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Physiotherapist-led education and exercise for patients with MRI-verified hip abductor tendon pathology: a protocol for a prospective cohort study

Por: Hogsholt · M. · Kierkegaard-Brochner · S. · Lange · J. · Thorborg · K. · Bohn · M. B.
Introduction

Lateral hip pain due to hip abductor tendon pathology (ie, gluteal tendinopathy or tendon rupture) is a relatively new diagnosis. This patient group has previously been described as a clinical dilemma due to the often-short-lived effects of treatment. In the process of identifying the underlying pathology, however, more targeted treatment strategies have been explored. Recent research recommends exercise as a first-line treatment for this patient group along with patient education. However, patients seen in a hospital setting (secondary healthcare) often present recalcitrant lateral hip pain, tendon ruptures and multiple comorbidities. Whether patient education and exercise therapy are beneficial for patients in secondary healthcare has only been sparsely investigated. Therefore, this study aims to investigate changes in lateral hip pain following a 3 month physiotherapist-led patient education and exercise intervention in patients with MRI-proven hip abductor tendon pathology seen in a hospital setting.

Methods and analysis

In this prospective cohort trial, 60 patients, presenting lateral hip pain and MRI-verified hip abductor tendon pathology at the orthopaedic outpatient clinic at Horsens Regional Hospital, Denmark, a public teaching hospital, are included. Hip abductor tendon pathology will be diagnosed by clinical tests and MRI. The intervention consists of seven physiotherapist-led patient education and exercise sessions at the hospital during 3 months. The instructions will guide the patients in their daily home-based exercise sessions.

The primary outcome is change in lateral hip pain measured by the ‘pain’ subscale from the patient-reported outcome measure: the revised Copenhagen Hip And Groin Outcome Score (HAGOS). Secondary outcomes are changes in the remaining subscales of the revised HAGOS, Oxford Hip Score, Victorian Institute of Sports Assessment-Gluteal Questionnaire, European Questionnaire-Five Dimensions Five-Level, lateral hip pain (numeric rating scale score, 0–10), hip muscle strength and the 30 s chair stand test. Also, patient-reported Global Rating of Change in hip condition, as well as adherence and harms, will be reported.

Ethics and dissemination

This trial has been accepted by the Central Denmark Regions Ethics Committee (1-10-72-136-22). The study is registered at the Central Denmark Region List of Research Projects (Journal No 1-16-02-180-24) and clinicaltrials.gov (NCT06418217).

All results from this study, regardless of the direction, will be published in a peer-reviewed journal and presented at national and international congresses.

Trial registration number

NCT06418217.

Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis

Por: Iannizzi · C. · Andreas · M. · Bohndorf · E. · Hirsch · C. · Zorger · A.-M. · Brinkmann-Paulukat · J. · Bormann · B. · Kaufman · J. · Lischetzki · T. · Monsef · I. · Neufeind · J. · Schmid-Küpke · N. · Thole · S. · Worbes · K. · Skoetz · N.
Objective

This systematic review investigates the effectiveness of different communication strategies to increase COVID-19 vaccine uptake and willingness.

Design

Systematic review and meta-analysis of randomised controlled trials (RCTs), following recommendations from the Cochrane Handbook and reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.

Data sources

We searched the following databases until 27 July 2022: Cochrane COVID-19 Study Register, PsycINFO, CINAHL, Web of Science Core Collection and WHO COVID-19 Global literature.

Eligibility criteria for study selection

We included RCTs investigating, any population, communication-based interventions to increase COVID-19 vaccine uptake and comparing these with no intervention (with or without placebo), another communication strategy or another type of intervention.

Methods

Screening, data extraction and bias assessment, using the Cochrane ROB 1.0 tool, were conducted by two authors independently. We performed meta-analyses if studies were homogeneous using the Review Manager (RevMan 5) software, synthesised the remaining results narratively and assessed the certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

We identified 49 studies reporting on the predefined four categories of communication interventions. Evidence from our meta-analyses shows that COVID-19 vaccine uptake may increase when education and information strategies are applied (risk ratio (RR) 1.23, 95% CI 1.17 to 1.28; high-certainty evidence) or social norms are communicated (RR 1.28, 95% CI 1.23 to 1.33; high-certainty evidence) compared with no intervention. The different communication strategies mostly have little to no impact on vaccine intention; however, there may be a slight increase in vaccine confidence when gain framing is applied compared with no intervention.

Conclusion

Overall, we found that education and information-based interventions or social norm-framing strategies are most effective compared with no intervention given. Our findings show that some of the investigated communication strategies might influence policy decision-making, and our results could be useful for future pandemics as well.

PROSPERO registration number

PROSPERO (CRD42021296618).

