Article
Medicine, General & Internal
Richu Philip, Thomas Beaney, Nick Appelbaum, Carmen Rodriguez Gonzalvez, Charlotte Koldeweij, Amelia Kataria Golestaneh, Neil Poulter, Jonathan M. Clarke
Summary: The study found that clinical practice guidelines for hypertension were generally consistent in defining, staging, and recommending target blood pressure, but showed extensive variation in treatment recommendations, especially for second-line therapy. Low-income countries tended to recommend cheaper drugs, offered less choice to clinicians in medications, and initiated dual therapy at later stages compared to high-income countries. Future research could explore underlying drivers of this variation to improve outcomes for hypertensive patients across different clinical contexts.
Review
Biochemistry & Molecular Biology
Aminah Alchakee, Munazza Ahmed, Leen Eldohaji, Hamid Alhaj, Maha Saber-Ayad
Summary: The review focuses on cytochrome P450 enzymes and their association with the metabolism of psychotropic medications, variations among different populations, impact on neurotransmitters, and the influence of non-genetic factors. It also discusses the association between adverse effects of psychiatric medications and human leukocytic antigen genotypes. The importance of pharmacogenetics implementation in psychiatry clinics is emphasized.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Critical Care Medicine
Michael B. Weykamp, Katherine E. Stern, Scott C. Brakenridge, Bryce R. H. Robinson, Charles E. Wade, Erin E. Fox, John B. Holcomb, Grant E. O'Keefe
Summary: Although blood product resuscitation is favored, crystalloid resuscitation remains a common practice in prehospital care. This study investigated the relationship between prehospital crystalloid (PHC) volume and clinical outcomes, and found that higher PHC volume is associated with worse coagulopathy and increased risk of ARDS, but lower risk of AKI.
Article
Health Care Sciences & Services
Elise L. Tierie, Dennis G. Barten, Laura M. Cuevas, Rebekka Veugelers, Menno I. Gaakeer
Summary: There is a lack of structural insights into the use of protocols and practice variation in Emergency Departments (EDs). This study aims to determine the extent of practice variation in Dutch EDs based on specified common practices. A comparative study was conducted on Dutch EDs that employ emergency physicians, and data on practices were collected through a questionnaire. The results showed significant practice variation in treatments among the studied subjects. Further research is needed to fully understand the variation in practice in EDs and its potential to improve quality and efficiency.
Article
Engineering, Manufacturing
Seokjun Youn, Gregory R. Heim, Subodha Kumar, Chelliah Sriskandarajah
Summary: This study examines the relationship between lower variations in clinical practice and hospital operational performance. The findings suggest that higher practice variation is associated with longer average patient length-of-stay and higher total cost per capita, particularly in hospitals providing higher quality patient experience services. Additionally, pursuing higher quality measures may have combined effects with test-ordering practice variation on hospital operational performance.
PRODUCTION AND OPERATIONS MANAGEMENT
(2021)
Article
Genetics & Heredity
Hui-Lin Chin, Nour Gazzaz, Stephanie Huynh, Iulia Handra, Lynn Warnock, Ashley Moller-Hansen, Pierre Boerkoel, Julius O. B. Jacobsen, Christele du Souich, Nan Zhang, Kent Shefchek, Leah M. Prentice, Nicole Washington, Melissa Haendel, Linlea Armstrong, Lorne Clarke, Wenhui Laura Li, Damian Smedley, Peter N. Robinson, Cornelius F. Boerkoel
Summary: This study developed a clinical variant analysis tool (CVAT) to assist in the interpretation of genomic test results. By applying CVAT to 289 clinical exome reports, the researchers found that it achieved performance comparable to experienced medical geneticists. However, there were some issues with reported variants, including reporting variants in genes without established disease association and in genes without sufficient phenotypic concordance.
GENETICS IN MEDICINE
(2022)
Review
Neurosciences
Tim A. Benke, Kristen Park, Ilona Krey, Chad R. Camp, Rui Song, Amy J. Ramsey, Hongjie Yuan, Stephen F. Traynelis, Johannes Lemke
Summary: Recent discoveries have shown a significant genetic variation in NMDARs, with individuals carrying GRIN variants presenting with various neurological conditions. Understanding the functional consequences of these genetic variations could lead to precision therapeutics. Animal models with human variants may uncover shared mechanisms among different neurological conditions, requiring further research and clinical trials to validate and determine the effectiveness of treatment methods.
