The best of the UK? A report on the value and future of UK databases in the health and social care fields: a systematic map protocol

INTRODUCTION: This protocol covers the first part of a two-part project funded by the Health Libraries Group and the University Health and Medical Librarians Group. It details the proposed methodology for a systematic map of the literature relating to UK bibliographic databases in the fields of health and social care. The aim of this mapping exercise is to consider ways in which UK bibliographic databases are described, considered and discussed in the published and unpublished literature. In doing so, we hope to gain a clearer sense of the ways in which UK bibliographic databases are used and viewed by the research community. It also enables the identification of any gaps in the literature for further research and discussion. This topic is important because UK databases are generally underused by researchers in the UK context and some databases are at risk of closure. A lack of access to UK databases means that researchers may miss relevant UK evidence when identifying an evidence base. / METHOD: Systematic Map. / ANALYSIS: The authors will present a narrative description of the literature relating to UK bibliographic databases in the fields of health and social care. They will use tables to present descriptive information about the literature (eg, frequency tables) and use cross-tabulations to demonstrate intersecting themes. Separately, guidance on how to use the resources (eg, areas of unique content, updating frequencies, unique truncation symbols) will be sought from stakeholders and reported alongside the report narrative as a guide to usage

Ten-Year Analysis of Bacterial Colonisation and Outcomes of Major Burn Patients with a Focus on Pseudomonas aeruginosa

A retrospective descriptive study included patients admitted with severe burns over the course of 10 years (2008–2018). Across all patients, there were 39 different species of bacteria, with 23 species being Gram-negative and 16 being Gram-positive bacteria, with also five different species of fungi cultured. Pseudomonas aeruginosa was the most commonly isolated organism, with 57.45% of patients having a positive culture. There was a significant difference in the number of P. aeruginosa isolated from patients that acquired their burns at work, in a garden, inside a vehicle, in a garage or in a public place. In patients that were positive for P. aeruginosa, the number of operations was higher (2.4) and the length of stay was significantly increased (80.1 days). Patients that suffered from substance abuse demonstrated significantly higher numbers of isolated P. aeruginosa (14.8%). Patients that suffered from both mental health illness and substance abuse demonstrated significantly higher numbers of P. aeruginosa isolated (18.5%). In the P. aeruginosa-negative group, there were significantly fewer patients that had been involved in a clothing fire. Furthermore, in the P. aeruginosa-negative patient cohort, the mortality rate was significantly higher (p = 0.002). Since the incidence of P. aeruginosa was also associated with a decreased mortality rate, it may be that patients admitted to hospital for shorter periods of time were less likely to be colonised with P. aeruginosa. This study demonstrates novel factors that may increase the incidence of P. aeruginosa isolated from burn patients

Results From Australia’s 2016 Report Card on Physical Activity for Children and Youth

Background: Two years on from the inaugural Active Healthy Kids Australia (AHKA) Physical Activity Report Card, there has been little to no change with the majority of Australian children still insufficiently active. Methods: The 2016 AHKA Report Card was developed using the best available national- and state-based physical activity data, which were evaluated by the AHKA Research Working Group using predetermined weighting criteria and benchmarks to assign letter grades to the 12 Report Card indicators. Results: In comparison with 2014, Overall Physical Activity Levels was again assigned a D- with Organized Sport and Physical Activity Participation increasing to a B (was B-) and Active Transport declining to a C- (was C). The settings and sources of influence again performed well (A- to a C+), however Government Strategies and Investments saw a decline (C+ to a D). The traits associated with physical activity were also graded poorly (C- to a D). Conclusions: Australian youth are insufficiently active and engage in high levels of screen-based sedentary behaviors. While a range of support structures exist, Australia lacks an overarching National Physical Activity Plan that would unify the country and encourage the cultural shift needed to face the inactivity crisis head on

Is inhaled prophylactic heparin useful for prevention and management of pneumonia in ventilated ICU patients?

Purpose: The purpose was to determine the efficacy of prophylactic inhaled heparin for the prevention and treatment of pneumonia in patients receiving mechanical ventilation (MV)

Australia and other nations are failing to meet sedentary behaviour guidelines for children: implications and a way forward

