Abstract:
OBJECTIVES:For people with end-stage renal disease requiring haemodialysis, exercise can improve aspects of quality of life (QoL). However, the relative benefits and risks of different types of exercise in this population are unknown. Therefore, this pilot study aimed to evaluate the feasibility of a main study evaluating the efficacy of cycling and resistance exercise each performed during the haemodialysis treatment on QoL. METHODS:In this factorial (2×2) pilot trial, 31 haemodialysis patients were randomised to cycling, resistance, cycling and resistance, or an attention control. Feasibility was defined a priori by criteria on recruitment, fidelity to the protocol and patient response to the intervention. To better understand feasibility, we conducted interviews with dialysis unit staff and trial participants. As secondary outcomes, we estimated the main effect of cycling and weights each compared with control on QoL, physical function and strength. FINDINGS:We exceeded the target accrual of 28 participants over 12 weeks. Irrespective of exercise group allocation, adherence was high; of the 1038 training sessions offered, 87% were initiated and over 80% of exercise sessions were performed as per protocol. Progression based on perceived exertion, individual instruction and interactions with the kinesiologist facilitated acceptability across exercise groups. Using an attention control, measures of contamination and attrition were low. Important barriers to unit staff readiness for the intervention were initial safety and workflow concerns, unit workload and onerous data collection. Secondary outcomes were not statistically significant. Adverse events were low and did not increase with a higher volume of exercise. CONCLUSIONS:The main study is feasible with minor modifications. In addition to practical assistance, involvement from unit staff could increase patient participation and improve trial implementation. Strategies to increase acceptability of the intervention for staff include improving workflow integration and using a prestudy demonstration phase to introduce the intervention. TRIAL REGISTRATION NUMBER:NCT02234232.
journal_name
BMJ Openjournal_title
BMJ openauthors
Thompson S,Klarenbach S,Molzahn A,Lloyd A,Gabrys I,Haykowsky M,Tonelli Mdoi
10.1136/bmjopen-2016-012085subject
Has Abstractpub_date
2016-09-06 00:00:00pages
e012085issue
9issn
2044-6055pii
bmjopen-2016-012085journal_volume
6pub_type
杂志文章,随机对照试验相关文献
BMJ Open文献大全abstract:INTRODUCTION:The prevalence of emotional difficulties in young people is increasing. This upward trend is largely accounted for by escalating symptoms of anxiety and depression. As part of a public health response, there is increasing emphasis on universal prevention programmes delivered in school settings. This protoc...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029044
更新日期:2019-09-03 00:00:00
abstract:OBJECTIVES:To determine how many kidney function tests are done, on whom, how frequently they are performed and how they have changed over time. DESIGN:Retrospective study of all serum creatinine, urine albumin and urine creatinine tests. SETTING:Primary and secondary care in Oxfordshire from 1993 to 2013. PARTICIPA...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009459
更新日期:2015-12-16 00:00:00
abstract:OBJECTIVES:To identify vulnerable cardiovascular patients in the hospital using a self-reported function-based screening tool. PARTICIPANTS:Prospective observational cohort study of 445 individuals aged ≥ 65 years admitted to a university medical centre hospital within the USA with acute coronary syndrome and/or decom...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008122
更新日期:2015-08-27 00:00:00
abstract:OBJECTIVE:To investigate how different lay and professional groups perceive and understand the use of routinely collected general practice patient data for research, public health, service evaluation and commissioning. DESIGN, METHOD, PARTICIPANTS AND SETTING:We conducted a multimethod, qualitative study. This entaile...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019378
更新日期:2018-01-08 00:00:00
abstract:OBJECTIVES:(1) Investigate and explore whether different classes of associative stigma (the process by which a person experiences stigmatisation as a result of an association with another stigmatised person) could be identified using latent class analysis; (2) determine the sociodemographic and employment-related corre...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028179
更新日期:2019-07-11 00:00:00
