Unplanned hospital readmissions within 30 days of discharge measure the quality of healthcare. This study aims to identify the characteristics of patients at higher risk of readmission.

Retrospective cohort study.

North-east Italy (Marca Trevigiana Local Health Authority).

The study examined a total of 39 467 index admissions from hospital discharges (SDO) in the 890 000-inhabitant area during 2022.

Readmission rates and 95% CIs were computed by risk factor, age and type of admission (surgical or medical). A logistic mixed-effects model was used to estimate readmission OR, adjusting for potential confounders.

A total of 2197 readmissions occurred within 30 days of the index admission, resulting in an overall rate of 30-day readmissions of 6.7% (CI 6.4% to 7.0%). The median time to readmission was 11 days (IQR 5 to 20). In the multivariate analysis, after adjusting for age and sex, the following clinical conditions were associated with a higher risk of readmission: alcohol-related disease (OR=2.06, CI 1.36 to 3.13), metastatic cancer (OR=1.98, CI 1.57 to 2.50), epilepsy (OR=1.93, CI 1.36 to 2.75), dialysis or end-stage kidney disease (OR=1.92, CI 1.39 to 2.66), chronic obstructive pulmonary disease (OR=1.88, CI 1.49 to 2.36), stoma (OR=1.72, CI 1.22 to 2.44), transplant (OR=1.62, CI 1.03 to 2.55), being bedridden (OR=1.57, CI 1.28 to 1.93), anaemia (OR=1.57, CI 1.35 to 1.83), urinary tract infection (OR=1.54, CI 1.30 to 1.83), pneumonia (OR=1.52, CI 1.31 to 1.75), dementia (OR=1.49, CI 1.24 to 1.79), diabetes (OR=1.37, CI 1.17 to 1.61) and transfusion (OR=1.34, CI 1.03 to 1.73).

Several chronic and acute conditions at index admission significantly increased the risk of readmission. Strengthening transitional care, outpatient services and palliative care could mitigate readmissions.

Nutrition counselling is recommended after pancreatic cancer surgery given the complex nutritional problems patients experience. In practice, access and delivery of nutrition counselling after pancreatic surgery varies across settings. To address this gap, our study team developed the Support Through Remote Observation and Nutrition Guidance (STRONG) programme, an implementation strategy that addresses common barriers to nutrition care delivery in oncology.

The STRONG programme includes a standardised protocol to specify the timing and amount of nutrition counselling that should be delivered and patient-mediated implementation strategies including collection of patient-reported information, an educational brochure summarising common nutrition problems and recommended dietary strategies after pancreatic surgery and a question prompt list for the patient-dietitian encounter. A pilot randomised controlled trial will be conducted to assess the feasibility and acceptability of the STRONG programme compared with usual care in pancreatic cancer surgery patients after hospital discharge (n = 80). The trial is designed to be pragmatic and integrated into existing workflows and clinic teams. The primary goal will be to compare feasibility and acceptability outcomes against pre-planned benchmarks. Data will be collected from patients and caregivers and healthcare providers who assist with STRONG implementation. Secondary goals include collecting preliminary data on effectiveness and implementation outcomes that will support a future definitive hybrid implementation-effectiveness trial.

This study was approved by the Moffitt Cancer Center Institutional Review Board of Record, Advarra (Pro00071143). Participants will be required to provide written consent prior to enrolment. Study findings will be disseminated through plain language summaries, conference abstracts and peer-reviewed publications.

ClinicalTrials.gov NCT06001268. Registered on 21 August 2023, prior to participant enrolment.

To implement an overview of reviews that discuss the current state of syntheses (such as systematic reviews) of only observational studies on health risk behaviours (HRBs), including smoking, alcohol intake, poor sleep, poor quality diet, common mental health problems (depression and anxiety), and glycated haemoglobin (HbA1c), while excluding synthesis of clinical trials.

Overview of reviews or umbrella review following Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines.

PubMed, Scopus, Web of Science, PsycINFO-PsychArticles and Epistemonikos, searched from January 2013 to 30 June 2025.

We included systematic reviews and meta-analyses of observational studies that assessed the relationship between HRBs—including smoking, alcohol intake, poor sleep, poor quality diet, physical activity and common mental health problems such as depression and anxiety—and HbA1c. Reviews of clinical trials were excluded.

We synthesised systematic reviews and meta-analyses on the above topic from five databases following the PRIOR protocol. Two independent reviewers screened titles, abstracts and full texts using standardised methods. Data extracted included study design, exposures, outcomes and population characteristics. Risk of bias was assessed using the AMSTAR-2 tool. Overlap across reviews was evaluated using the corrected covered area metric.

Eight systematic reviews were included in the final synthesis, encompassing a total sample size of around 307 019 individuals. The study highlights a significant paucity of systematic reviews of observational studies in this area, with no reviews on alcohol and exercise. The existing evidence on poor sleep, poor quality diet and smoking points towards these HRBs leading to worse HbA1c. A bidirectional relationship was found between depression and HbA1c.

This umbrella review highlights the significant association between HbA1c and key health risk factors underscoring the importance of observational studies, highlighting their ability to capture real-world conditions and complex interactions. While in agreement with existing study designs, this review provides convergent evidence of the critical role of HRBs in managing HbA1c levels.

We compared associations between self-reported and HearCheck screening device measures of hearing difficulty with subsequent general and domain-specific cognitive function in a population-based sample of older English adults.

Observational cohort study.

Population-based sample of older adults in wave 7 of the English Longitudinal Study of Ageing (ELSA) in 2014/15 and its Healthy Cognitive Ageing Project (HCAP) in 2018.

N=1119 adults aged ≥62 years.

Factor scores for general cognitive function and domains of memory, language, orientation and executive function were derived from the HCAP neuropsychological test battery (mean of 0 and SD of 1 for each). Hearing difficulty was assessed using a self-reported 5-point Likert-type scale and the HearCheck screening device, which administered a series of six tones in each ear.

According to the HearCheck device, 48% of participants had a mild or moderate-to-severe hearing difficulty, while 25% self-reported fair or poor hearing. In multivariable-adjusted, population-weighted linear regression models, hearing difficulty identified via HearCheck was associated with worse general cognitive function (β=–0.34 SD units; 95% CI –0.60 to –0.07 for moderate-to-severe hearing difficulty vs good hearing) as well as worse function in domains of memory, language and executive function, each with a dose-response relationship. Self-reported hearing difficulty was not associated with general or domain-specific cognitive function.

Peripheral hearing ability, as captured by the HearCheck screening device, may have stronger relevance for later-life cognitive outcomes than the broader construct of perceived hearing difficulty in one’s daily environment that is captured by a self-reported measure.