Background: Australia has joined a growing number of nations that have evaluated the physical activity and sedentary behavior status of their children. Australia received a D minus in the first Active Healthy Kids Australia Physical Activity Report Card. Methods: An expert subgroup of the Australian Report Card Research Working Group iteratively reviewed available evidence to answer 3 questions: (a) What are the main sedentary behaviors of children? (b) What are the potential mechanisms for sedentary behavior to impact child health and development? and (c) What are the effects of different types of sedentary behaviors on child health and development? Results: Neither sedentary time nor screen time is a homogeneous activity likely to result in homogenous effects. There are several mechanisms by which various sedentary behaviors may positively or negatively affect cardiometabolic, neuromusculoskeletal, and psychosocial health, though the strength of evidence varies. National surveillance systems and mechanistic, longitudinal, and experimental studies are needed for Australia and other nations to improve their grade. Conclusions: Despite limitations, available evidence is sufficiently convincing that the total exposure and pattern of exposure to sedentary behaviors are critical to the healthy growth, development, and wellbeing of children. Nations therefore need strategies to address these common behaviors

An evaluation of the Place Standard Tool as a means of examining inequalities in relation to place

Improving the quality of places is a crucial element in addressing the inequalities that exist across the UK. While standardised tools exist to structure conversations about place, the extent to which these capture inequalities remain unclear. This study examined the utility of the Place Standard Tool (PST) as a means of understanding inequalities in relation to place. A dataset of 8,218 PST responses collected in the north of England, and the PST itself, were analysed using an inequalities lens with a particular focus on the qualitative data collected through the tool. The results showed that despite limits to the demographic data recorded by the PST such as the lack of ethnicity and disability data, key themes relating to protected characteristic groups were captured in the data. The analysis identified the themes of ethnicity, gender, physical mobility, economic status, and housing situation as particularly prominent within the dataset, and reflects on how these themes affect people’s relationships with place. In its current form, the PST demonstrates an ability to improve understanding of inequalities in relation to place. However, extra consideration, particularly relating to ensuring the PST is applied equitably, and some adaptation of questions would unlock its full potential. Improving the quality of demographic data collected is a key part of improving the accuracy and equity of data collection.Responding proactively to gaps in response rates during data collection exercises can improve the overall quality of data collected, particularly for minority groups.Considering equitable and accessible ways to collect data using the Place Standard Tool is key to fulfilling its potential as a tool for examining inequalities in relation to place. Improving the quality of demographic data collected is a key part of improving the accuracy and equity of data collection. Responding proactively to gaps in response rates during data collection exercises can improve the overall quality of data collected, particularly for minority groups. Considering equitable and accessible ways to collect data using the Place Standard Tool is key to fulfilling its potential as a tool for examining inequalities in relation to place.</p

Remote monitoring after recent hospital discharge in patients with heart failure: a systematic review and network meta-analysis

Context Readmission to hospital for heart failure is common after recent discharge. Remote monitoring (RM) strategies have the potential to deliver specialised care and management and may be one way to meet the growing needs of the heart failure population. Objective To determine whether RM strategies improve outcomes for adults who have been recently discharged (<28 days) following an unplanned admission due to heart failure. Study design Systematic review and network meta-analysis. Data sources Fourteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to January 2012, and supplemented by hand-searching relevant articles. Study selection All randomised-controlled trials (RCTs) or observational cohort studies with a contemporaneous control group were included. RM interventions included home telemonitoring (TM) (including implanted monitoring devices) with medical support provided during office hours or 24/7 and structured telephone support (STS) programmes delivered via human-to-human contact (HH) or human-to-machine interface (HM). Data Extraction Data were extracted and validity was assessed independently by two reviewers. Results Twenty-one RCTs that enrolled 6317 patients were identified (11 studies evaluated STS (10 of which were HH, while 1 was HM), 9 studies assessed TM, and 1 study assessed both STS and TM). No trial of implanted monitoring devices met the inclusion criteria. Compared with usual care, although not reaching statitistical significance, RM trended to reduce all-cause mortality for STS HH (HR: 0.77, 95% credible interval (CrI): 0.55, 1.08), TM during office hours (HR: 0.76, 95% CrI: 0.49, 1.18) and TM24/7 (HR: 0.49, 95% CrI: 0.20, 1.18). Exclusion of one trial that provided better-than-usual support to the control group rendered each of the above comparisons statistically significant. No beneficial effect on mortality was observed with STS HM. Reductions were also observed in all-cause hospitalisations for TM interventions but not for STS interventions. Care packages generally improved health-related quality-of-life and were acceptable to patients. Conclusions STS HH and TM with medical support provided during office hours showed beneficial trends, particularly in reducing all-cause mortality for recently discharged patients with heart failure. Where ‘usual’ care is less good, the impact of RM is likely to be gr

Is inhaled prophylactic heparin useful for prevention and management of pneumonia in ventilated ICU patients?. The IPHIVAP investigators of the Australian and New Zealand Intensive Care Society Clinical Trials Group

Purpose: To determine whether prophylactic inhaled heparin is effective for the prevention and treatment of pneumonia patients receiving mechanical ventilation (MV) in the intensive care unit