Objectives To assess uptake of nirsevimab, a long-acting monoclonal antibody for respiratory syncytial virus (RSV) prevention, during the first season of Ireland’s Pathfinder pilot universal newborn immunisation programme and to identify socio-demographic and perinatal predictors of uptake. Design Cross-sectional analysis of routinely collected programme data. Setting Ireland’s Mid-West region, served by University Maternity Hospital Limerick, the sole maternity and neonatal hospital for the region. Participants Infants born 1 September 2024 to 28 February 2025. Outcome measure Uptake of…
Objectives To explore what works for whom, how and why when implementing women’s sexual and reproductive health interventions in prisons to understand the barriers and facilitators to implementation and to generate recommendations for policymakers. Design Realist review using the Realist And Meta-narrative Evidence Synthesis: Evolving Standards guidelines. Data sources We systematically searched Ovid MEDLINE, Global Health, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the American Psychological Association (APA) PsycINFO databases and hand-searched…
Objectives Health interventions should be designed to be appropriate for scaling from the outset, but the extent to which factors that are important for scalability are reported on in pilot randomised trials is unclear. This review assesses the extent to which pilot randomised trials report on 15 domains of intervention scalability. Design Methodological review. Data sources Four journals were searched: BMJ Open , BMC Pilot and Feasibility Studies , BMC Trials and PLoS One for articles published between January 2023 and October 2024. Eligibility criteria We included pilot randomised trials of…
Objectives The aim of the present study was to compare Area Under the Receiver Operating Characteristic curves (AUROCs) of age-and-sex alone, and in addition respectively, the Nordic Multimorbidity Index (NMI), Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI), and explore simple count-based measures on in-patient care and filled drug prescriptions, with the outcome mortality using Swedish health registries. Study design and setting Study population: All persons born in 1975 or earlier who were continuously resident in Sweden between 1 January 2010 and 31 December 2014…
Background Multiple sclerosis (MS) frequently leads to mobility impairment, fatigue and a significant decline in health-related quality of life (QoL). Home-based assistive technology, such as robotic exoskeletons, offers a promising solution to enhance independent mobility and increase the intensity of motor training. Long-term functional and quality of life benefits of light lower-limb exoskeleton home use have yet to be determined. Objective The primary objective of this study is to determine the efficacy of an 8-week period, home-based use of a robotic exoskeleton in improving QoL in…
Objectives To provide an updated systematic review of the effectiveness of workplace interventions for chronic musculoskeletal disorders, identify key intervention components and assess their impact on health and work-related outcomes. Design Systematic review of randomised controlled trials. Data sources MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus and Web of Science were searched for studies published between 2018 and 2024. Grey literature sources were also consulted. Eligibility criteria Randomised controlled trials and cluster-randomised trials evaluating workplace interventions targeting…
Introduction Avoidable and unfair variation in access to palliative care exists for different groups of people and communities. Primary and community care teams deliver most palliative care and care to people at the end of life at home but the quality of care provided is variable. This is an under-researched area and receives little attention in service design and policy. This study will investigate the key contexts, resources and components required for an integrated approach to palliative care to deliver improved and more equitable outcomes for patients and carers. Methods and analysis This…
Introduction The Healthy Early Life Moments in Singapore (HELMS) programme was developed by a multidisciplinary team to improve metabolic and mental health outcomes in women/mothers and to promote healthy growth and development in their children. Despite increasing interest in preventive life-course care, evidence on the long-term economic impact of these life-course interventions remains limited. This protocol outlines the economic evaluation of the HELMS integrated lifestyle intervention, supported by a mobile health (mHealth) app, across the reproductive continuum from preconception to…
Objectives Depressive symptoms are highly prevalent among medical students globally, yet estimates from Pakistan remain fragmented and inconsistent across studies. Medical students in Pakistan face multiple academic, social and environmental stressors that may increase their risk of depression. We conducted a systematic review and meta-analysis to estimate the prevalence of depressive symptoms among medical students in Pakistan and to explore sources of heterogeneity across studies. Design Systematic review and meta-analysis reported in accordance with the Meta-analysis Of Observational…
