BMJ open
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Multicenter Study Observational Study
Variation in survival after out-of-hospital cardiac arrest between receiving hospitals in Japan: an observational study.
Patient outcomes after out-of-hospital cardiac arrest (OHCA) varies at multilevel (geographical regions, emergency medical service agencies and receiving hospitals) in the USA. However, it remains unclear whether there is a variation in patient outcomes after OHCA between relevant units of the healthcare system such as receiving hospitals in Japan. Therefore, we aimed to quantify the variation in patient outcomes after OHCA between receiving hospitals in Japan. ⋯ We found substantial variations in patient outcomes after OHCA within a large group of hospitals in Japan, despite adjustment for patient factors that are known to be associated with different outcomes.
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Randomized Controlled Trial
Impact of cardiopulmonary resuscitation on a cannot intubate, cannot oxygenate condition: a randomised crossover simulation research study of the interaction between two algorithms.
During a 'cannot intubate, cannot oxygenate' situation, asphyxia can lead to cardiac arrest. In this stressful situation, two complex algorithms facilitate decision-making to save a patient's life: difficult airway management and cardiopulmonary resuscitation. However, the extent to which competition between the two algorithms causes conflicts in the execution of pivotal treatment remains unknown. Due to the rare incidence of this situation and the very low feasibility of such an evaluation in clinical reality, we decided to perform a randomised crossover simulation research study. We propose that even experienced healthcare providers delay cricothyrotomy, a lifesaving approach, due to concurrent cardiopulmonary resuscitation in a 'cannot intubate, cannot oxygenate' situation. ⋯ Cricothyrotomy, which is the most crucial treatment for cardiac arrest in a 'cannot intubate, cannot oxygenate' situation, was delayed by concurrent cardiopulmonary resuscitation. If cardiopulmonary resuscitation delays cricothyrotomy, it should be interrupted to first focus on cricothyrotomy.
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Peer reviewers of biomedical journals are expected to perform a large number of roles and tasks, some of which are seemingly contradictory or demonstrate incongruities between the respective positions of peer reviewers and journal editors. Our aim was to explore the perspectives, expectations and understanding of the roles and tasks of peer reviewers of journal editors from general and specialty biomedical journals. ⋯ These journal editors' accounts reveal issues of a social nature within the peer-review process related to missed opportunities for journal editors to engage with peer reviewers to clarify the expected roles and tasks.Further research is needed on actual performance of peer reviewers looking into the content of peer-reviewer reports to inform meaningful training interventions, journal policies and guidelines.
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Physicians often suffer from burnout and stress, not only affecting themselves, but also their patients and the healthcare system in general. An increasing number of studies suggest that mindfulness-based interventions improve physicians' well-being as well as the quality of care they deliver. However, the evidence is scattered, and a systematic review and meta-analysis is lacking. To the best of our knowledge, this systematic review and meta-analysis will be the first to assess the effectiveness of mindfulness-based interventions in reducing burnout and stress among physicians. Further, it aims to uncover potential moderators of intervention effectiveness. ⋯ CRD42019133077.
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In Latin America, the number of children and adolescents who are overweight or obese has significantly increased in recent decades, and this situation has become a major public health concern. To address this problem, several intervention programmes, based on factors such as physical activity and nutrition, have been implemented, and body mass index (BMI) has been widely used as a means of measuring the impact of such interventions. Although some Latin America-based systematic reviews have been performed, there have been no previous meta-analyses of findings regarding the effect of physical activity interventions on BMI. Thus, the objective of the systematic review and meta-analysis will be to provide an up-to-date synthesis of the effects of physical activity interventions on BMI of Latin American children and adolescents aged 4-18 years. ⋯ CRD42019077702.