abstract:INTRODUCTION:Developing electronic health record information systems is an international trend for promoting the integration of health information and enhancing the quality of medical services. Patient education is a frequent intervention in nursing care, and recording the amount and quality of patient education have b...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-020621
更新日期:2018-05-03 00:00:00
abstract:OBJECTIVES:To assess acceptability and feasibility of trial processes and the Rehabilitation Training (ReTrain) intervention including an assessment of intervention fidelity. DESIGN:A two-group, assessor-blinded, randomised controlled trial with parallel mixed methods process and economic evaluations. SETTING:Communi...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-018409
更新日期:2018-02-15 00:00:00
abstract:INTRODUCTION:Although shortcomings in clinician-family communication and decision making for incapacitated, critically ill patients are common, there are few rigorously tested interventions to improve outcomes. In this manuscript, we present our methodology for the Pairing Re-engineered Intensive Care Unit Teams with N...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033521
更新日期:2020-03-29 00:00:00
abstract:INTRODUCTION:Many studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2017-016694
更新日期:2017-08-31 00:00:00
abstract:OBJECTIVE:Since 2011 China's central government has committed to establishing a new 'general practitioner' (GP)-centred primary care system. To this end there have been great efforts to train an additional 300 000 GPs by 2020. This paper examines the perspective of practitioners in Henan, China, regarding general pract...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036240
更新日期:2020-02-03 00:00:00
abstract:INTRODUCTION:Alcohol use disorders (AUDs) and mood disorders commonly co-occur, and are associated with a range of negative outcomes for patients. Mobile phone technology has the potential to provide personalised support for such patients and potentially improve outcomes in this difficult-to-treat cohort. The aim of th...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2016-013587
更新日期:2017-05-29 00:00:00
abstract:OBJECTIVE:The global research group, DIPLOMATIC (Using eviDence, Implementation science, and a clinical trial PLatform to Optimise MATernal and newborn health in low Income Countries), aims to reduce stillbirths and preterm births and optimise outcomes for babies born preterm. Minimum datasets for routine data collecti...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038859
更新日期:2020-11-24 00:00:00
abstract:INTRODUCTION:Treatment fidelity is an important and often neglected component of complex behaviour change research. It is central to understanding treatment effects, especially for evaluations conducted outside of highly controlled research settings. Ensuring that promising interventions can be delivered adequately (ie...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028417
更新日期:2019-07-30 00:00:00
abstract:OBJECTIVES:To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. DESIGN:A descriptive drug utilisation study. SETTING:7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia Romagna and Tuscany), W...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2015-009237
更新日期:2016-01-19 00:00:00
abstract:INTRODUCTION:High rates of immigration pose challenges for the healthcare systems of many countries to offer high-quality care to diverse populations. Advancing health interventions with incorporating the cultural background of diverse populations can be helpful to overcome this challenge. First studies suggest that cu...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037698
更新日期:2020-11-09 00:00:00
abstract:OBJECTIVE:This study aimed to define the end-of-life (EOL) healthcare utilisation and its cost and determinants for cancer patients and to proactively inform related strategies in mainland China. DESIGN:A population-based retrospective study. SETTING AND PARTICIPANTS:Data from 894 cancer patients were collected in ur...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026309
更新日期:2019-03-20 00:00:00
abstract:OBJECTIVES:Hospitals devoted to maternal and child health represent unique healthcare institutions in China. Healthcare professionals in these hospitals attend to health services for women and children, and also provide technical services and support for district maternal and children's healthcare as well as family pla...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024205
更新日期:2019-01-25 00:00:00
abstract:INTRODUCTION:An increasing number of patients survive sepsis; however, we lack valid data on the long-term impact on morbidity from prospective observational studies. Therefore, we designed an observational cohort to quantify mid-term and long-term functional disabilities after intensive care unit (ICU)-treated sepsis....
