North Bristol NHS Trust

About: North Bristol NHS Trust is a healthcare organization based out in Bristol, United Kingdom. It is known for research contribution in the topics: Population & Medicine. The organization has 2204 authors who have published 2811 publications receiving 61110 citations.

Erratum zu: Kreislaufstillstand in besonderen Situationen. Kapitel 4 der Leitlinien zur Reanimation 2015 des European Resuscitation Council

Abstract: Notfall Rettungsmed 2017 · 20:540–542 DOI 10.1007/s10049-017-0337-z Online publiziert: 11. Juli 2017 © Springer Medizin Verlag GmbH 2017 A. Truhlář · C. D. Deakin · J. Soar · G. E. A. Khalifa · A. Alfonzo · J. J. L. M. Bierens · G. Brattebø · H. Brugger · J. Dunning · S. HunyadiAntičević · R. W. Koster · D. J. Lockey · C. Lott · P. Paal · G. D. Perkins · C. Sandroni · K.-C. Thies · D. A. Zideman · J. P. Nolan 1 Hradec Králové Region, Emergency Medical Services, Hradec Králové, Tschechien; 2 Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Hradec Králové, Tschechien; 3 Cardiac Anaesthesia and Cardiac Intensive Care, NIHR Southampton Respiratory Biomedical Research Unit, Southampton University Hospital NHS Trust, Southampton, Großbritannien; 4 Anaesthesia and Intensive Care Medicine, Southmead Hospital, North Bristol NHS Trust, Bristol, Großbritannien; 5 Emergency and Disaster Medicine, Six October University Hospital, Cairo, Ägypten; 6 Departments of Renal and Internal Medicine, Victoria Hospital, Kirkcaldy, Fife, Großbritannien; 7 Society to Rescue People from Drowning, Amsterdam, Niederlande; 8 Bergen Emergency Medical Services, Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norwegen; 9 EURAC Institute of Mountain Emergency Medicine, Bozen, Italien; 10 Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, Großbritannien; 11 Centre for Emergency Medicine, Clinical Hospital Center Zagreb, Zagreb, Kroatien; 12 Department of Cardiology, Academic Medical Center, Amsterdam, Niederlande; 13 Intensive Care Medicine and Anaesthesia, Southmead Hospital, North Bristol NHS Trust, Bristol, Großbritannien; 14 Department of Anesthesiology, University Medical Center, Johannes Gutenberg-Universitaet,Mainz, Deutschland; 15 Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trus, QueenMary University of London, London, Großbritannien; 16 Department of Anaesthesiology and Critical Care Medicine, University Hospital Innsbruck, Innsbruck, Österreich; WarwickMedical School, University of Warwick, Coventry, Großbritannien; 18 Critical Care Unit, Heart of England NHS Foundation Trust, Birmingham, Großbritannien; 19 Department of Anaesthesiology and Intensive Care, Catholic University School of Medicine, Rome, Italien; 20 Birmingham Children’s Hospital, Birmingham, Großbritannien; 21 Department of Anaesthetics, Imperial College Healthcare NHS Trust, London, Großbritannien; 22 Anaesthesia and Intensive Care Medicine, Royal United Hospital, UK and Bristol University, Bath, Großbritannien

Direct and Indirect Benefits Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews

Abstract: Background There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. Objectives The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. Design A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Methods A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Results Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. Conclusions The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention.

Randomised controlled trial to compare the diagnostic yield of positron emission tomography CT (PET-CT) TARGETed pleural biopsy versus CT-guided pleural biopsy in suspected pleural malignancy (TARGET trial).

Abstract: Introduction Pleural malignancy, particularly malignant pleural mesothelioma (MPM) is increasing in incidence due to the long latency period from exposure to asbestos to development of the disease. MPM can be challenging to diagnose. For patients presenting without a pleural effusion, CT-guided biopsy remains the primary choice of biopsy, but the diagnostic sensitivity of this investigation is 70%–75%. Therefore, a proportion of patients will go on to require further biopsies. If the first biopsy is non-diagnostic, the chances of further non-diagnostic biopsies are high in MPM. Methods Target is a multicentre randomised controlled trial, aiming to recruit 78 patients over a 30-month period, from 10 centres in the UK. Patients will be randomised to either the standard arm which is a second CT-guided biopsy, or the interventional arm, a positron emission tomography-CT scan followed by a targeted CT-guided biopsy. Patients will be followed up for 12 months (patients recruited in the last 6 months of recruitment will have 6 months of follow-up). MPM biomarker mesothelin will be checked at baseline, 6 month and 12 month follow-up appointments where patients are able to attend these appointments. Ethics and dissemination Ethical approval for this trial was granted by the South West—Exeter research and ethics committee (reference number 15/SW/0156). Results of the trial will be published in a peer-reviewed journal and presented at an international conference. Trial registration number ISRCTN 14024829; Pre-results.

A Systematic Review and Classification of Interventions for Speech-Sound Disorder in Preschool Children.

Abstract: Background: Multiple interventions have been developed to address speech sound disorder (SSD) in children.Many of these have been evaluated but the evidence for these has not been considered within a model whichcategorizes types of intervention. The opportunity to carry out a systematic review of interventions for SSD aroseas part of a larger scale study of interventions for primary speech and language impairment in preschool children.Aims: To review systematically the evidence for interventions for SSD in preschool children and to categorize themwithin a classification of interventions for SSD.Methods & Procedures: Relevant search terms were used to identify intervention studies published up to 2012, withthe following inclusion criteria: participants were aged between 2 years and 5 years, 11 months; they exhibitedspeech, language and communication needs; and a primary outcome measure of speech was used. Studies thatmet inclusion criteria were quality appraised using the single case experimental design (SCED) or PEDro-P,depending on their methodology. Those judged to be high quality were classified according to the primary focusof intervention.Outcomes & Results: The final review included 26 studies. Case series was the most common research design.Categorization to the classification system for interventions showed that cognitive–linguistic and productionapproaches to intervention were the most frequently reported. The highest graded evidence was for three studieswithin the auditory–perceptual and integrated categories.Conclusions & Implications: The evidence for intervention for preschool children with SSD is focused on seven outof 11 subcategories of interventions. Although all the studies included in the review were good quality as definedby quality appraisal checklists, they mostly represented lower-graded evidence. Higher-graded studies are neededto understand clearly the strength of evidence for different interventions.