Introduction Emergency EEG (emEEG) is increasingly used in the emergency department (ED), but its diagnostic yield remains uncertain. This protocol describes a multicentre observational study aiming to evaluate emEEG findings and their relationship with diagnostic pathways and therapeutic management of patients admitted to the ED. Methods and analysis This multicentre retrospective study will analyse emEEGs performed on patients admitted to the ED of some Italian teaching and community hospitals over a 1-year period with a target sample size of 3850 patients. The diagnostic yield of emEEG will…
Introduction Steatotic liver disease (SLD), particularly its metabolic forms (metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis), is highly prevalent worldwide yet remains substantially underdiagnosed. Neck circumference (NC) is a simple anthropometric measure reflecting upper-body adiposity and cardiometabolic risk and has been increasingly investigated as a potential screening or risk-stratification tool for SLD. However, existing evidence is heterogeneous, and no comprehensive meta-analysis has synthesised the diagnostic…
Objectives This study aims to estimate the rate of recruitment of participants. Design This is a pilot, multicentre, double-blind, placebo-controlled, randomised controlled trial of oral oxycodone and sublingual placebo vs sublingual buprenorphine and oral placebo for postoperative pain management for 7 days after pelvic exenteration. Setting Patients will be recruited from three metropolitan quaternary referral centres that offer advanced gastrointestinal surgery in Australia. Participants The inclusion criteria will be patients over the age of 18 years undergoing pelvic exenteration surgery…
Introduction Knee osteoarthritis is a leading cause of pain and disability and frequently results in total knee arthroplasty (TKA). Decisions about surgery and postoperative management rely largely on subjective pain scales and patient-reported outcome measures (PROMs), and 10–15% of patients remain dissatisfied after TKA despite technically successful surgery. Evidence suggests that pain is partly reflected in peripheral immune signalling, yet this neuroimmune interface has not been studied in patients with joint pain due to knee osteoarthritis. This study will explore whether peripheral…
Introduction Gastrointestinal cancer surgery commonly leads to postoperative complications and other adverse outcomes. While prehabilitation shows promise in reducing adverse postoperative outcomes, most hospitals have resource limitations that preclude its use as standard of care. Additionally, the need to expedite surgery from diagnosis often creates a narrow window for prehabilitation initiatives. Online, self-reported screening tools may address these challenges by facilitating early identification of high-risk patients and enabling targeted preoperative interventions, thereby allowing…
Background: Securing meaningful employment as a physician is anxiety provoking, particularly in resource-intensive specialties, and newly certified specialists continue to report difficulty obtaining employment despite proposed solutions. In this study, we aimed to explore the lived experiences of decision-makers and trainees navigating job-seeking and placement in resource-intensive specialties in Canada and identify suggestions for improvement. Methods: In this qualitative interview study, guided by phenomenology, we recruited trainees, recent graduates, program directors, and division…
Background: Advocacy is a professional competency for Canadian physicians, yet adoption into medical education, academic medicine, and physician practice varies. We sought to explore perspectives on why and how physicians integrate health advocacy into their professional identity and to develop a model framework. Methods: We used a phenomenological approach to develop a socioecological framework. Using purposeful and chain sampling, we conducted semi-structured interviews with physician advocates of diverse backgrounds, clinical specialties, and advocacy interests from across Canada. We used…
This randomized clinical trial assesses whether a hybrid hospital-at-home model increases physical activity and patient satisfaction and perceived safety compared with standard inpatient care among adults admitted to the hospital with acute illness.
This cohort study evaluates the association of antidiabetic medication initiation timing with the risk of major adverse cardiovascular events and all-cause mortality among individuals newly meeting diagnostic criteria for type 2 diabetes.
This cohort study examines the association of long-term resistance training with risk of incident type 2 diabetes and assesses the joint associations with aerobic physical activity and sedentary behavior among adult health care professionals in the US.
This qualitative study uses semistructured interviews with key stakeholders involved in funding, design, sponsorship, and ethical or regulatory overview of randomized clinical trials to guide potential improvements in the prefunding and peer review processes, trial design, and best practices.