Article
Gastroenterology & Hepatology
Anthony Lembo, Shahnaz Sultan, Lin Chang, Joel J. Heidelbaugh, Walter Smalley, G. Nicholas Verne
Summary: This article presents medication management guidelines for irritable bowel syndrome (IBS). The guidelines provide 8 recommendations for the pharmacological treatment of IBS-D patients, and evaluate the evidence and certainty of different medications.
Article
Clinical Neurology
Yuqian Pan, Rui Luo, Shuqi Zhang, Yuxia Liu, Yiping Wang, Simeng Feng, Hengfen Li
Summary: This study investigated the efficacy of SSRIs and SNRIs in treating depressed patients with high and low CRP levels. The findings suggest that SNRIs may be more effective for high CRP patients, while SSRIs may be more effective for low CRP patients. Limitations include small sample sizes of MT and NaSSA, as well as uncontrolled factors that may affect CRP levels.
JOURNAL OF AFFECTIVE DISORDERS
(2022)
Article
Genetics & Heredity
Anneke Lucassen, Angus Clarke
Summary: The topic of how genetic information should be kept confidential while respecting the interests of others, such as close relatives, has been debated extensively since genetic testing became more common. In this paper, two authors with differing views on familial disclosure discuss where they agree on this subject.
Article
Education & Educational Research
Michael Tran, Susan Wearne, Amanda Tapley, Alison Fielding, Andrew Davey, Mieke van Driel, Elizabeth Holliday, Jean Ball, Kristen FitzGerald, Neil Spike, Parker Magin
Summary: This study found that differences in demographic, clinical, and educational factors are significantly more pronounced in the early stages of registrar training. This has important implications for educational resource allocation, trainee supervision, and curriculum design. The study highlights the importance of sociocultural learning theory in understanding and supporting general practice trainees and supervisors during transitions.
BMC MEDICAL EDUCATION
(2022)
Editorial Material
Medicine, General & Internal
Jennifer E. Posey, James R. Lupski
Summary: The Deciphering Developmental Disorders (DDD) project in the UK and Ireland investigated rare genomic diseases and provided molecular diagnoses to over 13,500 families, improving diagnostic yield compared to the previous standard of care.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Pediatrics
Ravi M. Patel, Jeanne E. Hendrickson, Marianne E. Nellis, Rebecca Birch, Ruchika Goel, Oliver Karam, Matthew S. Karafin, Sheila J. Hanson, Bruce S. Sachais, Ronald George Hauser, Naomi L. C. Luban, Jerome Gottschall, Cassandra D. Josephson, Martha Sola-Visner
Summary: This study estimated the incidence of blood product transfusion and characterized pretransfusion hematologic values for infants during their initial hospitalization after birth. Results showed wide variability in pretransfusion hemoglobin, platelet count, and international normalized ratio values for neonatal transfusions, suggesting room for improved patient blood management in the US.
JOURNAL OF PEDIATRICS
(2021)
Review
Oncology
Veronica Davalos, Manel Esteller
Summary: Cancer development is caused by changes in the structure and function of the genome. Epigenetic alterations regulate gene expression programs that promote tumorigenesis and can be used as useful tools in clinical decision making. Unlike genetic changes, epigenetic modifications can be reversed, making them an attractive target for drug development.
CA-A CANCER JOURNAL FOR CLINICIANS
(2023)
Article
Psychiatry
Xiao Wang, Wenwang Rao, Xueyan Chen, Xinqiao Zhang, Zeng Wang, Xianglin Ma, Qinge Zhang
Summary: This study examines the outpatient attendance of Late-life depression (LLD) patients in a psychiatric hospital in China, finding that LLD patients are mostly women and commonly have comorbid generalized anxiety. The study also reveals that LLD patients primarily use SSRIs and NaSSAs medications, with outpatient costs mainly attributed to medication expenses.
