BMJ open
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To develop and externally validate a risk algorithm (QAdmissions) to estimate the risk of emergency hospital admission for patients aged 18-100 years in primary care. ⋯ The QAdmissions model provided a valid measure of absolute risk of emergency admission to hospital in the general population as shown by its performance in a separate validation cohort. Further research is needed to evaluate the cost-effectiveness of using these algorithms in primary care.
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This study aimed to investigate the efficacy of intrathecal morphine in the long term by hypothesising that a reduction of the intrathecal opioid dose following long-term administration would increase the level of pain intensity. ⋯ This double-blind randomised controlled trial of chronic intrathecal morphine administration suggests the effectiveness of this therapy for the management of chronic non-cancer pain. However, owing to the small number of patients completing the study (n=8), further studies are warranted.
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The aim of this analysis was to investigate the relationship of statins with institutionalisation and death in older men living in the community, accounting for frailty. ⋯ These data suggest a lack of significant association between statin use and institutionalisation or death in older men. These findings call for real-world trials specifically designed for frail older people to examine the impact of statins on clinical outcomes.
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Immobilisation in the intensive care unit (ICU) leads to muscle weakness and is associated with increased costs and long-term functional disability. Previous studies showed early mobilisation of medical ICU patients improves clinical outcomes. The Surgical ICU Optimal Mobilisation Score (SOMS) trial aims to test whether a budget-neutral intervention to facilitate goal-directed early mobilisation in the surgical ICU improves participant mobilisation and associated clinical outcomes. ⋯ This study has been registered at clinicaltrials.gov (NCT01363102).
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Helicopter emergency medical services (HEMS) aim to bring highly specialised crews to the major incident for triage, treatment and transport. When the site is difficult to access, HEMS may be the only mode of transportation of both personnel and patients. This systematic review will identify, describe and appraise literature regarding the role of HEMS in medical response to major incidents. We aim to improve knowledge on HEMS role in a major incident and provide a basis for future research. ⋯ PROSPERO CRD42013004473.