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-016827
更新日期:2017-08-23 00:00:00
abstract:INTRODUCTION:This study aims to explore the prospective association between the dietary quality (DQ) of preschoolers and their health status in Hong Kong, with the body mass index as the main outcome variable. METHODS AND ANALYSIS:This prospective cohort study has recruited 3539 children aged between 2 and 4 years old...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-018380
更新日期:2017-11-08 00:00:00
abstract:OBJECTIVES:Taiwan succeeded in raising the proportion of peritoneal dialysis (PD) usage after the National Health Insurance (NHI) payment scheme introduced financial incentives in 2005. This study aims to compare the economic costs between automated PD (APD) and continuous ambulatory PD (CAPD) modalities from a societa...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015067
更新日期:2017-03-21 00:00:00
abstract:OBJECTIVES:Patients with congestive heart failure (CHF) may be at a higher risk of mortality from sepsis than patients without CHF due to insufficient cardiovascular reserves during systemic infections. The aim of this study is to compare sepsis-related mortality between CHF and no CHF in patients presenting to a terti...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-022185
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:Social interaction may be particularly important for people with chronic health conditions, due to the numerous benefits to an individual's health. This paper aims to determine if labour force participation is a factor that influences individuals with chronic health conditions partaking in social or cultural...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002054
更新日期:2013-01-30 00:00:00
abstract:OBJECTIVES:Respiratory symptoms are associated with spirometry results but more strongly with smoking history, suggesting that alterations in the lung other than those revealed by spirometry contribute to cause symptoms. Smoking may cause obstruction of peripheral airways that is poorly detected by spirometry. The slop...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001488
更新日期:2012-11-27 00:00:00
abstract:OBJECTIVES:To estimate the prevalence of sleepiness on duty among day workers and watchkeepers on board. DESIGN:Cross-sectional survey in a maritime field study. SETTING:10 shipping companies with container vessels under German management. PARTICIPANTS:The whole crew (75 day workers and 123 watchkeepers) during 18 v...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028449
更新日期:2019-07-09 00:00:00
abstract:OBJECTIVES:In England, the NHS111 service provides assessment and triage by telephone for urgent health problems. A digital version of this service has recently been introduced. We aimed to systematically review the evidence on digital and online symptom checkers and similar services. DESIGN:Systematic review. DATA S...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027743
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Achilles tendon injuries give rise to substantial long-lasting morbidity and pose considerable challenges for clinicians and patients during the lengthy healing period. Current treatment strategies struggle to curb the burden of this injury on health systems and society due to lengthy rehabilitation, work ab...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-018135
更新日期:2017-11-16 00:00:00
abstract:INTRODUCTION:Type 2 diabetes (T2D) is a significant problem, and lifestyle modifications including self-management are important. We have developed a structured individual-based lifestyle education (SILE) programme for T2D. With attention now being paid to techniques to change behaviour, we recently developed a behavio...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-017838
更新日期:2017-10-24 00:00:00
abstract:OBJECTIVES:To investigate the accuracy, reproducibility and costs of different laboratory assays for the monitoring of unfractionated heparin (UFH) in clinical practice and to study test utilisation in Switzerland. DESIGN:Prospective evaluation study and survey among Swiss hospitals and laboratories. SETTING:Secondar...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-022943
更新日期:2018-06-09 00:00:00
abstract:OBJECTIVE:To identify the main areas of uncertainty and subsequent research priorities to inform the ongoing debate around assisted dying. DESIGN:Two-round electronic modified Delphi consultation with experts and interested bodies. SETTING AND PARTICIPANTS:110 groups and individuals interested in the subject of end-o...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012213
更新日期:2016-06-07 00:00:00
abstract:OBJECTIVE:Severe infections are a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Our primary objective was to use data from a large Spanish cohort to develop a risk score for severe infection in SLE, the SLE Severe Infection Score (SLESIS) and to validate SLESIS in a separat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028697
更新日期:2019-06-14 00:00:00