Article
Health Policy & Services
Jon Gibson, Anne McBride, Katherine Checkland, Mhorag Goff, Mark Hann, Damian Hodgson, Imelda McDermott, Matt Sutton, Sharon Spooner
Summary: This study confirms the increasing role of diverse teams in providing primary care in England. Practice managers prefer accessing new non-medical roles through primary care networks rather than directly employing all new roles within the practice. A more detailed investigation of future workforce requirements is necessary to ensure that health policy supports the mix of roles needed in an effective primary care workforce.
JOURNAL OF HEALTH SERVICES RESEARCH & POLICY
(2023)
Article
Pediatrics
Sarah de Voss, Philip Wilson, Sofie Saxild, Gritt Overbeck
Summary: This study investigates the clinical barriers and facilitators of introducing standardized child records with increased focus on psychosocial wellbeing and mental health into child developmental assessments. The results show that clinicians are positive towards increasing the psychosocial focus, but face challenges such as rigid conversations, limited space for parents to raise other issues, and discomfort when addressing unsolvable problems. Implementing standardized child development records with an increased psychosocial focus is feasible but improvements are needed. Parental views should be investigated before further implementation.
Article
Public, Environmental & Occupational Health
Charlie Moss, Laura Anselmi, Matt Sutton
Summary: This study investigates the discharge destinations and re-attendance within 7 days among homeless patients in emergency departments. Results show that patients with a high frequency of past ED use are more likely to leave without treatment and re-attend within 7 days. Patients not registered at a general practice are more likely to leave without treatment or die in the ED and have lower odds of unplanned re-attendance. Patients with a primary diagnosis of 'social problems' are more likely to be discharged without follow-up, while patients with a psychiatric primary diagnosis are more likely to be referred to other healthcare providers or outpatient clinics.
EUROPEAN JOURNAL OF PUBLIC HEALTH
(2023)
Article
Rheumatology
Fraser R. Morton, Bhautesh Jani, Frances S. Mair, Philip McLoone, Jordan Canning, Sara Macdonald, Ross McQueenie, Stefan Siebert, Barbara Nicholl
Summary: This longitudinal observational study investigates the association between multimorbidity and hospitalizations in people with established and early rheumatoid arthritis (RA). Participants with RA and multiple long-term conditions (LTCs) had higher hospitalization rates and longer durations compared to those with RA alone. Additionally, the hospitalization rate and duration were higher in RA participants with LTCs than in non-RA controls.
SEMINARS IN ARTHRITIS AND RHEUMATISM
(2023)
Review
Pediatrics
Smita Dick, Clare MacRae, Claire McFaul, Philip Wilson, Stephen W. Turner
Summary: This study systematically reviewed community-based interventions aimed at reducing emergency department visits or urgent hospital admissions for children. The analysis of seven studies found that staff role reconfiguration and telemedicine can reduce ED visits and admissions, while pathways of care and point-of-care testing did not have an impact. Therefore, new out-of-hospital models of urgent care for children need to be introduced and evaluated without delay.
ARCHIVES OF DISEASE IN CHILDHOOD
(2023)
Article
Economics
Anna Wilding, Luke Munford, Matt Sutton
Summary: Social participation is associated with improved health, well-being, and reduced social isolation. Using data from the UK's Community Life Survey, the study finds that social participation is linked to reduced loneliness, improved health, increased life satisfaction, and happiness. These effects are more pronounced for individuals with lower socio-economic status and suggest that interventions should focus on increasing community asset infrastructure and encouraging social participation in this group.
Article
Public, Environmental & Occupational Health
Georgia Chatzi, William Whittaker, Tarani Chandola, Thomas Mason, Claudia Soiland-Reyes, Matt Sutton, Peter Bower
Summary: The impact factors of the NHS Diabetes Prevention Programme (DPP) in England are not well understood. This study compares the representation of non-diabetic hyperglycaemia (NDH) population at different stages of the DPP and finds that younger and older adults, as well as people living in deprived areas, are slightly under-represented in the programme. Ethnic minorities are over-represented at the identification and offer stages but drop at the programme completion stage. The DPP has the potential to reduce ethnic inequalities but may widen socioeconomic, age, and health-related inequalities in T2DM.