Clinical Efficacy of Ovine Forestomach Matrix and Collagen/Oxidised Regenerated Cellulose for the Treatment of Venous Leg Ulcers: A Retrospective Comparative Real‐World Evidence Study

ABSTRACT

Venous leg ulcers (VLUs) are traditionally managed with standard-of-care dressings, compression and appropriate adjunctive venous interventions for pathologic venous reflux. Due to pathophysiological complexity and underlying patient comorbidities, conducting randomised controlled trials to evaluate the comparative efficacy of advanced treatment modalities is difficult, as many patients would likely be excluded. This retrospective, pragmatic, real-world evidence (RWE) study compared the healing outcomes of VLUs treated with either ovine forestomach matrix (OFM) (n = 312) or collagen/oxidised regenerated cellulose (ORC) (n = 239) in outpatient wound care centres. Unlike restrictive randomised controlled trials, minimal inclusion and exclusion criteria were applied to create two treatment cohorts that reflected the general VLU population. The incidence (%) of closure was greater in OFM-treated VLUs at 12, 24 and 36 weeks, and this difference was significant at 24 and 36 weeks compared to collagen/ORC. Median time to wound closure was significantly faster (p = 0.045) in the OFM cohort (11.1 ± 0.6 weeks) compared to the collagen/ORC group (12.3 ± 1.0 weeks). Cox proportional hazards analysis demonstrated that OFM-treated VLUs had a significantly greater probability of healing (up to ~40%). This RWE comparative efficacy study further substantiates the clinical benefit of OFM in the treatment of chronic wounds, such as VLU, in a real-world patient cohort.

National survey evaluating the introduction of new and alternative staffing models in intensive care (SEISMIC-R) in the UK

Por: Hadley · R. · Dogan · B. · Wood · N. · Bohnacker · N. · Mouncey · P. R. · Pattison · N. · SEISMIC-R investigator group · Griffiths · Endacott · Leon-Villapalos · Saville · Monks · Dearling · Gordon · Wythe · Handley · Whiting · DallOra · Pearce · Bench
Objective

To report on the findings from a national survey of UK intensive care units (ICUs) exploring nurse staffing models currently in use and changes since COVID-19.

Design

A survey was designed and distributed using a web-based platform to senior unit leads via Intensive care national audit & research centre contacts.

Participants

Senior nurses representing the 331 National Health Service adult ICUs across the UK (across 231 hospitals/155 trusts), including the Channel Islands and Isle of Man.

Outcome measures

A 15-item survey.

Results

A total of 196 survey responses representing 300 units, majority general and single units, resulting in a 90.6% unit-level response rate. ICU unit characteristics included the average number of total, level 3 and level 2 critical care beds of 26.36 (SD=21.48), 15.67 (SD=15.33) and 10.96 (SD=8.86), respectively. Most units reported nurse to patient ratios compliant with national guidelines and service specifications. Post-COVID-19 changes to ICU nurse staffing establishments were reported by 44% respondents, including increases in non-registered staff. However, limited data were provided regarding decision-making around and changes to bedside allocation of nurses since COVID-19.

Conclusions

Increased numbers and use of non-registered staff within the ICU is indicative of an alternative staffing model to address nursing shortages. However, more research is needed to understand how this staffing group is being used compared with, and alongside, registered nurses.

Trial registration number

Clinicaltrials.gov: NCT05917574.

International consensus-based core outcome set for airway management clinical trials and observational studies: the Airway Terminology and Outcome Measures (ATOM) protocol

Por: Hansel · J. · Fuchs · A. · Radcliffe · G. · Sotiriou · A. · Rivett · K. · Bohnenblust · V. · Grimes · R. · Fally · M. · Greif · R. · Cook · T. M. · El-Boghdadly · K. · on behalf of the Airway Terminology and Outcome Measures (ATOM) Group · Perin · Brewster · Myatra · Hofmeyr · Li
Introduction

Airway management describes a range of commonly performed procedures undertaken to enable invasive respiratory support for patients. Studies of airway management interventions report heterogeneous outcomes, impeding evidence synthesis and translation of findings into clinical practice. A core outcome set is a consensus-based standardised minimum collection of outcomes to be reported in a given area of healthcare. The Airway Terminology and Outcome Measures project aims to define a core outcome set and select outcome measurement instruments for future airway management research.

Methods and analysis

Following a systematic literature search, we generated a list of candidate outcomes by extracting outcomes and their measurement instruments from a random sample of included studies until saturation was reached and no new outcomes emerged. The search resulted in a long list of 64 outcomes for inclusion in the consensus building stage. Key stakeholders, including patients, clinicians and researchers, will be invited to participate in a multiround modified Delphi process and a panel meeting to finalise the core outcome set and agree to their measurement instruments.

Ethics and dissemination

The study was approved by the Health Research Authority and the London – Fulham Research Ethics Committee (24/LO/0544). All participants will provide informed consent. Study findings will be presented as conference proceedings and published in peer-reviewed medical journals.

Estimated start of this study

20 November 2024

Registration number

COMET 3146

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