medical Ethical Committee of the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands (ID of the approval 2018.399). All participants provided written informed consent prior to being enrolled onto the study. Results will be submitted for publication in peer-reviewed journals and will be made available to stakeholders (ie, older adults, healthcare professionals and industry).

ClinicalTrials.gov Registry (NCT03712306).

ClinicalTrials.gov Registry (NCT03712306).

To assess the prevalence of food insecurity (FI) and its predictors among lactating mothers in Ataye District, North Shoa Zone, Central Ethiopia.

A community-based cross-sectional study design was used.

Two urban and four rural randomly selected kebeles of the Ataye District in Ethiopia.

Out of 635 participants, 612 lactating mothers aged 15-49 years participated from February to April 2018. Mothers who lived for at least 6 months and above in the district were included, and mothers who were not able to respond to an interview were excluded. A single lactating mother per household was included. Lactating mothers in the households were selected using a cluster sampling technique. NHWD-870 chemical structure The number of lactating mothers found in each kebele was taken from family folder documentation.

The prevalence and predictors of food insecurity.

The prevalence of FI among lactating mothers was 36.8%. No formal education (adjusted OR (AOR) =1.82, 95% CI 1.13 to 2.92), no income-generating activities (AOR=3.39, 95% CI 2.0versity score, fewer than three frequencies of meals and three meals only per day were independent predictors of FI. Therefore, increasing home gardening, decreasing alcohol intake, increasing dietary diversity and performing income-generating activities are highly recommended to reduce FI.

First-time traumatic anterior shoulder dislocation (TASD) is predominantly managed non-operatively. People sustaining TASD have ongoing pain, disability and future risk of redislocation. There are no published randomised controlled trials (RCTs) comparing different non-operative rehabilitation strategies to ascertain the optimum clinically effective approach after TASD.

In this multicentre adaptive RCT, with internal pilot, adults with a radiologically confirmed first time TASD treated non-surgically will be screened at a minimum of 30 sites. People with neurovascular complications, bilateral dislocations or are unable to attend physiotherapy will be excluded.Randomisation will be on a 11 treatment allocation, stratified by age, hand dominance and site. Participants will receive a single session of advice; or a single session of advice plus offer of further physiotherapy (maximum 4 months). The primary analysis will be the difference in Oxford Shoulder Instability Score at 6 months. A sample size of a minimum of 478 participants will allow us to show a four point difference with 90% power.An embedded qualitative study will explore the participants' experiences of the trial interventions.

Funded by NIHR HTA (16/167/56), 1 June 2018; National Research Ethic Committee approved (18/WA/0236), 26 July 2018. First site opened 5 November 2018 and final results will be updated on trial registries and submitted to a peer-reviewed journal and will inform rehabilitation strategies after a TASD. Study Within A Trial (SWAT) funded by MRC (MR/R013748/1), 1 May 2019; registered on the MRC-HTMR All-Ireland Hub (reference number SWAT 121).

ISRCTN63184243. (Trial stage Pre-results).

ISRCTN63184243. (Trial stage Pre-results).

A number of studies have explored delayed help-seeking practices for acute coronary syndrome (ACS) and have indentified multiple intersecting factors which may play a role, for example, attributing symptoms, age, gender, ethnicity and contextual influences. However, the pathway to diagnosis for suspected coronary heart disease (CHD) symptoms in a rapid access chest pain clinic (RACPC) context is underexplored. The objective of this study was to examine patients' help-seeking experiences of accessing RACPC services, from the point at which they notice and interpret symptoms, to their decision to seek help from their general practitioner.

Qualitative study.

Interviews were conducted in the RACPC at Queen Mary's Roehampton Hospital, London, UK.

Maximum variation sampling was used to recruit 30 participants (15 men and 15 women) referred to a RACPC, using sampling dimensions of age, ethnicity and occupation.

Semi-structured interviews focussed on the patient experience of their pathway to the RACPC. Thematic analysis was used to analyse the interview data.

Participant interpretation of symptoms was shaped by multiple influences; reluctance to seek help contributed to delay; various factors acted as drivers as well as barriers to help-seeking; and GP referrals to RACPC were based on symptoms as well as patients' need for reassurance.

We found complex issues shaped the patient's decision-making when accessing the RACPC, including making sense of symptoms and help-seeking practices. These findings can be used to develop health promotion literature to encourage early help-seeking and improve RACPC services.

We found complex issues shaped the patient's decision-making when accessing the RACPC, including making sense of symptoms and help-seeking practices. These findings can be used to develop health promotion literature to encourage early help-seeking and improve RACPC services.

Older adults are hospitalised from the emergency department (ED) without potentially needing hospital care. Knowledge about rates, associative factors and causes of these preventable emergency admissions (PEAs) is limited. This study aimed to determine the rates, associative factors and causes for PEAs of older adults.

A mixed-method observational study.

The EDs of two Dutch hospitals.

492 patients aged >70 years and hospitalised from the ED.

Quantitative data were retrospectively extracted from the electronical medical record over a 1-month period. Admissions were classified (non)preventable based on a standardised approach. Univariate and multivariate multilevel logistic regression analyses were performed to identify possible associations between PEAs and demographic, clinical and care process factors. Qualitative data were prospectively collected by email and telephone interviews and analysed thematically to explore hospital physician's perceived causes for the identified PEAs.

Of the 492 inful, hospital care.

Our findings contribute to existing evidence that many emergency admissions of older adults are preventable, thereby indicating a possible source of unnecessary expensive, and potentially harmful, hospital care.

We aimed to investigate demographic, lifestyle, socioeconomic and clinical risk factors for COVID-19, and compared them to risk factors for pneumonia and influenza in UK Biobank.

Cohort study.

UK Biobank.

49-83 year olds (in 2020) from a general population study.

Confirmed COVID-19 infection (positive SARS-CoV-2 test). Incident influenza and pneumonia were obtained from primary care data. Poisson regression was used to study the association of exposure variables with outcomes.

Among 235 928 participants, 397 had confirmed COVID-19. After multivariable adjustment, modifiable risk factors were higher body mass index and higher glycated haemoglobin (HbA1C) (RR 1.28 and RR 1.14 per SD increase, respectively), smoking (RR 1.39), slow walking pace as a proxy for physical fitness (RR 1.53), and use of blood pressure medications as a proxy for hypertension (RR 1.33). Higher forced expiratory volume in 1 s (FEV1) and high-density lipoprotein (HDL) cholesterol were both associated with lower risk (RR 0.84 and RR 0.83 per SD increase, respectively). Non-modifiable risk factors included male sex (RR 1.72), black ethnicity (RR 2.00), socioeconomic deprivation (RR 1.17 per SD increase in Townsend Index), and high cystatin C (RR 1.13 per SD increase). The risk factors overlapped with pneumonia somewhat, less so for influenza. The associations with modifiable risk factors were generally stronger for COVID-19, than pneumonia or influenza.

These findings suggest that modification of lifestyle may help to reduce the risk of COVID-19 and could be a useful adjunct to other interventions, such as social distancing and shielding of high risk.

These findings suggest that modification of lifestyle may help to reduce the risk of COVID-19 and could be a useful adjunct to other interventions, such as social distancing and shielding of high risk.