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH
(2023)
Article
Obstetrics & Gynecology
Sofie Saxild, Philip Wilson, Sarah de Voss, Gritt Overbeck
Summary: Signposting web-programs to improve parental mentalization skills can be accepted by clinicians in general practice, but need to be more tailored to suit the everyday workflow of the clinics. Addressing parental mentalization remains largely unknown for pregnant women and clinicians alike, therefore training on the subject and its presentation should be offered.
BMC PREGNANCY AND CHILDBIRTH
(2023)
Article
Medicine, General & Internal
Daniel R. Morales, Mark Minchin, Evangelos Kontopantelis, Martin Roland, Matt Sutton, Bruce Guthrie
Summary: This study aimed to compare the impact of the withdrawal of the Quality and Outcomes Framework (QOF) scheme in primary care in Scotland in 2016 on the recorded quality of care, compared with England where the scheme continued. The results showed a significant decrease in performance for most quality of care indicators in Scotland after the abolition of QOF.
BMJ-BRITISH MEDICAL JOURNAL
(2023)
Article
Pediatrics
James Law, Jenna Charlton, Philip Wilson, Robert Rush, Vicky Gilroy, Cristina Mckean
Summary: A measure has been developed to accurately identify children at risk of low language, allowing clinicians to target resources efficiently and intervene early.
Article
Gastroenterology & Hepatology
C. Macleod, A. Foxton, P. Wilson, S. Treweek, A. J. M. Watson
Summary: Among symptomatic patients, younger age was associated with obtaining a successful CCE test. Clinicians could consider patient selection based on these results to improve the rate of successful testing in clinical practice.
COLORECTAL DISEASE
(2023)
Article
Health Care Sciences & Services
Charlie Moss, Laura Anselmi, Marcello Morciano, Luke Munford, Jonathan Stokes, Matt Sutton
Summary: Financial flows relating to health care are often analyzed at national and international level, but local level analysis is rare. This study adapted the System of Health Accounts framework to map the flow of public health and care funding in Greater Manchester (GM), UK, following a health and social care devolution deal. The findings suggest that GM may have faced challenges in redirecting resources towards their goals, highlighting the importance of mapping financial flows at a local level.
Article
Psychiatry
Ida Scheel Rasmussen, Katrine Strandberg-Larsen, Gritt Overbeck, Philip Wilson
Summary: The objective of this study was to describe the differences between the official Danish Strengths and Difficulties Questionnaire (SDQ) norms and data from a sample based on the Danish National Birth Cohort (DNBC). The study compared risk classification, cut-off bandings and group sizes between the Danish norms and the values found in the DNBC sample at ages 7, 11 and 18 years. The results showed inconsistencies between the existing norms and the DNBC sample, indicating that the current SDQ norms may not be appropriate for a large-scale cohort sample in Denmark.
NORDIC JOURNAL OF PSYCHIATRY
(2023)
Article
Medicine, General & Internal
Emma King, Smita Dick, Pat Hoddinott, Cari Malcolm, Emma France, Richard G. Kyle, Lorna Aucott, Philip Wilson, Stephen Turner
Summary: This study examines the variations in paediatric short stay admission rates across different Health Board regions in Scotland. The findings highlight the factors that contribute to these regional differences, such as socioeconomic status, types of conditions, and geographical factors.
Article
Health Care Sciences & Services
Maggie Lawrence, Bridget Davis, Leyla De Amicis, Jo Booth, Sylvia Dickson, Nadine Dougall, Madeleine Grealy, Bhautesh Jani, Margaret Maxwell, Ben Parkinson, Matilde Pieri, Stewart Mercer
Summary: By conducting two rounds of MBSR "taster" sessions and focus groups, the research team successfully adapted a standard MBSR course for stroke survivors, resulting in a stroke-specific MBSR course called HEADS: UP. The study findings suggest that HEADS: UP may provide a feasible, appropriate, and meaningful self-management intervention to help alleviate symptoms of mood disorder.
