Introduction Growing evidence suggests that higher ambient temperatures may increase the risk of mental health disorders and exacerbate existing conditions. Despite this, most studies evaluating the association between temperature and mental health rely on hospitalisation records or insurance claims data, which only capture the most severe outcomes. To effectively intervene to prevent mental health crises associated with ambient temperature, it is necessary to identify and develop novel ways to reach patients before they require care. Digital health tools offer a promising way to address these…
Introduction Spondyloarthritis (SpA) comprises a heterogeneous group of chronic inflammatory diseases. Axial SpA (axSpA) predominantly involves the sacroiliac joints and the spine and typically presents with back pain and stiffness. Modern imaging techniques, especially MRI, allow earlier detection of axSpA compared to conventional radiography, but imaging findings still need cautious interpretation to facilitate a clinical diagnosis. This cohort study of patients with suspected SpA is designed to (1) compare demographic, clinical, laboratory, imaging data and patient-reported outcomes (PROs)…
Introduction Child marriage remains a pressing social and public health issue globally, with significant implications for the rights, well-being and development of affected individuals. In Iran, legal frameworks that permit marriage from as young as 9 lunar years for girls—despite countervailing influences such as rising education levels and social reforms—have failed to curb the persistence of early marriage, which continues to be driven by entrenched cultural, socioeconomic and legal factors. Understanding the multifaceted nature of child marriage within this context is crucial for…
Introduction Psychotic disorders account for significant morbidity and healthcare costs and yet their pathophysiology remains poorly understood. The National Institute for Health and Care Research (NIHR) Severe Mental Illness Longitudinal Evaluation (SMILE) BioResource is a collaborative project that aims to collect clinical data and biological samples from people with psychosis for long-term storage, future projects and recontact for targeted trials. Methods and analysis The NIHR SMILE BioResource cohort will initially include up to 2000 UK-based patients with a recorded diagnosis of…
Objectives To investigate the association between drinking-water sodium concentration and blood pressure among non-pregnant women living in a high-salinity, climate-vulnerable coastal region of Bangladesh. Design Follow-up study of women originally enrolled in a population-based study conducted during pregnancy between 2009 and 2011. Setting Rural coastal subdistrict in southwest Bangladesh affected by saltwater intrusion and seasonal drinking-water insecurity. Participants Of 1208 women enrolled in the original study, 900 were located in 2018 and 740 non-pregnant women were re-enrolled and…
Introduction Artificial intelligence (AI) is increasingly used in tuberculosis (TB) diagnosis, but its clinical adoption depends not only on accuracy but also on physicians’ trust and understanding of AI outputs. Explainable AI (XAI) has been proposed to address this challenge, but limited evidence exists on which explanation features are most valued by physicians in TB diagnostic settings. Discrete choice experiments (DCEs) offer a structured method to elicit physicians’ preferences and quantify trade-offs among explainability attributes. This protocol describes a DCE designed to examine TB…
Background Frailty is a common condition in older adults which becomes more prevalent and more severe with age. Health and care services designed to meet the needs of older adults living with frailty are expanding in number and scope, but information on the workforce needed to deliver services both now and in the future is lacking. Objectives To understand the service design and staffing configurations for frailty services through gathering data on the setting and purpose of services; target population; referral methods into the service; specific activities delivered; frailty assessment tools…
Objectives To explore refill adherence to prescribed treatment for chronic heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD), during and after a remote person-centred care (PCC) intervention. Design Post hoc analysis of a randomised controlled trial cohort. Setting We used data from the PROTECT (Person-Centred Care at Distance) randomised controlled trial in Swedish primary care, which were linked to data from the Swedish Prescribed Drug Register. Participants A total of 222 participants from nine primary care centres were enrolled in PROTECT. This study included…
Introduction Postoperative atrial fibrillation (POAF) remains one of the most common complications following coronary artery bypass grafting (CABG), including minimally invasive cardiac surgery-CABG (MICS-CABG). The ligament of Marshall (LOM), containing myocardial fibres and rich autonomic innervation, has been implicated in atrial arrhythmogenesis. Despite evidence that catheter ablation targeting the LOM or surgical interruption during conventional CABG can be effective, prophylactic surgical excision of the LOM during MICS-CABG has not been evaluated in randomised controlled trials (RCTs)…
Introduction Growing evidence suggests that a part of the burden of Parkinson’s disease (PD) can be explained by exposure to environmental factors, including pesticides, heavy metals, solvents, and air pollution. However, several questions remain unanswered, pertaining to the associations with PD of environmental factors that are still in use today; the added risks of co-exposure to multiple environmental factors and gene–environment interactions. Additional questions remain on the relevant time window, duration, and level of environmental exposures in relation to PD risk. Furthermore, it is…
Introduction Outdoor active play is essential for children’s health, well-being and holistic development. However, there is a lack of high-quality evidence on effective sustainable and scalable interventions that leverage outdoor play and environmental affordances to promote physical literacy, including motor competence, physical activity, engagement and motivation for movement in early childhood. In particular, limited research has examined how outdoor kindergarten environments can be intentionally used and optimised to support diverse forms of active play through social and other potential…
Introduction Narcolepsy type 1 (NT1) is a chronic neurological disorder characterised by excessive daytime sleepiness, cataplexy and disturbed nocturnal sleep. Current pharmacological treatments often have limited efficacy, significant side effects or potential for abuse. Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation technique that has shown promise in regulating sleep–wake cycles and neural network activity. Preliminary evidence from our prior study on Transcutaneous Auricular Vagus Nerve Stimulation in patients with NT1 (TARGET-NT1 study) suggests…
Objectives Same-day emergency care (SDEC) has been rolled out as a model of care in England with a limited evidence base. This study examined conversion to inpatient admission, 30-day reattendance and 30-day mortality, among adults managed through SDEC compared with those admitted for ≤48 hours, as a proxy for low acuity, over a 4-year period, to assess safety and effectiveness in a real-world operational setting across two acute hospital sites. Design Retrospective cohort study. Setting Two acute hospital sites within one National Health Service (NHS) trust in England, UK. Participants…
Flavoured noodle products are the most likely source of an ongoing multi-country outbreak of Salmonella Stanley infections, with evidence linking the cases to items from the same brand, according to a Rapid Outbreak Assessment by EFSA and ECDC.
Presence of a Foreign Tablets: Complaint received, possible mix-up of Selexipag 1000 mcg tablet in a bottle of Lacosamide Tablets USP, 100mg. — Annora Pharma Private Limited · Class II · Ongoing · 31,392 60-count bottles
Incorrect product formulation: bag did not contain copper and famotidine per label. — Central Admixture Pharmacy Services, Inc. · Class II · Ongoing · One (1) patient-specific TPN prescription