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To assess the feasibility of conducting a definitive randomised controlled trial (RCT) to test the clinical and cost-effectiveness of a tailored exercise intervention compared with usual care for people aged 80 years and older with hip and/or knee osteoarthritis (OA) and comorbidities.
Two-arm, parallel-design, multicentre, pragmatic, feasibility RCT.
Four National Health Service outpatient physiotherapy services across England.
Adults aged 80 years and over with clinical hip and/or knee OA and ≥1 comorbidity.
Participants were randomised 1:1 via a central web-based system to be offered: (1) a 12-week tailored exercise programme or (2) usual care. Participants and outcome assessors were not blinded to treatment allocation.
(1) Ability to screen and recruit participants; (2) retention of participants at 14-week follow-up; (3) intervention fidelity (proportion of participants who received ≥4 intervention sessions as per protocol) and (4) participant engagement (assessed by home exercise adherence).
Between 12 May 2022 and 26 January 2023, 133 potential participants were screened, of whom 94 were eligible. The main reasons for ineligibility were symptoms not consistent with hip or knee OA (10/39, 25.6%) or already having had a physiotherapy appointment (8/39, 20.5%). 51 of 94 (54%) eligible participants were recruited. Participants had a mean age of 84 years (SD 3.5), 31 (60.8%) were female and 96.1% reported their ethnicity as White British (n=49/51). 45 of 51 participants (88%) provided outcome data at the 14-week follow-up time point. Four or more intervention sessions were attended by 13/25 (52%) participants. Home exercise log completion declined over time: 6/23 participants (26.1%) returned completed exercise logs for all 12 weeks. The median number of days home exercises were recorded each week was 5 (range 0–7).
This study demonstrated that a definitive trial would be feasible. Before proceeding, modifications to ensure recruitment of a diverse population and intervention fidelity should be addressed.
To describe diagnostic and management characteristics of acute rheumatic fever (ARF) among participants in the ‘Searching for a Technology-Driven Acute Rheumatic Fever Test’ study, in order to answer clinical questions and determine epidemiological and practice differences in different settings.
Multisite, prospective cohort study.
One hospital in northern Australia and two hospitals in New Zealand, 2018–2021.
143 episodes of definite, probable or possible ARF among 141 participants (median age 10 years, range 5–23; 98% Indigenous).
Participant characteristics, clinical, biochemical and echocardiographic data were explored using descriptive data. Associations with length of stay were determined using multivariable regression analysis.
ARF presentations were heterogeneous with the most common ARF ‘phenotype’ in 19% of cases being carditis with joint manifestations (polyarthritis, monarthritis or polyarthralgia), fever and PR prolongation. The total proportion of children with carditis was 61%. Australian compared with New Zealand participants more commonly had ARF recurrence (22% vs 0%), underlying RHD (48% vs 0%), possible/probable ARF (23% vs 9%) and were underweight (64% vs 16%). Erythrocyte sedimentation rate (ESR) provided an incremental diagnostic yield of 21% compared with C reactive protein. No instances of RHD were diagnosed among participants in New Zealand. Positive throat Group A Streptococcus culture was more common in New Zealand than in Australian participants (69% vs 3%). Children often required prolonged hospitalisation, with median hospital length-of-stay being 7 days (range 2–66). Significant predictors for length of stay in a multivariable regression model were valve disease (adjusted OR (aOR) 1.56, 95% CI 1.23 to 1.98, p
This study provides new knowledge on ARF characteristics and management and highlights international variation in diagnostic and management practice. Differing approaches need to be aligned. Meanwhile, locally specific information can help guide patient expectations after ARF diagnosis.
We aimed to analyse the time trends of cardiometabolic risk factors in Senegal from 1975 to 2021.
Ecological study of publicly available data from the WHO Health Inequality Data Repository.
Disaggregated datasets from publicly available sources.
Trends of age-standardised prevalence rates, stratified by sex for tobacco use, obesity, diabetes and hypertension, were analysed for significance.
Only data from Senegal were included in this study.
Tobacco use decreased in both sexes between 2000 and 2021, from 1.7% to 0.7% (p value 0.04) in females and from 28.1% to 12.8% (p value 0.04) in males. Obesity and overweight increased in both sexes between 1975 and 2016, from 14.2% to 35.9% (p value
Our findings highlight changes in cardiometabolic risk factors in Senegal between 1975 and 2020 by sex. While tobacco use declined, rates of obesity, diabetes and hypertension increased. These findings underscore the need for strategies to mitigate this increase in cardiometabolic risk factors and a consequential rise in non-communicable diseases.
The aim of this review was to explore the influencing factors that contribute to medication administration errors (MAEs) made by novice registered nurses (NRNs).
MAEs are a significant yet preventable risk to patient safety in healthcare settings, compromising both patient health and care quality. Evidence suggests that NRNs are more prone to MAEs, highlighting the importance of exploring the contributing factors to develop effective prevention strategies.
An integrative review.
An electronic literature search was conducted in which articles were restricted to peer-reviewed, full-text articles published in the English language between January 2013 and December 2023. Quality assessments and data syntheses were conducted by two independent authors.
CINAHL Complete, MEDLINE, APA PsycArticles, APA PsycInfo, PubMed, Cochrane Library and Web of Science.
Eleven studies met the inclusion criteria. The main influencing factors identified in this review were intrinsic factors (lack of confidence, reduced coping skills and reluctance to seek assistance) and extrinsic factors (time pressures, hectic workloads, low staffing and high-stress environments). Clinical, educational and research implications were also identified.
This integrative review explored the various influencing factors contributing to MAEs by NRNs in healthcare settings. These included gaps in pharmacological knowledge, limited simulation-based learning and challenges in using electronic medical records. Addressing these issues through targeted education and increased simulation experiences in undergraduate curricula could enhance NRNs' competence and confidence.
Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
No patient or public contribution was made due to the study design.
Understanding the factors behind medication administration errors among new nurses helps organisations develop strategies to address these issues, reducing patient harm and enhancing nursing practice. Our findings offer recommendations to improve nursing education worldwide.
FreshRSS 