BMJ Open

Na Uy là một trong số các quốc gia châu Âu thiếu bộ giá trị quốc gia và thuật toán tính điểm cho EuroQol năm chiều (EQ-5D). Các nghiên cứu gần đây đã phát hiện ra sự khác biệt giữa các quốc gia về giá trị sức khỏe hoặc sở thích đối với các trạng thái sức khỏe được mô tả bằng các công cụ như EQ-5D. Dự án nhằm mục đích xây dựng bộ giá trị quốc gia cho phiên bản năm cấp độ của EQ-5D dựa trên những giá trị thu thập từ mẫu đại diện của người trưởng thành Na Uy về các yếu tố như vùng, độ tuổi, giới tính và trình độ học vấn. Bằng cách sử dụng chiến lược lấy mẫu hỗ trợ việc thu thập giá trị cho cả các trạng thái sức khỏe giả thuyết và đã trải nghiệm, nghiên cứu sẽ có thêm mục tiêu đánh giá tính khả thi của việc thu thập giá trị dựa trên kinh nghiệm theo giao thức nghiên cứu định giá EQ-5D mới nhất, và so sánh các giá trị với những giá trị được đưa ra cho các trạng thái sức khỏe giả thuyết.

To analyse injuries related to manual and electric scooter use from January 2016 up to and including July 2019.

Electric scooter rental services were launched in Denmark in January 2019. The services were provided by private companies. Although rules for handling and riding scooters have been established, no reports either before or after introduction of electric scooters anticipated the full extent of use, and injuries to riders and pedestrians.

All patient records mentioning manual or electric scooters. Records were reviewed, and data were stratified according to two groups: manual and electric scooters.

A predefined survey was completed in all cases where ‘scooter’ was present. This contained variables such as type of scooter, type of participant, mechanism of injury, acuity, intoxication, referral to treatment facility.

Among incidents involving scooters, summary statistics on continuous and categorical variables of interest were reported.

468 scooter-related injuries were recorded. We found that manual scooter riders were more likely to be children under the age of 15; fall alone—involving no other party; sustain contusions, sprains and lacerations; and bruise either their fingers or toes. Riders of electric scooters were likely to be 18–25 years, sustain facial bruising and lacerations requiring sutures, and be under the influence of alcohol or drugs. Non-riders of electric scooters were mostly elderly people who tripped over scooters, consequently sustaining moderate to severe injuries.

There were two different types of population sustaining injuries from manual and electric scooters, respectively. The proportion of non-riders injured by electric scooters were surprisingly large (17%), and while electric scooters are here to stay, several apparently preventable injuries occur as a result of reckless driving and discarded electric scooters. Current rules for usage might not prevent unnecessary accidents and secure traffic safety and the lives of older individuals.

Teachers and student teachers in Germany are a high-risk population for stress and stress-related mental health problems. This often leads to early retirement in subsequent professional life. Various trials have demonstrated positive effects of stress prevention training on the perceived stress and stress-related symptoms of teachers. Although many studies show positive effects of mindfulness-based stress interventions, there is not yet any mindfulness-based intervention for teachers or student teachers in Germany. The aim of this trial is to evaluate a training that combines mindfulness-based and cognitive interventions into one programme, addressing to the specific burdens of student teachers.

This study protocol presents a prospective block-randomised controlled trial. Assessment will take place at three time points (baseline, post-intervention, 3-month follow-up) for an intervention and waiting control group, and at a fourth assessment point for the waiting control group after receiving the training. The aim is to evaluate the effects of mindfulness-based stress prevention on stress, psychological morbidity, burnout and self-efficacy using validated measures. Participants are student teachers from German teacher training colleges and participation will be voluntary. The targeted total sample size is 96 at 3-month follow-up. The training will comprise three 4-hour sessions conducted every 2 weeks. The control group will participate in the training after the 3-month follow-up. The allotment will be randomised with a stratified allocation ratio by gender. After descriptive statistics have been evaluated, inferential statistical analysis will be conducted using repeated measures analysis of variance with interactions between time and group. Effect sizes will be calculated using partial η²values.

Results will be disseminated at conferences, in specialist magazines and through peer-reviewed publications. The trial has been approved by the ethics review board of the local medical association, Mainz, Germany, under the reference number 837.192.16 (10511).

DRKS00010897.

No intervention has been shown to prevent falls poststroke. We aimed to determine if perturbation-based balance training (PBT) can reduce falls in daily life among individuals with chronic stroke.

Assessor-blinded randomised controlled trial.

Two academic hospitals in an urban area.

Participants were allocated using stratified blocked randomisation to either ‘traditional’ balance training (control) or PBT. PBT focused on improving responses to instability, whereas traditional balance training focused on maintaining stability during functional tasks. Training sessions were 1 hour twice/week for 6 weeks. Participants were also invited to complete 2 ‘booster’ training sessions during the follow-up.

Eighty-eight participants with chronic stroke (>6 months poststroke) were recruited and randomly allocated one of the two interventions. Five participants withdrew; 42 (control) and 41 (PBT group) were included in the analysis.

The primary outcome was rate of falls in the 12 months post-training. Negative binomial regression was used to compare fall rates between groups. Secondary outcomes were measures of balance, mobility, balance confidence, physical activity and social integration.

PBT participants reported 53 falls (1.45 falls/person-year) and control participants reported 64 falls (1.72 falls/person-year; rate ratio: 0.85(0.42 to 1.69); p=0.63). Per-protocol analysis included 32 PBT and 34 control participants who completed at least 10/12 initial training sessions and 1 booster session. Within this subset, PBT participants reported 32 falls (1.07 falls/person-year) and control participants reported 57 falls (1.75 falls/person-year; rate ratio: 0.62(0.29 to 1.30); p=0.20). PBT participants had greater improvement in reactive balance control than the control group, and these improvements were sustained 12 months post-training. There were no intervention-related serious adverse effects.

The results are inconclusive. PBT may help to prevent falls in daily life poststroke, but ongoing training may be required to maintain the benefits.

ISRCTN05434601; Results.

This study aimed to establish the association between timing and provision of palliative care (PC) and quality of end-of-life care indicators in a population of patients dying of cancer.

This study uses linked cancer patient data from the National Cancer Registry, the electronic medical record system used in primary care (SystmOne) and the electronic medical record system used within a specialist regional cancer centre. The population resided in a single city in Northern England.

Retrospective data from 2479 adult cancer decedents who died between January 2010 and February 2012 were registered with a primary care provider using the SystmOne electronic health record system, and cancer was certified as a cause of death, were included in the study.

Linkage yielded data on 2479 cancer decedents, with 64.5% who received at least one PC event. Decedents who received PC were significantly more likely to die in a hospice (39.4% vs 14.5%, P<0.005) and less likely to die in hospital (23.3% vs 40.1%, P<0.05), and were more likely to receive an opioid (53% vs 25.2%, P<0.001). PC initiated more than 2 weeks before death was associated with avoiding a hospital death (≥2 weeks, P<0.001), more than 4 weeks before death was associated with avoiding emergency hospital admissions and increased access to an opioid (≥4 weeks, P<0.001), and more than 33 weeks before death was associated with avoiding late chemotherapy (≥33 weeks, no chemotherapy P=0.019, chemotherapy over 4 weeks P=0.007).

For decedents with advanced cancer, access to PC and longer duration of PC were significantly associated with better end-of-life quality indicators.